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Samwiri Nkambule E, Msiska G. Chronic illness experience in the context of resource-limited settings: a concept analysis. Int J Qual Stud Health Well-being 2024; 19:2378912. [PMID: 39007854 PMCID: PMC11251436 DOI: 10.1080/17482631.2024.2378912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 07/08/2024] [Indexed: 07/16/2024] Open
Abstract
AIM This review describes the ways in which individuals experience chronic illnesses in resource-limited settings; to define the concept and understand its attributes, antecedents and consequences. METHODS A comprehensive analysis of the databases CINAHL, PubMed and Google Scholar was conducted. During literature search the following limits were applied: articles published in English with available full-text; articles that focused on living with chronic illness in adults from the patient's perspective. RESULTS The following three attributes of chronic illness experience were identified: transformational experience, acceptance and self-management. Prominent predisposing factors (antecedents) were: genetic inheritance, malnutrition and poverty, high levels of stress and unhealthy lifestyle. The most dominant consequences were as follows: impact on quality of life; self-management burden; burden to others and economic stressors. CONCLUSIONS The findings underscore the need for health-care professionals to understand the chronic illness experience in the context of resource-limited settings and its consequences. The greater insights into the concept of chronic illness experience in resource-limited settings will guide nurses to support people in the realities of chronic illness experience in resource-limited settings in developing countries. This knowledge can guide nurses in providing competent care to chronically ill individuals, including meeting their individual needs with such illnesses.
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Affiliation(s)
| | - Gladys Msiska
- School of Nursing, Kamuzu University of Health Sciences, Lilongwe, Malawi
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2
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Flick U, Röhnsch G. Young adults living with chronic illness: disclosure strategies and peers' understanding. Disabil Rehabil 2024:1-12. [PMID: 39258793 DOI: 10.1080/09638288.2024.2400598] [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: 09/20/2023] [Revised: 08/30/2024] [Accepted: 08/31/2024] [Indexed: 09/12/2024]
Abstract
PURPOSE Many young adults living with chronic illness fear being perceived as different by their peers and excluded from social activities. This forces them to consider whether to disclose or conceal their illness. This article analyses young adults' disclosure strategies and links them to peers' understanding of illness. MATERIALS AND METHODS The explorative study is based on episodic interviews with sixty young adults living with chronic illnesses (type 1 diabetes, cancer, chronic inflammatory bowel disease or a rare disease) and thirty peers. The interviews were thematically coded. The young adults' statements were compared to the peer perspectives on a case-by-case basis. RESULTS We identified three groups of young adults: 1) those who are generally open with peers about their illness and its subjective meaning; 2) those who share selected health-related information's with selected peers; 3) those who refrain from active disclosure and are unsure how they might talk about their illness when it becomes apparent. Our findings also indicate that peers differ in the sophistication of their illness perceptions and the meaning they ascribe to living with a chronic illness. CONCLUSION Trainings should target both young adults and peers, and should assist both sides in talking about (serious) chronic illness.
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Affiliation(s)
- Uwe Flick
- Department of Education and Psychology, Qualitative Social and Education Research, Freie Universität Berlin, Berlin, Germany
| | - Gundula Röhnsch
- Department of Education and Psychology, Qualitative Social and Education Research, Freie Universität Berlin, Berlin, Germany
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3
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Navas-Otero A, Calvache-Mateo A, Calles-Plata I, Valenza-Peña G, Hernández-Hernández S, Ortiz-Rubio A, Valenza MC. A lifestyle adjustments program in long COVID-19 improves symptomatic severity and quality of life. A randomized control trial. PATIENT EDUCATION AND COUNSELING 2024; 122:108180. [PMID: 38330704 DOI: 10.1016/j.pec.2024.108180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 01/23/2024] [Accepted: 01/27/2024] [Indexed: 02/10/2024]
Abstract
OBJECTIVE To evaluate the efficacy of a therapeutic intervention based on self-adjustment strategies for improving of symptomatic severity and quality of life. METHODS The study was a randomised single-blind clinical trial. Quality of life, disability, and functional impairment were collected. The control group received a leaflet with information on the main symptoms of Long-COVID-19 syndrome, in addition to standard medical treatment. The intervention group received treatment following a dual approach; on the one hand, monitoring and recognition of symptomatology and on the other hand, adaptation and functional improvement. RESULTS A total of 54 participants were included, 27 were included in the intervention group and 27 in the control group. At the beginning of the study, no significant differences were found between groups. After intervention, the quality of life variable showed significant differences between groups in the self-care and anxiety/depression dimensions. Significant between-groups differences were also found for the self-care subscale of the disability variable. The intervention group showed significant differences from baseline on some subscales of the quality of life, disability, and functional impairment variables. CONCLUSION Strategies based on lifestyle adjustments are adequate for the improvement of quality of life and symptom severity in the long COVID-19 population. PRACTICE IMPLICATION The findings suggest that applying an intervention focused in self-adjustment for long COVID patients can have positive effects.
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Affiliation(s)
- A Navas-Otero
- Department of Physiotherapy, Faculty of Health Sciences. University of Granada, Spain
| | - A Calvache-Mateo
- Department of Physiotherapy, Faculty of Health Sciences. University of Granada, Spain
| | - I Calles-Plata
- Department of Physiotherapy, Faculty of Health Sciences. University of Granada, Spain
| | - G Valenza-Peña
- Department of Physiotherapy, Faculty of Health Sciences. University of Granada, Spain
| | - S Hernández-Hernández
- Department of Physiotherapy, Faculty of Health Sciences. University of Granada, Spain
| | - A Ortiz-Rubio
- Department of Physiotherapy, Faculty of Health Sciences. University of Granada, Spain
| | - M C Valenza
- Department of Physiotherapy, Faculty of Health Sciences. University of Granada, Spain.
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Amadu M, Soldera J. Duodenal Crohn's disease: Case report and systematic review. World J Methodol 2024; 14:88619. [PMID: 38577197 PMCID: PMC10989410 DOI: 10.5662/wjm.v14.i1.88619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 12/16/2023] [Accepted: 01/18/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Inflammatory bowel disease, including ulcerative colitis, microscopic colitis, and Crohn's disease (CD), has a global impact. This review focuses on duodenal CD (DCD), a rare subtype affecting the duodenum. DCD's rarity and asymptomatic nature create diagnostic challenges, impacting prognosis and patient well-being. Delayed diagnosis can worsen DCD outcomes. AIM To report a rare case of DCD and to discuss the diagnostic challenges and its implications on prognosis. METHODS A systematic literature search, following the PRISMA statement, was conducted. Relevant studies were identified and analysed using specific Medical Subject Terms (MeSH) from PubMed/MEDLINE, American Journal of Gastroenterology, and the University of South Wales database. Data collection included information from radiology scans, endoscopy procedures, biopsies, and histopathology results. RESULTS The review considered 8 case reports and 1 observational study, involving 44 participants diagnosed with DCD, some of whom developed complications due to delayed diagnosis. Various diagnostic methods were employed, as there is no gold standard workup for DCD. Radiology scans [magnetic resonance imaging (MRI), computed tomography (CT), and upper gastrointestinal X-ray], endoscopy procedures (colonoscopy and esophagogastroduodenoscopy), biopsies, and clinical suspicions were utilized. CONCLUSION This review discusses DCD diagnosis challenges and the roles of CT, MRI, and fluoroscopy. It notes their limitations and compares findings with endoscopy and histopathology studies. Further research is needed to improve diagnosis, emphasizing scan interpretation, endoscopy procedures, and biopsies, especially in high-risk patients during routine endoscopy.
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Affiliation(s)
- Muniratu Amadu
- Department of Gastroenterology, University of South Wales, Cardiff CF37 1DL, United Kingdom
| | - Jonathan Soldera
- Department of Gastroenterology, University of South Wales, Cardiff CF37 1DL, United Kingdom
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Yang MC, Clayton C, Harris D, Pelletier C, Schmidt J, Zwicker JG, Sakakibara BM. A Qualitative Investigation on Chronic Disease Management and Prevention Among Older Adults During the COVID-19 Pandemic. Am J Health Promot 2024; 38:384-393. [PMID: 38000140 PMCID: PMC10903114 DOI: 10.1177/08901171231218681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2023]
Abstract
PURPOSE To qualitatively describe experiences of chronic disease management and prevention in older adults (age ≥65 years) during COVID-19. APPROACH Qualitative descriptive approach. SETTING Data collected online via telephone and video-conferencing technologies to participants located in various cities in British Columbia, Canada. Data analyzed by researchers in the cities of Vancouver and Kelowna in British Columbia. PARTICIPANTS Twenty-four community-living older adults (n = 24) age ≥65 years. METHODS Each participant was invited to complete a 30-to-45-minute virtual, semi-structured, one-on-one interview with a trained interviewer. Interview questions focused on experiences managing health prior to COVID-19 and transitioning experiences of practicing health management and prevention strategies during COVID-19. Audio recordings of interviews were transcribed verbatim and analyzed thematically. RESULTS The sample's mean age was 73.4 years (58% female) with 75% reporting two or more chronic conditions (12.5% none, 12.5% one). Three themes described participants' strategies for chronic disease management and prevention: (1) having a purpose to optimize health (i.e., managing health challenges and maintaining independence); (2) internal self-control strategies (i.e., self-accountability and adaptability); and (3) external support strategies (i.e., informational support, motivational support, and emotional support). CONCLUSION Helping older adults identify purposes for their own health management, developing internal control strategies, and optimizing social support opportunities may be important person-centred strategies for chronic disease management and prevention during unprecedented times like COVID-19.
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Affiliation(s)
- Michelle C. Yang
- Graduate Programs in Rehabilitation Sciences, University of British Columbia, Vancouver, BC, Canada
- Centre for Chronic Disease Prevention and Management, University of British Columbia, Kelowna, Canada
| | - Cam Clayton
- Vancouver Fraser Medical Program, University of British Columbia, Vancouver, BC, Canada
| | - Devin Harris
- Department of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada
- Interior Health Authority, Kelowna, BC, Canada
| | - Chelsea Pelletier
- School of Health Sciences, University of Northern British Columbia, Prince George, BC, Canada
| | - Julia Schmidt
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Jill G. Zwicker
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
- BC Children’s Hospital Research Institute, Vancouver, BC, Canada
| | - Brodie M. Sakakibara
- Centre for Chronic Disease Prevention and Management, University of British Columbia, Kelowna, Canada
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
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Lee CS, Freedland KE, Jaarsma T, Strömberg A, Vellone E, Page SD, Westland H, Pettersson S, van Rijn M, Aryal S, Belfiglio A, Wiebe D, Riegel B. Patterns of self-care decision-making and associated factors: A cross-sectional observational study. Int J Nurs Stud 2024; 150:104665. [PMID: 38103267 DOI: 10.1016/j.ijnurstu.2023.104665] [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: 08/10/2023] [Revised: 11/15/2023] [Accepted: 11/25/2023] [Indexed: 12/18/2023]
Abstract
OBJECTIVE The aim of this study was to identify for the first time patterns of self-care decision-making (i.e. the extent to which participants viewed contextual factors influencing decisions about symptoms) and associated factors among community-dwelling adults with chronic illness. METHODS This was a secondary analysis of data collected during the development and psychometric evaluation of the 27-item Self-Care Decisions Inventory that is based on Naturalistic Decision-Making (n = 430, average age = 54.9 ± 16.2 years, 70.2 % female, 87.0 % Caucasian, average number of chronic conditions = 3.6 ± 2.8). Latent class mixture modeling was used to identify patterns among contextual factors that influence self-care decision-making under the domains of external, urgency, uncertainty, cognitive/affective, waiting/cue competition, and concealment. Multivariate multinomial regression was used to identify additional socio-demographic, clinical, and self-care behavior factors that were different across the patterns of self-care decision-making. RESULTS Three patterns of self-care decision-making were identified in a cohort of 430 adults. A 'maintainers' pattern (48.1 %) consisted of adults with limited contextual influences on self-care decision-making except for urgency. A 'highly uncertain' pattern (23.0 %) consisted of adults whose self-care decision-making was largely driven by uncertainty about the cause or meaning of the symptom. A 'distressed concealers' pattern (28.8 %) consisted of adults whose self-care decision-making was highly influenced by external factors, cognitive/affective factors and concealment. Age, education, financial security and specific symptoms were significantly different across the three patterns in multivariate models. CONCLUSION Adults living with chronic illness vary in the extent to which contextual factors influence decisions they make about symptoms, and would therefore benefit from different interventions.
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Affiliation(s)
- Christopher S Lee
- Boston College William F. Connell School of Nursing, Chestnut Hill, MA, USA.
| | - Kenneth E Freedland
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
| | | | | | - Ercole Vellone
- Tor Vergata University of Rome, Rome, Italy; Wroclaw Medical University, Poland
| | | | | | | | | | - Subhash Aryal
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Andrew Belfiglio
- University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | | | - Barbara Riegel
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA
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Feng Y, Su M, Liu Y, Peng J, Sun X. Health-related quality of life among cancer survivors: pre-existing chronic conditions are to be given priority. Support Care Cancer 2024; 32:124. [PMID: 38252273 DOI: 10.1007/s00520-024-08315-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 01/09/2024] [Indexed: 01/23/2024]
Abstract
PURPOSE This study aimed to describe the health-related quality of life (HRQoL) of cancer survivors in China by the five-level EuroQol-5-dimension (EQ-5D-5L) questionnaire and to explore the impact of the comorbidity of pre-existing chronic conditions on HRQoL in cancer survivors. METHODS Data on cancer survivors were obtained from two cross-sectional surveys conducted in Shandong Province, China. The data of the Chinese general population, the Chinese diabetes population, the Chinese hypertension population, and the Chinese urban population from the published studies were used as the controls. The χ2 test was conducted to compare the incidence of five-dimensional problems between the study and control populations. The non-parametric Mann-Whitney U test and Kruskal-Wallis test were performed to examine the differences in EQ-5D-5L utility scores. Besides, the Tobit regression model was used to examine the variables influencing the EQ-5D-5L utility score. RESULTS One thousand fifty-one adult cancer survivors were included. Cancer survivors had significantly lower EQ-5D-5L utility scores (Z = - 15.939, P < 0.001) and EQ-VAS scores (Z = - 11.156, P < 0.001) than the general adult population. The average EQ-5D-5L utility score of hypertensive cancer survivors was lower than that of the hypertensive population (Z = - 1.610, P = 0.107), but the difference was not statistically significant. CONCLUSION Compared to the general population, the HRQoL of cancer survivors was extremely poor in all dimensions of the EQ-5D-5L. Pre-existing chronic conditions had significant antecedent effects on the HRQoL of cancer survivors. Therefore, more attention should be paid to chronic diseases, and effective interventions should be adopted based on this.
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Affiliation(s)
- Yujia Feng
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Wenhuaxi Road 44#, Jinan, China
- National Health Commission Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Mingzhu Su
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Wenhuaxi Road 44#, Jinan, China
- National Health Commission Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Yanxiu Liu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Wenhuaxi Road 44#, Jinan, China
- National Health Commission Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Jiaqi Peng
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Wenhuaxi Road 44#, Jinan, China
- National Health Commission Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Xiaojie Sun
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Wenhuaxi Road 44#, Jinan, China.
- National Health Commission Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China.
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Mullan LJ, Blackburn NE, Gracey J, Dunwoody L, Lorimer J, Semple CJ. Evaluating the effects of lymphoedema management strategies on functional status and health-related quality of life following treatment for head and neck cancer: a systematic review. J Cancer Surviv 2023:10.1007/s11764-023-01453-7. [PMID: 37648875 DOI: 10.1007/s11764-023-01453-7] [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: 08/07/2023] [Accepted: 08/17/2023] [Indexed: 09/01/2023]
Abstract
PURPOSE Patients living with head and neck lymphoedema (HNL) after completion of head and neck cancer (HNC) often can experience long-term functional challenges and overall poorer health-related quality of life (HRQOL). This systematic review aims to explore components of effective HNL interventions through identification and synthesising literature on existing HNL management interventions. METHODS Five electronic databases (MEDLINE via Ovid and PubMed, CINAHL, CENTRAL, and Scopus) were systematically searched using Medical Subject Headings and free text, as well as citation tracking and Google Scholar for grey literature. RESULTS A total of 1910 studies were screened, with 12 studies meeting the inclusion criteria. Findings indicated vast heterogeneity within HNL interventions. Patients' adherence to intervention strategies was reported as low and partially adhered to, particularly at home. This impacted on function domains and overall HRQOL during the post-treatment HNC phase, as well as further increasing the demands placed on healthcare professionals. CONCLUSIONS Synthesis of the research findings highlighted a need to provide and educate patients with individualised HNL self-management intervention strategies. Promoting adherence was reported as being essential, with self-efficacy and behaviour change techniques being emphasised as a critical element to enhance motivation and therefore effective intervention delivery. Further work is important to address barriers to adherence and promote both motivation and behaviour change, to develop individualised self-management interventions for this cancer population. IMPLICATIONS FOR CANCER SURVIVORS The findings from this systematic review will provide guidance in the development and delivery of individualised self-management HNL interventions for patients who have completed HNC treatment.
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Affiliation(s)
- Lauren J Mullan
- School of Nursing, Institute of Nursing and Health Research, Ulster University, Belfast, UK.
| | - Nicole E Blackburn
- School of Health Sciences, Institute of Nursing and Health Research, Ulster University, Londonderry, UK
| | - Jackie Gracey
- School of Health Sciences, Institute of Nursing and Health Research, Ulster University, Londonderry, UK
| | - Lynn Dunwoody
- School of Psychology, Faculty of Life and Health Sciences, Ulster University, Londonderry, UK
| | - Jill Lorimer
- Physiotherapy Department, Cancer Centre, Belfast Health and Social Care Trust, Belfast, UK
| | - Cherith J Semple
- School of Nursing, Institute of Nursing and Health Research, Ulster University, Belfast, UK
- Cancer Services, South Eastern Health and Social Care Trust, Belfast, UK
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Tak CR. The health impact of long COVID: a cross-sectional examination of health-related quality of life, disability, and health status among individuals with self-reported post-acute sequelae of SARS CoV-2 infection at various points of recovery. J Patient Rep Outcomes 2023; 7:31. [PMID: 36943643 PMCID: PMC10029785 DOI: 10.1186/s41687-023-00572-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 03/05/2023] [Indexed: 03/23/2023] Open
Abstract
OBJECTIVE The novel Coronavirus (COVID-19) has continued to present a significant burden to global public health efforts. The purpose of this study was to estimate the health-related quality of life, disability, and health status of individuals with self-reported long COVID at various lengths of recovery. METHODS We conducted a cross-sectional online survey of individuals with self-reported long COVID. Participants were asked to complete the five-item EuroQOL EQ-5D-5L and EQ visual analog scale, the 12-item World Health Organization Disability Assessment Schedule (WHODAS) 2.0 and the 10-item Patient Reported Outcome Measurement Information System (PROMIS) Global Health v1.2 short form. Descriptive and inferential statistics were used to characterize the responses and differences across groups. RESULTS Eighty-two participants from 13 countries completed the EQ-5D-5L, 73 completed the WHODAS 2.0 and 80 participants completed the PROMIS. The mean EQ-5D-5L utility score was 0.51. The mean WHODAS score was 49.0. In the previous 30 days, participants reported their symptoms affected them for a mean of 24 days, they were totally unable to carry out usual activities for 15 days, and they cut back or reduced activities for 26 days. The mean PROMIS physical health and mental health scores were 10.7 and 8.6, respectively, corresponding to below-average health. No significant differences were detected across time or according to severity of acute infection. CONCLUSIONS Long COVID presents a significant chronic health burden to adults in the US and abroad. This health burden may persist for many months post-acute infection.
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Affiliation(s)
- Casey R Tak
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT, USA.
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Heckemann B, Graf T, Ung EJ, Jakobsson S, Ragnarsson O, Olsson DS, Blomdahl C. The importance of personal documentation for patients living with long-term illness symptoms after pituitary surgery: A Constructivist Grounded Theory study. Health Expect 2022; 26:226-236. [PMID: 36335563 PMCID: PMC9854328 DOI: 10.1111/hex.13648] [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: 01/25/2022] [Revised: 09/06/2022] [Accepted: 10/22/2022] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION Despite surgical treatment, pituitary adenomas often cause long-term illness symptoms, that profoundly impact patients' quality of life physically, psychologically and socially. Healthcare professionals often fail to recognize and discuss the ensuing problems. Personal documentation, such as symptom monitoring, reflective writing or even posts on social media, may help this patient group to manage their daily life and support communication of their care needs. Documentation strategies and the role of documentation for people with long-term symptoms after pituitary adenoma surgery are currently unknown. AIM To examine the effects and strategies of documenting symptoms, activities and physical and emotional well-being among people living with long-term pituitary adenoma. METHODS In this Constructivist Grounded Theory study, 12 individuals living with long-term illness symptoms after pituitary adenoma surgery described their documentation strategies in in-depth interviews using teleconferencing and photo-elicitation between August and October 2020. RESULTS Strategies for documentation included analogue and digital media. One core category (Exercising autonomy) and three categories describing processes (Gaining insight, Striving for control and Sharing) emerged from the analysis. These three interrelated processes become an expression of autonomy to manage life and make sense of chronic illness. Personal documentation is a flexible tool that is used more extensively in times of ill health and less in times of relative well-being. Sharing documentation with healthcare professionals facilitated care planning and sharing with friends and family fostered emotional well-being. CONCLUSION Personal documentation is a valuable resource for managing life after pituitary adenoma surgery. The current findings may be relevant to other chronic illnesses. Further research exploring potential tools for personal documentation is needed. PATIENT OR PUBLIC CONTRIBUTION We deliberately chose a Constructivist Grounded Theory approach for this interview study. Using Constructivist Grounded Theory, we gave people living with long-term symptoms a voice, allowing them to freely speak about managing their illness in connection with personal documentation. The theoretical sampling approach enabled us to invite participants that could provide a broad overview of the landscape of personal documentation.
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Affiliation(s)
- Birgit Heckemann
- Section for Care in Long‐term Conditions, Institute of Health and Care Sciences, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden,Department of Anesthetics, Surgery and Intensive CareSahlgrenska University HospitalGothenburgSweden
| | - Tatjana Graf
- Department of SociologyUniversity of LucerneLucerneSwitzerland
| | - Eva Jakobsson Ung
- Section for Learning and Leadership for Health Care Professionals, Institute of Health and Care Sciences, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | - Sofie Jakobsson
- Section for Care in Long‐term Conditions, Institute of Health and Care Sciences, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | - Oskar Ragnarsson
- Department of MedicineSahlgrenska University HospitalGothenburgSweden,Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, Institute of MedicineUniversity of GothenburgGothenburgSweden
| | - Daniel S. Olsson
- Department of MedicineSahlgrenska University HospitalGothenburgSweden,Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, Institute of MedicineUniversity of GothenburgGothenburgSweden
| | - Christina Blomdahl
- Research and Development Centre Södra Älvsborg, Research and Development Primary HealthcareRegion Västra GötalandBoråsSweden
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Lex H, Price P, Clark L. Qualitative study identifies life shifts and stress coping strategies in people with multiple sclerosis. Sci Rep 2022; 12:6536. [PMID: 35444194 PMCID: PMC9021186 DOI: 10.1038/s41598-022-10267-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 03/30/2022] [Indexed: 12/02/2022] Open
Abstract
Multiple sclerosis (MS) is an auto-immune disease in which the body’s immune system attacks the central nervous system. The demyelination of the nerve fibers can lead to physical, emotional, and cognitive impairments. We wanted to learn about challenges of living with the illness and how people deal with stress. 128 individuals with MS from Austria and the US participated in the qualitative interviews. We interviewed participants and coded their answers using inductive grounded theory. We asked three open-ended questions to inquire about life since being diagnosed with MS as well as about dealing with stress. Life shifts since diagnosis involved ‘experiencing limitations’ and could be categorized in ‘emotional changes’, ‘changes with work’, ‘changes in social interaction’, ‘physical changes’, ‘changes in the medical context’. For dealing with stress active (strategies and activities) and passive coping strategies (avoid/ignore) were employed. General stress reactions were expressed in areas of emotional, physical and /or lifestyle. We recommend developing interventions in three core areas for the MS population: (1) dealing with life changes and significant experiences with MS, (2) focusing on the areas where life shifts took place, (3) focusing on active coping with stress and discussing consequences of passive coping strategies.
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Affiliation(s)
- Heidemarie Lex
- Department of Psychiatry, University of Utah, 383 Colorow Drive, Salt Lake City, UT, 84108, USA.
| | - Pollie Price
- OTR/L, FAOTA, University of Utah College of Occupational and Recreational Therapies, Salt Lake City, USA
| | - Lauren Clark
- FAAN, University of California at Los Angeles College of Nursing, Los Angeles, USA
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Emery H, Padgett C, Ownsworth T, Honan CA. A systematic review of self-concept change in multiple sclerosis. Neuropsychol Rehabil 2022; 32:1774-1813. [PMID: 35168496 DOI: 10.1080/09602011.2022.2030367] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Self-concept or sense of self is often altered in the context of neurological illness. Yet, these core aspects of subjective experience are poorly understood for people with multiple sclerosis (MS). This systematic review aimed to synthesize the findings of quantitative and qualitative studies investigating self-concept in MS. PsycINFO, MEDLINE (PubMed), CINAHL, Scopus, and Web of Science were last systematically searched in May 2021, with the Mixed Methods Appraisal Tool and Consolidated Criteria for Reporting Qualiatative Research used to appraise the quality of the eligible articles. Articles were included if they measured or explored self-concept in MS populations, were published in English and peer-reviewed. A total of 30 studies (11 quantitative, 19 qualitative) were identified. Quantitative studies were synthesized using a narrative approach, with results suggesting that MS is associated with some degree of self-concept change. Qualitative studies were synthesized using thematic synthesis, with results illustrating a complex process of self-concept change that is catalyzed by MS-related events and characterized by varying degrees of resistance to, or acknowledgement of, such changes. Future prospective longitudinal studies are needed to characterize the nature of self-concept change in MS using validated tools that measure relevant aspects of self-concept for the MS population.
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Affiliation(s)
- Holly Emery
- School of Psychological Sciences, University of Tasmania, Launceston, Australia
| | - Christine Padgett
- School of Psychological Sciences, University of Tasmania, Hobart, Australia
| | - Tamara Ownsworth
- School of Applied Psychology, Griffith University, Mount Gravatt, Australia
| | - Cynthia A Honan
- School of Psychological Sciences, University of Tasmania, Launceston, Australia
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13
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Röhnsch G, Hämel K. Co-production in coping with care dependency in Germany: How can integrated local care centres contribute? HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:1868-1875. [PMID: 33528072 DOI: 10.1111/hsc.13300] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 12/08/2020] [Accepted: 01/04/2021] [Indexed: 06/12/2023]
Abstract
In Germany, most care dependent people are looked after by family members at home. Professional support can help ease the burden of caring relatives and stabilise home care. Ideally, care then is provided through the co-production of formal and informal caregivers. This article analyses how care dependent people and their family caregivers integrate professional support into their care arrangements. An analysis was conducted using data collected for a qualitative study evaluating integrated local care centres in North-Rhine-Westphalia, Germany. The study is based on episodic interviews with users of these care centres and their family caregivers (N = 26). During the analysis, three interpretive and practice patterns relating to co-production of care were identified. These patterns reveal how the interviewees deal with (increasing) needs for assistance and care while incorporating professional care into their lives. The patterns help differentiate whether the interviewees (a) use developed care skills to contribute actively to the co-production with their layman knowledge, or (b) seek relief of their care responsibilities and withdraw temporarily from the direct sphere of care applying freed capacities to organise family daily life, or (c) use the services of the care centres to meet with other older people and to develop spaces for mutual help and co-production. The interpretive and practice patterns thus differ in the extent to which care users and family caregivers continue to play an 'active role' in the care process and contribute their own knowledge, ideas, expectations and particular care activities. In order to achieve a functioning co-production, professionals face the challenge of understanding these patterns that have been established over many years and of taking them into account appropriately.
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Affiliation(s)
- Gundula Röhnsch
- Department of Health Services Research and Nursing Science, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Kerstin Hämel
- Department of Health Services Research and Nursing Science, School of Public Health, Bielefeld University, Bielefeld, Germany
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14
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Cheng C, Bai J. Coping with Multiple Chronic Conditions in the Family Context: A Meta-Synthesis. West J Nurs Res 2021; 44:972-984. [PMID: 34433327 DOI: 10.1177/01939459211041171] [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: 11/17/2022]
Abstract
This study was to collect, synthesize, and interpret the current qualitative evidence from studies that investigated family coping among people with multiple chronic conditions (MCCs). A meta-synthesis approach was used to report this study. A systematic search was performed in five electronic databases, including CINAHL, EMBASE, PsycINFO, Web of Science, and PubMed from January 2000 to December 2020. The PRISMA flow chart and Joanna Briggs Institute Qualitative Assessment and Review Instrument checklist are integrated into the meta-synthesis. A total of ten eligible studies including data from 381 participants were identified. Three meta-themes were identified in the synthesis: (1) family role maintenance in MCCs management, (2) coping as a family, and (3) be frustrated with family interactions. This meta-synthesis indicated the importance of maintaining social roles and family support within family interactions for coping with MCCs. It also demonstrated the frustrations in the family coping process experienced by people with MCCs. Health care professionals should understand the interactions between people with MCCs and their family members that may impact people's coping. Such an understanding may contribute to the development of supportive programs such as family-based interventions for people with MCCs.
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Affiliation(s)
- Cheng Cheng
- School of Nursing, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jie Bai
- Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
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15
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Sematlane NP, Knight L, Masquillier C, Wouters E. Adapting to, integrating and self-managing HIV as a chronic illness: a scoping review protocol. BMJ Open 2021; 11:e047870. [PMID: 34162650 PMCID: PMC8231044 DOI: 10.1136/bmjopen-2020-047870] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 05/27/2021] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION The process of adapting to a life with a chronic illness, is a well-researched phenomenon for a number of common chronic illnesses. The construct, adaptation, embeds the notions of integration of the chronic illness into identity and self-management. Integration precedes self-management and is key to living positively with a chronic illness. Adaptation is an important concept in understanding trajectory and outcomes of living with a chronic illness. Applicability of these concepts to HIV as a chronic illness; when suppressive adherence has been achieved, however, is unknown. Specifically, the adaptation process to living with HIV as a chronic illness, the integration of HIV into identity and the resulting self-management behaviours by adults living with HIV are relatively unexplored. We describe a protocol for a scoping review of adaptation to living with HIV, we structure the enquiry around integration of HIV into identity and self-management and interrogate theories, models and frameworks that have been proposed and studied and we evaluate them for relevance and usefulness in the care and management of HIV. METHODS AND ANALYSIS Methods proposed by the Johanna Briggs Institute will be followed. The protocol was drafted using the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for Scoping Reviews and was registered with the Open Science Framework. MEDLINE, SCOPUS, Cochrane Library, CINHAL and SocINDEX databases will be searched. A search in Social Science Research Network eLibrary and Open Access Theses and Dissertations will gather grey literature and reference lists of included sources will be screened. Study selection process will involve a title and abstract review and full text review, guided by clearly defined inclusion and exclusion criteria. ETHICS AND DISSEMINATION Ethical approval is not required because this is a proposed review and collection of data on publicly available materials. The results will be published in a topic relevant journal and presented at related scientific events.
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Affiliation(s)
- Neo Phyllis Sematlane
- School of Public Health, University of the Western Cape Faculty of Community and Health Sciences, Bellville, South Africa
| | - Lucia Knight
- School of Public Health, University of the Western Cape Faculty of Community and Health Sciences, Bellville, South Africa
- Division of Social and Bahavioural Sciences, School of Public Health and Family Medicine, University of Cape Town, Rondebosch, South Africa
| | - Caroline Masquillier
- Centre for Population, Family & Health, Department of Sociology, Faculty of Social Sciences, University of Antwerp, Antwerp, Belgium
| | - Edwin Wouters
- Centre for Population, Family & Health, Department of Sociology, Faculty of Social Sciences, University of Antwerp, Antwerp, Belgium
- Centre for Health Systems Research & Development, University of the Free State, Bloemfontein, South Africa
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16
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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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17
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Dornan M, Semple C, Moorhead A, McCaughan E. A qualitative systematic review of the social eating and drinking experiences of patients following treatment for head and neck cancer. Support Care Cancer 2021; 29:4899-4909. [PMID: 33646367 PMCID: PMC8295127 DOI: 10.1007/s00520-021-06062-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 02/07/2021] [Indexed: 01/02/2023]
Abstract
PURPOSE Patients living with and beyond head and neck cancer (HNC) often have long-term, functional challenges as a result of treatment. A key functional challenge relates to eating and drinking; often associated with physical, emotional, and social difficulties. Eating and drinking with family members and friends can become a struggle, increasing the risk of social isolation and loneliness. This systematic review aims to identify and synthesise the literature on the experiences of social eating and drinking for patients following treatment for HNC. METHODS Six electronic databases (Pubmed, Web of Science, CINAHL, EMBASE, PsychINFO, and Scopus) were systematically searched using subject headings and free-text word searches in February 2020. Citation chaining and Google Scholar were used to identify grey literature. PRISMA procedures were followed. RESULTS Of 6910 records identified, 24 studies met the inclusion criteria. Synthesis of the research findings results in two major themes: (1) the experience of loss associated with social eating and drinking, and (2) adjusting and support to promote social eating and drinking. CONCLUSION Losses associated with social eating affect a patient's psychological and emotional well-being and impact on close relationships. To promote positive participation in social eating, patients were more likely to seek and receive support from someone within their close social network, rather than a healthcare professional. Family and friends are an essential source of support and are integral in facilitating engagement with social eating following treatment for HNC. Future interventions should promote family orientated resources, incorporating self-management strategies.
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Affiliation(s)
- Mark Dornan
- School of Nursing, Institute of Nursing and Health Research, Ulster University, Newtownabbey, UK.
| | - Cherith Semple
- School of Nursing, Institute of Nursing and Health Research, Ulster University, Newtownabbey, UK
- Cancer Services and Ulster Hospital, South Eastern Health and Social Care Trust, Belfast, UK
| | - Anne Moorhead
- School of Communication and Media, Institute of Nursing and Health Research, Ulster University, Newtownabbey, UK
| | - Eilís McCaughan
- School of Nursing, Institute of Nursing and Health Research, Ulster University, Coleraine, UK
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18
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Vanotti S, Cabral N, Eizaguirre MB, Marinangeli A, Roman MS, Alonso R, Silva B, Garcea O. Coping strategies: Seeking personalized care in relapsing-remitting multiple sclerosis. A patient reported measure-coping responses inventory. Mult Scler J Exp Transl Clin 2021; 7:2055217320987588. [PMID: 33633866 PMCID: PMC7887687 DOI: 10.1177/2055217320987588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 12/01/2020] [Indexed: 11/23/2022] Open
Abstract
Coping is defined as a set of cognitive and behavioral efforts made to master stressful specific demands. Adaptation to chronic diseases, such as Multiple Sclerosis (MS), depends on the effectiveness of coping. Objective: To assess the psychometric properties of the Coping Responses Inventory (CRI-A) in persons with MS (PwMS), verifying the transferability of the measure, already validated in the Argentine general population, and to describe the types of coping strategies available for PwMS. Methods: 90 PwMS were included. Outcome measures: CRI-A Inventory, Expanded Disability Status Scale (EDSS), Beck Depression Inventory, Fatigue Severity Scale and MS International Quality of Life questionnaire. Results: Descriptive data is as follows: mean age (years): 40.97 ± 12.85; years of education: 13.46 ± 3.93; EDSS: 2.48 ± 1.79; disease evolution (years): 10.76 ± 9.72; depression: 13.92 ± 10.45; fatigue 3.77 ± 1.72. The psychometric properties of the CRI-A Inventory observed in the Argentine general population are present in the MS sample as well, with adequate validity and reliability. The respondents most frequently utilized a problem-focused coping style. Conclusions: Results showed the CRI-A has good transferability properties from the Argentine general population to the MS population.
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Affiliation(s)
- Sandra Vanotti
- Multiple Sclerosis Unit, José María Ramos Mejía General Hospital, Buenos Aires, Argentina
| | - Nadia Cabral
- Multiple Sclerosis Unit, José María Ramos Mejía General Hospital, Buenos Aires, Argentina
| | | | - Aldana Marinangeli
- Multiple Sclerosis Unit, José María Ramos Mejía General Hospital, Buenos Aires, Argentina
| | - Maria Sol Roman
- Multiple Sclerosis Unit, José María Ramos Mejía General Hospital, Buenos Aires, Argentina
| | - Ricardo Alonso
- Multiple Sclerosis Unit, José María Ramos Mejía General Hospital, Buenos Aires, Argentina
| | - Berenice Silva
- Multiple Sclerosis Unit, José María Ramos Mejía General Hospital, Buenos Aires, Argentina
| | - Orlando Garcea
- Multiple Sclerosis Unit, José María Ramos Mejía General Hospital, Buenos Aires, Argentina
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19
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Kordowicz M, Hack-Polay D. Community assets and multimorbidity: A qualitative scoping study. PLoS One 2021; 16:e0246856. [PMID: 33626064 PMCID: PMC7904158 DOI: 10.1371/journal.pone.0246856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 01/27/2021] [Indexed: 11/18/2022] Open
Abstract
Little is known of how community assets can play a role in multimorbidity care provision. Using a rapid ethnographic approach, the study explored perceptions of the role of community assets in how multimorbidity is managed within Southwark and Lambeth in Southeast London, England. The scoping work comprised of four micro-studies covering (1) Rapid review of the literature (2) Documentary analysis of publicly available local policy documents (3) Thematic analysis of community stories and (4) Semi-structured stakeholder interviews. The data were analysed using framework thematic analysis. Themes are presented for each of the microstudies. The literature review analysis highlights the role of attitudes and understandings in the management of multiple long-term conditions and the need to move beyond silos in their management. Documentary analysis identifies a resource poor climate, whilst recognising the role of community assets and solution-focussed interventions in the management of multimorbidity. Community patient stories underline the lack of joined up care, and psychosocial issues such as the loss of control and reducing isolation. The stakeholder interview analysis reveals again a sense of disjointed care, the need for holism in the understanding and treatment of multimorbidity, whilst recognising the important role of community-based approaches, beyond the biomedical model. Recommendations stemming from the study's findings are proposed. Upholding access to and resourcing community assets have key practical importance.
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Affiliation(s)
- Maria Kordowicz
- Department of Management, Lincoln International Business School, University of Lincoln, Lincoln, United Kingdom
- School of Population Health & Environmental Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, United Kingdom
- * E-mail:
| | - Dieu Hack-Polay
- Department of Management, Lincoln International Business School, University of Lincoln, Lincoln, United Kingdom
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20
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Ambrosio L, Perez-Manchon D, Carvajal-Carrascal G, Fuentes-Ramirez A, Caparros N, Ruiz de Ocenda MI, Timonet E, Navarta-Sanchez MV, Rodriguez-Blazquez C. Psychometric Validation of the Living with Chronic Illness Scale in Patients with Chronic Heart Failure. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020572. [PMID: 33445479 PMCID: PMC7828024 DOI: 10.3390/ijerph18020572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 12/18/2020] [Accepted: 01/01/2021] [Indexed: 01/06/2023]
Abstract
It is necessary to develop self-reported instruments that evaluate the process of living with chronic heart failure (HF) holistically. The Living with Chronic Illness Scale—HF (LW-CI-HF) is the only available tool to evaluate how patients are living with HF. The aim is to analyse the psychometric properties of the LW-CI scale in the HF population. An international, cross-sectional validation study was carried out in 603 patients living with HF from Spain and Colombia. The variables measured were living with HF, perceived social support, satisfaction with life, quality of life and global impression of severity. The LW-CI-HF scale presented good data quality and acceptability. All domains showed high internal consistency with Cronbach’s alpha coefficient ≥ 0.7. The intraclass correlation coefficient for the total score was satisfactory (0.9) in test–retest reliability. The LW-CI-HF correlated 0.7 with social support and quality of life measures. Standard error of measurement was 6.5 for total scale. The LW-CI-HF scale is feasible, reliable and valid. However, results should be taken with caution in order to be used in clinical practice to evaluate the complex process of living with HF. Further research is proposed.
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Affiliation(s)
- Leire Ambrosio
- School of Health Sciences, University of Southampton, Southampton SO17 1BJ, UK
- Correspondence: ; Tel.: +44-(0)23-8059-7591
| | | | - Gloria Carvajal-Carrascal
- Facultad de Enfermería y Rehabilitación, Universidad de La Sabana, Bogotá 53753, Colombia; (G.C.-C.); (A.F.-R.)
| | - Alejandra Fuentes-Ramirez
- Facultad de Enfermería y Rehabilitación, Universidad de La Sabana, Bogotá 53753, Colombia; (G.C.-C.); (A.F.-R.)
| | - Neus Caparros
- Faculty of Legal and Social Science, La Rioja University, 26004 La Rioja, Spain;
| | | | - Eva Timonet
- Department of Cardiology, Costa del Sol Hospital, 29603 Malaga, Spain;
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21
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Williams BR, Vargo K, Newman DK, Yvette Lacoursiere D, Mueller ER, Connett J, Low LK, James AS, Smith AL, Schmitz KH, Burgio KL. It's About Time: The Temporal Burden of Lower Urinary Tract Symptoms Among Women. UROLOGIC NURSING 2020; 40:10.7257/1053-816x.2020.40.6.277. [PMID: 33642840 PMCID: PMC7906293 DOI: 10.7257/1053-816x.2020.40.6.277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This secondary analysis studied 50 transcripts of women who shared day-to-day experiences of lower urinary tract symptoms (LUTS) and characterized temporal (time-associated) features of living with LUTS. Findings revealed two overarching time-associated themes: The Complexity of LUTS and The Quest for Empowerment over LUTS. Findings suggest that the temporal burden of LUTS is the accumulated impact of symptoms and symptom management on women's daily lives within multiple contexts across the life course. Increasing nurses' knowledge of the temporal context of LUTS may heighten awareness and improve symptom detection and management.
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Affiliation(s)
- Beverly Rosa Williams
- University of Alabama at Birmingham School of Medicine, Department of Veterans Affairs, Birmingham, AL
| | - Keith Vargo
- University of Minnesota School of Public Health
| | - Diane K Newman
- Division of Urology, Department of Surgery, University of Pennsylvania, Perelman School of Medicine
| | | | | | | | | | - Aimee S James
- Washington University in St. Louis School of Medicine
| | | | | | - Kathryn L Burgio
- University of Alabama at Birmingham School of Medicine, Department of Veterans Affairs, Birmingham, AL
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22
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Engberg H, Möller A, Hagenfeldt K, Nordenskjöld A, Frisén L. Identity, Sexuality, and Parenthood in Women with Congenital Adrenal Hyperplasia. J Pediatr Adolesc Gynecol 2020; 33:470-476. [PMID: 32473322 DOI: 10.1016/j.jpag.2020.05.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 05/15/2020] [Accepted: 05/18/2020] [Indexed: 11/17/2022]
Abstract
STUDY OBJECTIVE To explore how women with congenital adrenal hyperplasia (CAH) describe their experiences of gender role behavior, psychosexual development, and intimate relationships. CAH results in increased androgen exposure in affected females, and is the most common reason for unclear sex at birth. Women with CAH have been studied to find answers to the role of androgens in psychosexual development. Nevertheless, factors that may account for the variability of outcomes in women with CAH are unclear. DESIGN, SETTING AND PARTICIPANTS This was a qualitative study with 13 Swedish women (aged ≥18 years) with CAH. Semi-structured interviews were analyzed using inductive content analysis. MAIN OUTCOME MEASURES Direct quotes of patients' experiences derived from interview transcripts were sorted in categories, subcategories, and according to latent theme. RESULTS The main categories were "forming identity" and "establishing relationships." Forming identity encompasses that of a girl, a tomboy, and/or a woman. Establishing relationships focuses on intimate relationships, pregnancy, and parenthood. A latent theme was interpreted as "shifting perspectives," with CAH being the main focus of some participants' lives but a side issue for others. CONCLUSION These women's experiences are varied and describe shifting perspectives on how much CAH affects their lives. Health care providers can play an important role in helping women with CAH to separate what is caused by the condition and what is not. The long-term goal is to help girls and women to feel in control of their condition across their whole life.
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Affiliation(s)
- Hedvig Engberg
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Child and Adolescent Psychiatry Research Centre, Stockholm, Sweden; Department of Women's and Children's Health, Division of Obstetrics and Gynecology, Karolinska Institutet, Stockholm, Sweden.
| | - Anders Möller
- Ersta Sköndal University College, Campus Bräcke, Gothenburg, Sweden
| | - Kerstin Hagenfeldt
- Department of Women's and Children's Health, Division of Obstetrics and Gynecology, Karolinska Institutet, Stockholm, Sweden
| | - Agneta Nordenskjöld
- Department of Women's and Children's Health, Pediatric Surgery Unit and Centre for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden; Pediatric Surgery, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Louise Frisén
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Child and Adolescent Psychiatry Research Centre, Stockholm, Sweden
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23
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Beanlands H, McCay E, Pahati S, Hladunewich MA. Through the Lens of Chronic Kidney Disease: A Qualitative Study of the Experiences of Young Women Living With CKD. Can J Kidney Health Dis 2020; 7:2054358120945475. [PMID: 32864150 PMCID: PMC7430077 DOI: 10.1177/2054358120945475] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 06/03/2020] [Indexed: 12/31/2022] Open
Abstract
Background: Young women may be particularly vulnerable to the negative psychosocial consequences of living with chronic kidney disease (CKD). To date, little is known about how women themselves experience and manage their illness. Objectives: This study explored the experiences of young women living with CKD. Design: Qualitative descriptive study. Setting: Nephrology program in an urban setting in Ontario, Canada. Participants: Women with category G1-3 glomerular-based CKD between 18 and 40 years of age. Methods: Focus group discussions guided by semi-structured interview questions. Qualitative content analysis was used to analyze interview transcripts. Results: Eleven women participated in 3 separate focus group discussions. Participants described living life through the lens of CKD, which was the central theme unifying their experiences of encountering CKD, re-encountering CKD, and getting on with life. Life decisions significant to women like pursuing a career or motherhood were often colored by CKD, particularly by illness-related challenges, such as unsatisfactory health care support and the physical implications of chronic illness. The women used a variety of strategies including seeking information and relying on supportive people to mitigate these challenges. Although these strategies sometimes enabled them to balance the demands of illness with other life priorities, the lack of resources directed toward their unique needs as young women with CKD often caused them difficulties in managing their illness. Limitations: Participants were from one nephrology program in an urban setting and were well educated overall. Their experiences may not be reflective of young women in other settings or from diverse backgrounds. Conclusions: The women’s emotional well-being and life choices were considerably influenced by CKD. Although the women were often able to manage challenges associated with CKD, they acknowledged the need to seek additional professional resources to complement their own self-identified strategies. As the women sought out these supports, they identified gaps in resources specific to women with CKD. This article summarizes recommendations from their perspective. Trial Registration: Not applicable as this was a qualitative study.
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Affiliation(s)
- Heather Beanlands
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, ON, Canada
| | - Elizabeth McCay
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, ON, Canada
| | - Sheryll Pahati
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, ON, Canada
| | - Michelle A Hladunewich
- Division of Nephrology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, ON, Canada
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Abstract
The world is experiencing a cataclysmically increasing burden from chronic illnesses. Chronic diseases are on the advance worldwide and treatment strategies to counter this development are dominated by symptom control and polypharmacy. Thus, chronic conditions are often considered irreversible, implying a slow progression of disease that can only be hampered but not stopped. The current plant-based movement is attempting to alter this way of thinking. Applying a nutrition-first approach, the ultimate goal is either disease remission or reversal. Hereby, ethical questions arise as to whether physicians' current understanding of chronic illness is outdated and morally reprehensible. In this case, physicians may need to recommend plant-based diets to every patient suffering from chronic conditions, while determining what other socioecological factors and environmental aspects play a role in the chronic disease process. This article provides insights to aspects of diet and chronic illness and discusses how the plant-based movement could redefine current understanding of chronic disease. The ethical justifications for recommending of a plant-based diet are analyzed. The article concludes that not advocating for plant-based nutrition is unethical and harms the planet and patients alike.
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Wang X, Zhang Q, Shao J, Ye Z. Conceptualisation and measurement of adaptation within the Roy adaptation model in chronic care: a scoping review protocol. BMJ Open 2020; 10:e036546. [PMID: 32565472 PMCID: PMC7311031 DOI: 10.1136/bmjopen-2019-036546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION The Roy adaptation model provides a basis for developing the science of nursing. Its theoretical assumptions have been tested in empirical studies. Although several works have historically reviewed the development of this model, a refinement of its key concepts is needed. The proposed scoping review aims to describe how the concept of adaptation was defined and measured in nursing studies related to chronic health conditions. METHODS AND ANALYSIS This scoping review will adopt the methodology proposed by Arksey and O'Malley. Several databases, including MEDLINE (OVID), CINAHL, EMBASE, PsycINFO, PubMed, Wan Fang, China National Knowledge Infrastructure and VIP net, will be selected and used to mine literature published in English and Chinese languages, up to December 2019. Key terms related to 'Roy adaptation model' will be identified and used for developing tailored search strategies for each database. Articles will be included in the analysis if they are primary research reports explaining the concept of adaptation within the field of chronic care. All screening and extraction of literature will be independently performed and checked by two authors, according to the guideline of Preferred Reporting Items for Systematic Review and Meta-Analysis-Extension for Scoping Reviews. The findings will be organised and summarised into narratives in line with the construction of conceptual-theoretical-empirical system of knowledge for further consultation and translation. ETHICS AND DISSEMINATION This scoping review does not require ethical approval. The findings are expected to be published in peer-reviewed English or Chinese journals as well as conference proceedings in the area of chronic care.
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Affiliation(s)
- Xiyi Wang
- Department of Nursing, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, Zhejiang, China
| | - Qi Zhang
- Department of Nursing, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, Zhejiang, China
| | - Jing Shao
- Department of Nursing, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Zhihong Ye
- Department of Nursing, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, Zhejiang, China
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Benkel I, Arnby M, Molander U. Living with a chronic disease: A quantitative study of the views of patients with a chronic disease on the change in their life situation. SAGE Open Med 2020; 8:2050312120910350. [PMID: 32341782 PMCID: PMC7171994 DOI: 10.1177/2050312120910350] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 01/30/2020] [Indexed: 11/15/2022] Open
Abstract
Objectives: Chronic diseases have an impact on and change patient’s lives which means that they need to find ways to cope with the new situation. The aim was to describe how the chronic disease has influenced patients’ views of their life situation. Methods: The study was quantitative in design with data collected using a semi-structured questionnaire. Descriptive statistics were used to compare similarities and differences between patients with asthma-allergy, diabetes mellitus, cancer and inflammatory rheumatoid arthritis. Results: Changes in their life were experienced as a negative outcome for the majority of participants. Support can be in the form of interpersonal support from various persons, but also from activities and beliefs/religion. Family and friends as well as healthcare professionals were identified as being most supportive. Sadness and worry were the most common emotions among the participants and their surrounding networks. Conclusion: People with a chronic disease have to live with the consequences the disease has for their life situation. They need to find strategies to cope with the negative outcome in their new life. Support from their own network and healthcare professionals can be helpful in the new life situation.
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Affiliation(s)
- Inger Benkel
- Geriatric Medicine and Clinical Osteoporosis Research School, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Palliative section, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Maria Arnby
- Palliative section, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ulla Molander
- Geriatric Medicine and Clinical Osteoporosis Research School, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Palliative section, Sahlgrenska University Hospital, Gothenburg, Sweden
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Yan T, Chan CWH, Chow KM, Zheng W, Sun M. A systematic review of the effects of character strengths-based intervention on the psychological well-being of patients suffering from chronic illnesses. J Adv Nurs 2020; 76:1567-1580. [PMID: 32187708 DOI: 10.1111/jan.14356] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 02/01/2020] [Accepted: 03/04/2020] [Indexed: 12/15/2022]
Abstract
AIMS To identify and evaluate the available evidence on the effectiveness of character strengths-based intervention on the psychological well-being of patients with chronic illnesses. DESIGN A systematic review with meta-analysis. DATA SOURCES Six electronic databases, including PubMed, EMBASE, EBSCO (CINAHL® and MEDLINE), Web of Science, and PsycINFO, were searched from inception to December 2018. REVIEW METHODS The quality appraisal of evidence and summary of studies were undertaken following Joanna Briggs Institute critical appraisal checklists and the standard guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Meta-analysis was conducted according to Cochrane methods using RevMan 5.1. RESULTS Clinical studies on the character strengths-based intervention for patients with chronic illnesses are limited. Eight studies involving 692 patients were identified and critically appraised in this review. Meta-analysis results for three comparable studies indicated that character strengths-based intervention was effective in improving the self-esteem of patients with chronic illnesses and it significantly enhanced their general self-efficacy and reduced their depression. CONCLUSIONS The findings support the effectiveness of character strengths-based intervention on improving the psychological well-being of patients with chronic illnesses. However, caution is needed in interpreting these results due to limited studies and heterogeneity across studies. Further research is needed to provide strong evidence on the applicability of the intervention in clinical practice. IMPACT This rigorous review provided current evidence on using character strengths-based intervention to improve the psychological well-being of patients with chronic illnesses. Character strengths-based intervention provides a creative approach for patients because it may help improve their well-being, happiness, self-esteem, and self-efficacy, and reduce depression and mental symptoms. Studies in different groups of patients suffering from chronic illnesses are recommended in the future. The character strengths-based intervention should be replicated in various inpatient facilities and include a larger and a more ethnically and socioeconomically diverse sample.
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Affiliation(s)
- Tingting Yan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
| | - Carmen W H Chan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
| | - Ka Ming Chow
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
| | - Wei Zheng
- The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Meng Sun
- The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Makanjee CR, Xu D, Sarswat D, Bergh AM. 'It is just part of life': patient perspectives and experiences of diagnostic imaging referrals. Aust J Prim Health 2020; 26:507-513. [PMID: 33211998 DOI: 10.1071/py20146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 09/24/2020] [Indexed: 11/23/2022]
Abstract
Referral for a medical imaging examination is an integral part of the medical consultation; however, not much is known about patients' experience of these referrals. The life-world experiences and perspectives of patients as 'persons' referred for an imaging investigation are explored through the lens of person-centred and whole-person care. Individual interviews were conducted with 22 patients referred for an imaging investigation. The findings were interpreted in terms of the journey of a patient; that is, the processes the patient undergoes as a person in the course of a referral for a diagnostic imaging investigation as part of the disease and its treatment. Participants' life and health journeys are described in terms of three themes: (1) events leading to an imaging examination; (2) the imaging referral experience embedded within the medical encounter; and (3) the integration of the findings of the imaging examination into their everyday life. Health practitioners should be mindful of the complexity of medical consultations that include a referral for an imaging investigation.
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Affiliation(s)
- Chandra Rekha Makanjee
- Department of Medical Radiation Science, University of Canberra, ACT 2617, Australia; and Corresponding author.
| | - Deon Xu
- Prince of Wales Hospital, Randwick, NSW 2031, Australia
| | | | - Anne-Marie Bergh
- Research Centre for Maternal, Fetal, Newborn and Child Health Care Strategies, University of Pretoria, South Africa
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Thomas A, Sowerbutts AM, Burden ST. The impact of home enteral feeding on the daily lives of people with head and neck cancer: a metasynthesis of qualitative studies. J Hum Nutr Diet 2019; 33:538-549. [DOI: 10.1111/jhn.12724] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- A. Thomas
- Wirral Community Health and Care NHS Foundation Trust Victoria Central Health Centre Birkenhead UK
| | | | - S. T. Burden
- School of Health Science University of Manchester Manchester UK
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Johansson K, Österberg SA, Leksell J, Berglund M. Supporting patients learning to live with diabetes: a phenomenological study. ACTA ACUST UNITED AC 2019; 27:697-704. [PMID: 29953270 DOI: 10.12968/bjon.2018.27.12.697] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This article describes a study of the phenomenon of supporting patients who are learning to live with diabetes, from a diabetes specialist nurse (DSN) perspective. Guided by principles of reflective lifeworld research, data from six interviews (four in groups and two individual) with 16 DSNs were analysed. The results show that, in order to support learning, DSNs use a self-critical approach with the insight that they should not take over responsibility for their patients' diabetes. The DSNs support, encourage and challenge the patients to self-reflect and take responsibility based on patients' own goals and needs. To provide support, DSNs need to assume a tactful, critically challenging approach, dare to confront patients' fears and other emotions and have the insight to know that the responsibility for learning and integration of the condition lies with the patient. To be able to support patients in this way, it is necessary that the DSN is mentored and supported in this role.
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Affiliation(s)
- Karin Johansson
- Diabetes Specialist Nurse in Primary Health Care, Department of Administration/Primary Care, Region Kronoberg County Council, Växjö, Sweden
| | - Sofia Almerud Österberg
- Associate Professor, Department of Health and Care Sciences, Faculty of Health and Life Science, Linnaeus University, Växjö, Sweden
| | - Janeth Leksell
- Associate Professor, School of Health and Social Sciences, University Dalarna, Falun, and Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Mia Berglund
- Associate Professor, School of Health and Education, University of Skövde, Skövde, Sweden
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Martino G, Catalano A, Bellone F, Russo GT, Vicario CM, Lasco A, Quattropani MC, Morabito N. As Time Goes by: Anxiety Negatively Affects the Perceived Quality of Life in Patients With Type 2 Diabetes of Long Duration. Front Psychol 2019; 10:1779. [PMID: 31428028 PMCID: PMC6689992 DOI: 10.3389/fpsyg.2019.01779] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 07/17/2019] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Age-related medical conditions are increasing worldwide. Type 2 Diabetes mellitus (T2DM) represents a chronic disease, which affects a large amount of general population, accounting for over 90% of diabetes mellitus (DM) cases. PURPOSE As psychopathological symptoms frequently occur in medical conditions, our study aimed at exploring whether psychological factors and metabolic control may affect health related quality of life (HRQoL). METHODS Forty five patients with T2DM were consecutively recruited and assessed with a psychodiagnostic battery: Hamilton Anxiety Rating Scale (HAM-A), Beck Depression Inventory II edition (BDI-II) and the 36-Item Short Form Health Survey (SF-36), including indexes Physical and Mental Component Summary (PCS, MCS). Moreover, time since DM diagnosis and glycated hemoglobin (HbA1c) values were detected. RESULTS Participants (mean age 65.3 ± 5.9 years) had a mean time since diagnosis of 11.6 ± 6.7 years, and showed a good metabolic control as highlighted by mean HbA1c values 7.1 ± 0.9%. Median HAM-A score [25(20.7-30.6)], represented high prevalence of anxious symptoms. A moderate expression of depressive symptoms was observed [BDI-II score: 13(8.3-21.4)]. A multiple regression analysis, after correcting for age, BMI, HbA1c value and BDI-II score, showed the perceived quality of life relative to PCS was significantly related to both disease duration (β = -0.55, p = 0.03, SE = 0.25) and HAM-A scores (β = -0.52, p = 0.04, SE = 0.24). Moreover, both HAM-A (β = -0.67, p = 0.01, SE = 0.26) and BDI-II (β = -0.48, p = 0.02, SE = 0.20) scores were independently predictive of MCS. Metabolic control, instead, was not a significant predictor. CONCLUSION Our study suggests a predictive role of both anxiety levels and time since diagnosis in perceived HRQoL in T2DM patients. PCS was associated with anxiety and time since diagnosis and MCS was associated with anxiety and depressive symptoms but not with diabetes duration or metabolic control. These data could be useful to plan T2DM training programs focused on psychological health concerns, possibly leading to a healthy self-management and a better perceived HRQoL, even assisting patients in reducing the negative effect due to the chronicization of T2DM.
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Affiliation(s)
- Gabriella Martino
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Antonino Catalano
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Federica Bellone
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | | | - Carmelo Mario Vicario
- Department of Cognitive Sciences, Psychology, Education and Cultural Studies, University of Messina, Messina, Italy
| | - Antonino Lasco
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | | | - Nunziata Morabito
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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Nilsson C, Lindberg B, Juuso P, Olsson M. Experiences of striving to maintain daily life among women with osteoporosis. Int J Qual Stud Health Well-being 2019; 14:1647402. [PMID: 31349764 PMCID: PMC6711187 DOI: 10.1080/17482631.2019.1647402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
In order to describe how women with osteoporosis strive to maintain daily life we interviewed 11 women using a reflective lifeworld approach based on phenomenological analysis. Osteoporosis is a major public health concern in the Western world, and is predominant among women. Our findings indicated that meanings of striving to maintain daily life imply a belief in oneself and one’s own capabilities. The women expressly speak out for themselves as a way of finding reconciliation without giving in to the illness. Women with osteoporosis expect to gain support early in the course of their illness. They require advice on how to manage the disease as well as support for striving to maintain daily living. Therefore, it is crucial that the women not only are given information about the disease. Equally important is to establish continuity in healthcare encounters, and that health care offers support founded in the women’s lived experiences with focus on their capacities.
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Affiliation(s)
- Carina Nilsson
- a Division of Nursing, Department of Health Sciences, Luleå University of Technology , Luleå , Sweden
| | - Birgitta Lindberg
- a Division of Nursing, Department of Health Sciences, Luleå University of Technology , Luleå , Sweden
| | - Päivi Juuso
- a Division of Nursing, Department of Health Sciences, Luleå University of Technology , Luleå , Sweden
| | - Malin Olsson
- a Division of Nursing, Department of Health Sciences, Luleå University of Technology , Luleå , Sweden
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Gabay G. A Nonheroic Cancer Narrative: Body Deterioration, Grief, Disenfranchised Grief, and Growth. OMEGA-JOURNAL OF DEATH AND DYING 2019; 83:287-309. [PMID: 31138010 DOI: 10.1177/0030222819852836] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This longitudinal nonheroic narrative study allows familiarity with personal and societal transitions in the self-identity of individuals with life-threatening cancer. The theoretical anchor is Bion's container-contained theory. Five interviews with a terminally ill hospitalized male in his 30s were conducted along intervals of between 6 and 8 weeks, up to 2 months before his death. Data were analyzed using the selection mechanisms method. Findings provide insights about the hospitalization experience, his grief, and disenfranchised grief. A rigid mode of container-contained relationships with clinicians created disenfranchised grief. Reflection and coherence among self-identities lead to inner strength and emotional growth despite the body's deterioration. Clinicians have a role in holistic identity transitions of individuals with cancer. Findings illuminate practical recommendations that clinicians may adopt to improve the experience of individuals suffering from cancer at the chronic and terminal phase of illness.
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Affiliation(s)
- Gillie Gabay
- School of Behavioral Sciences & Psychology, College of Management Academic Studies, Rishon LeZion, Israel
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Öberg U, Hörnsten Å, Isaksson U. The Self-Management Assessment Scale: Development and psychometric testing of a screening instrument for person-centred guidance and self-management support. Nurs Open 2019; 6:504-513. [PMID: 30918701 PMCID: PMC6419131 DOI: 10.1002/nop2.233] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 11/19/2018] [Indexed: 11/07/2022] Open
Abstract
AIM To develop and psychometrically test the Self-Management Assessment Scale (SMASc), a screening instrument for person-centred guidance and self-management support of persons with type 2 diabetes (T2D). BACKGROUND T2D is a common and globally increasing chronic condition. Improved self-management is a vital and integral component of diabetes care to prevent complications from poorly managed diabetes. For diabetes nurses to better understand persons with diabetes experienced challenges and needs regarding self-management and further for persons with T2D to take an active role in managing their condition, an instrument measuring this is needed. DESIGN Instrument development and psychometric testing of the content and construct validity, factor structure and reliability. METHOD The SMASc was psychometric tested on a sample of participants (September 2017-November 2017) with a confirmed diagnosis of T2D (N = 104). RESULTS Psychometric findings were satisfactory and supported the scale´s reliability. Cronbach's alpha, CVI and goodness-of-fit were acceptable. CONCLUSION Self-Management Assessment Scale is a short validated screening instrument, which can indicate possible barriers for self-management that ought to be approached during the conversation between the person with T2D and the primary healthcare nurses. Therefore, it is a promising instrument to be used to facilitate person-centred guidance and to improve self-management of people living with T2D.
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Andersson S, Berglund M, Vestman C, Kjellsdotter A. Experiences of specially trained personnel of group education for patients with type 2 diabetes-A lifeworld approach. Nurs Open 2019; 6:635-641. [PMID: 30918714 PMCID: PMC6419299 DOI: 10.1002/nop2.248] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 12/03/2018] [Accepted: 01/09/2019] [Indexed: 11/29/2022] Open
Abstract
AIM To describe how the group education process for people with type 2 diabetes is experienced by diabetes nurses and dietitians who support the patients' learning, in a primary care setting. DESIGN The project took place at two primary care settings in the south of Sweden. METHODS Data collected from focus-group interviews and reflection notes were subjected to phenomenological analysis. RESULTS The specially trained personnel experienced that group education made it possible for the patients to learn through reflection concerning their own and others' experiences. Furthermore, group education entailed increased knowledge for the trained personnel. When the patients were challenged to make changes in their lives with the illness, the personnel experienced that both patients and personnel supported each other. The study concludes that the trained personnel person-centred approach, with help of the didactic model, get tools to support patients learning.
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Affiliation(s)
| | - Mia Berglund
- School of Health and EducationUniversity of SkövdeSkövdeSweden
| | | | - Anna Kjellsdotter
- School of Health and EducationUniversity of SkövdeSkövdeSweden
- Research and Development CentreSkaraborg Hospital SkövdeSkövdeSweden
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Cerna K, Ivarsson J, Weilenmann A, Steineck G. Supporting self-management of radiation-induced bowel and bladder dysfunction in pelvic-cancer rehabilitation: An ethnographic study. J Clin Nurs 2019; 28:2624-2634. [PMID: 30865355 DOI: 10.1111/jocn.14849] [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] [Received: 06/23/2018] [Revised: 02/06/2019] [Accepted: 02/09/2019] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To describe and understand strategies that oncological nurses use to support self-management of radiation-induced bowel and bladder issues in pelvic-cancer rehabilitation patients. BACKGROUND Nurse-led self-management of radiation-induced bowel and bladder issues holds the potential to support cancer survivors. DESIGN An ethnographic approach was applied in this study, which adhered to Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. METHODS Data collection was conducted in Sweden between October 2015-April 2018, involving observations of nurses' daily work, formal and informal interviews, individual and group interviews, and reviews of relevant documents used in the studied practice. Furthermore, 15 supportive nurse-patient talks were observed, and an ethnographic analysis was performed. RESULTS The analysis identified the following three categories of nursing strategies that support self-management of radiation-induced bowel and bladder issues in pelvic-cancer rehabilitation patients: encouraging self-reflection, tailoring solutions together and keeping patients motivated. Nurses and patients jointly make sense of patients' symptoms using data that patients collect about themselves. Based on their shared understanding, they can co-create solutions to meet each individual patient's needs and develop routines to keep the patient motivated in performing the devised solutions. CONCLUSIONS The results indicate that the strategies nurses use to support patients in self-management of radiation-induced bowel and bladder issues entail intertwining patients' experiences with their nurses' medical knowledge and specific clinical practice. Nurses' strategies build on their ability to connect patients' experiences and the elements of their own work practice. RELEVANCE TO CLINICAL PRACTICE A deeper understanding of nurses' strategies to support self-management of radiation-induced bowel and bladder issues in pelvic-cancer rehabilitation patients can improve other self-management programmes, inform nurses' education and aid in the design of tools for pelvic-cancer rehabilitation support.
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Affiliation(s)
- Katerina Cerna
- Department of Education, Communication, and Learning, University of Gothenburg, Gothenburg, Sweden
| | - Jonas Ivarsson
- Department of Education, Communication, and Learning, University of Gothenburg, Gothenburg, Sweden
| | | | - Gunnar Steineck
- Department of Oncology at Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg, Sweden
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Rechenberg K, Grey M, Sadler L. "Anxiety and Type 1 diabetes are like cousins": The experience of anxiety symptoms in youth with Type 1 diabetes. Res Nurs Health 2018; 41:544-554. [PMID: 30375003 DOI: 10.1002/nur.21913] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 08/09/2018] [Indexed: 01/09/2023]
Abstract
Type 1 diabetes (T1D) is one of the most common chronic health conditions in youth in the United States, and its incidence is rising worldwide. Youth with T1D are at a high risk of psychological comorbidity, for example, anxiety, depression, and eating disorders. Psychological comorbidities, especially anxiety symptoms, have been correlated with poorer diabetes outcomes, but anxiety symptoms have not been well studied in these youth. The primary aim of this study was to describe the experience of anxiety symptoms in youth with T1D, especially as those symptoms relate to diabetes self-management tasks. We used a qualitative descriptive approach, consisting of an in-depth, semi-structured interview comprising 10 open-ended questions with follow-up probes. The analysis was guided by the principles of thematic analysis. Demographic data, Hemoglobin A1c levels, and the State-Trait Anxiety Inventory for Children survey data were also collected and analyzed. We identified four themes and seven sub-themes. Participants (n = 29, ages 10-16, 55% female) reported that T1D was an extra layer of responsibility that took time away from their ability to participate fully in other aspects of their lives. Some participants were able to integrate diabetes management into their lives, while others were not. Some participants were dependent on parents and the school nurse for diabetes management. Participants described two types of anxiety symptoms, general and diabetes-specific, and they noted that their experience of anxiety was associated with poor quality sleep, general lifestyle factors, and diabetes.
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Affiliation(s)
| | - Margaret Grey
- Yale University School of Nursing, West Haven, Connecticut
| | - Lois Sadler
- Yale University School of Nursing, West Haven, Connecticut
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Mirkovic J, Jessen S, Kristjansdottir OB, Krogseth T, Koricho AT, Ruland CM. Developing Technology to Mobilize Personal Strengths in People with Chronic Illness: Positive Codesign Approach. JMIR Form Res 2018; 2:e10774. [PMID: 30684404 PMCID: PMC6334702 DOI: 10.2196/10774] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 05/11/2018] [Accepted: 05/11/2018] [Indexed: 12/11/2022] Open
Abstract
Background Emerging research from psychology and the bio-behavioral sciences recognizes the importance of supporting patients to mobilize their personal strengths to live well with chronic illness. Positive technology and positive computing could be used as underlying design approaches to guide design and development of new technology-based interventions for this user group that support mobilizing their personal strengths. Objective A codesigning workshop was organized with the aim to explore user requirements and ideas for how technology can be used to help people with chronic illness activate their personal strengths in managing their everyday challenges. Methods Thirty-five participants from diverse backgrounds (patients, health care providers, designers, software developers, and researchers) participated. The workshop combined principles of (1) participatory and service design to enable meaningful participation and collaboration of different stakeholders and (2) an appreciative inquiry methodology to shift participants’ attention to positive traits, values, and aspects that are meaningful and life-giving and stimulate participants’ creativity, engagement, and collaboration. Utilizing these principles, participants were engaged in group activities to develop ideas for strengths-supportive tools. Each group consisted of 3-8 participants with different backgrounds. All group work was analysed using thematic analyses. Results Participants were highly engaged in all activities and reported a wide variety of requirements and ideas, including more than 150 personal strength examples, more than 100 everyday challenges that could be addressed by using personal strengths, and a wide range of functionality requirements (eg, social support, strength awareness and reflection, and coping strategies). 6 concepts for strength-supportive tools were created. These included the following: a mobile app to support a person to store, reflect on, and mobilize one’s strengths (Strengths treasure chest app); “empathy glasses” enabling a person to see a situation from another person’s perspective (Empathy Simulator); and a mobile app allowing a person to receive supportive messages from close people in a safe user-controlled environment (Cheering squad app). Suggested design elements for making the tools engaging included: metaphors (eg, trees, treasure island), visualization techniques (eg, dashboards, color coding), and multimedia (eg, graphics). Maintaining a positive focus throughout the tool was an important requirement, especially for feedback and framing of content. Conclusions Combining participatory, service design, and appreciative inquiry methods were highly useful to engage participants in creating innovative ideas. Building on peoples’ core values and positive experiences empowered the participants to expand their horizons from addressing problems and symptoms, which is a very common approach in health care today, to focusing on their capacities and that which is possible, despite their chronic illness. The ideas and user requirements, combined with insights from relevant theories (eg, positive technology, self-management) and evidence from the related literature, are critical to guide the development of future more personalized and strengths-focused self-management tools.
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Affiliation(s)
- Jelena Mirkovic
- Center for Shared Decision Making and Collaborative Care Research, Division of Medicine, Oslo University Hostipal, Oslo, Norway
| | - Stian Jessen
- Center for Shared Decision Making and Collaborative Care Research, Division of Medicine, Oslo University Hostipal, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Olöf Birna Kristjansdottir
- Center for Shared Decision Making and Collaborative Care Research, Division of Medicine, Oslo University Hostipal, Oslo, Norway
| | - Tonje Krogseth
- Center for Shared Decision Making and Collaborative Care Research, Division of Medicine, Oslo University Hostipal, Oslo, Norway.,Center for Learning and Mastery for Children, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Absera Teshome Koricho
- Center for Shared Decision Making and Collaborative Care Research, Division of Medicine, Oslo University Hostipal, Oslo, Norway.,Center for Learning and Mastery for Children, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Cornelia M Ruland
- Center for Shared Decision Making and Collaborative Care Research, Division of Medicine, Oslo University Hostipal, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
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Dealing with Chronic Illness: Experiences of Iranian Families of Persons with Multiple Sclerosis-A Qualitative Study. Mult Scler Int 2017; 2017:9243161. [PMID: 29082042 PMCID: PMC5610797 DOI: 10.1155/2017/9243161] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 02/03/2017] [Accepted: 08/01/2017] [Indexed: 02/03/2023] Open
Abstract
Background Today family members are providing care and support to each other during illness. In particular, in chronic illness, such as multiple sclerosis, the families are more involved in caring for and supporting their patients, so they use several strategies to cope with this situation. The purpose of this study was to explore the coping strategies in family caregivers of persons with multiple sclerosis in Iran. Methods This is a qualitative study that was conducted through 18 family caregivers of persons with multiple sclerosis. A purposeful sampling method was used. Data were collected through semistructured and in-depth interviews conducted in Multiple Sclerosis Society and hospitals of Tabriz in Iran. The collected data was analyzed according to qualitative content analysis. Results Five main categories were elicited from interviews: “using spirituality,” “living with hope,” “experiencing persistence and stability,” “seeking support,” and “seeking alternative treatments.” Conclusion. The study findings can help to inform the support given to families to help them cope with the effects of caring for someone with multiple sclerosis. Health system managers and professionals by using these results are able to support patients and their families appropriately in order to improve their quality of life and alleviate the complications of disease.
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40
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Olausson JM, Clark L, Morse JM, Hammer M, Allen N, Grant M. Psychosocial Response to New-Onset Diabetes as a Long-Term Effect of Allogeneic Hematopoietic Stem Cell Transplantation. QUALITATIVE HEALTH RESEARCH 2017; 27:1816-1827. [PMID: 28728478 DOI: 10.1177/1049732317719434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Currently, little information is available to guide health care practitioners on how to facilitate positive outcomes in individuals who develop new-onset diabetes after allogeneic hematopoietic stem cell transplantation (allo HSCT) for treatment of hematological cancers. Results from this constructivist grounded theory study provide a theoretical framework explaining the psychosocial process of change that middle-age and older adults experience when developing new-onset diabetes in this context. Two predominant factors influenced this change: treatment burden and perception of diabetes. Key findings were that participants with ongoing complications, primarily graft-versus-host disease, experienced a high degree of treatment-related burden and unclear perceptions of diabetes when compared with those with no or few post-allo-HSCT complications. These factors limited their capacity to positively respond to and self-manage their condition. Implications for practice are to thoroughly consider these two factors when developing patient-centered interventions for middle-age and older adults with new-onset diabetes after allo HSCT.
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Affiliation(s)
- Jill M Olausson
- 1 Azusa Pacific University, Azusa, California, USA
- 2 The University of Utah, Salt Lake City, Utah, USA
| | - Lauren Clark
- 1 Azusa Pacific University, Azusa, California, USA
| | | | - Marilyn Hammer
- 3 The Mount Sinai Hospital, New York City, New York, USA
| | - Nancy Allen
- 1 Azusa Pacific University, Azusa, California, USA
| | - Marcia Grant
- 4 City of Hope National Medical Center, Duarte, California, USA
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41
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Robinson CA. Families Living Well With Chronic Illness: The Healing Process of Moving On. QUALITATIVE HEALTH RESEARCH 2017; 27:447-461. [PMID: 28682734 DOI: 10.1177/1049732316675590] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Chronic illness is a global issue of escalating importance. While prevention, control, and management of chronic disease are imperative, it is also critical to shift our focus away from illness and toward living. In particular, attention needs to focus on living well despite illness. This article reports a grounded theory study with 43 members from 17 families who perceived they were managing well with serious chronic illnesses. The theory that captures the circular, iterative healing process of moving on is comprised of five phases: the fight, accepting, living with the chronic illness, sharing the experience, and reconstructing life. Families moved on through the process and moved on over time toward healing where they lived well alongside chronic illness. Family issues associated with each phase are identified as well as implications for health care providers. The theory provides a way of conceptualizing wellness in illness that supports patient- and family-centered care.
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42
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Christensen S, Wagner L, Coleman MM, Appell D. The lived experience of having a rare medical disorder: Hermansky-Pudlak syndrome. Chronic Illn 2017; 13:62-72. [PMID: 27358286 DOI: 10.1177/1742395316655854] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Hermansky-Pudlak Syndrome is a rare form of albinism, affecting approximately one in 500,000 to one in 1,000,000 non-Hispanic individuals. The syndrome is more commonly found in Hispanics, where one in 18,00 individuals in Northwestern Puerto Rico are impacted. Because of the rarity of this chronic condition, patients often face challenges in their ability to cope with the diagnosis. A phenomenological study was conducted to explore the experience of individuals with this rare genetic disease. A purposive sample of adults between the ages of 20 and 49 diagnosed with Hermansky-Pudlak Syndrome was interviewed (N = 23). The majority (83%) were female. Data analysis resulted in the emergence of themes related to long road to diagnosis, learning to move forward, burden of being the expert, and survival through belonging to the HPS community.
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Affiliation(s)
- Stacy Christensen
- 1 Department of Nursing, Central Connecticut State University, New Britain, CT, USA
| | - Linda Wagner
- 2 University of Bridgeport School of Nursing, Bridgeport, CT, USA
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43
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Nilsson C, Lindberg B, Skär L, Söderberg S. Meanings of balance for people with long-term illnesses. Br J Community Nurs 2017; 21:563-567. [PMID: 27809585 DOI: 10.12968/bjcn.2016.21.11.563] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The aim of this study was to elucidate meanings of balance in everyday life for people with long-term illnesses living at home. People living with long-term illnesses are in need of help and support to manage their daily lives. Twelve adults with extensive needs for help and support were interviewed. A phenomenological hermeneutic interpretation was used to analyse the interview texts. The findings show that balance in everyday life for people with long-term illnesses means striving for independence through care and support in their surroundings. It was also important to be able to choose how their lives would be and to be with others who listened and understood them for who they are. By building a relationship with patients at an early stage of their illnesses, nursing staff have an opportunity to understand what people who are living at home with long-term illnesses need in order to achieve balance in their everyday lives.
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Affiliation(s)
- Carina Nilsson
- Division of Nursing, Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
| | - Birgitta Lindberg
- Division of Nursing, Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
| | - Lisa Skär
- Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden
| | - Siv Söderberg
- Department of Nursing Sciences, Mid Sweden University, Östersund, Sweden
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44
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van Wissen K, Thunders M, Mcbride-Henry K, Ward M, Krebs J, Page R. Cardiovascular disease and prediabetes as complex illness: People's perspectives. Nurs Inq 2017; 24. [DOI: 10.1111/nin.12177] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Kim van Wissen
- School of Nursing; Massey University; Wellington New Zealand
| | - Michelle Thunders
- School of Food and Nutrition; Massey University; Wellington New Zealand
| | - Karen Mcbride-Henry
- Postgraduate School of Nursing Midwifery and Health; Victoria University of Wellington; Wellington New Zealand
| | - Margaret Ward
- Endocrine, Diabetes and Research Centre; Capital and Coast District Health Board; Wellington New Zealand
| | - Jeremy Krebs
- Endocrine, Diabetes and Research Centre; Capital and Coast District Health Board; Wellington New Zealand
- Otago University; Dunedin New Zealand
| | - Rachel Page
- School of Food and Nutrition; Massey University; Wellington New Zealand
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Lafontaine S, Ellefsen É. Difficultés liées à l’autosoin chez les personnes vivant avec le diabète de type 2 : une revue de la littérature narrative basée sur le modèle d’Audulv, Asplund et Norbergh. Rech Soins Infirm 2017:29-40. [DOI: 10.3917/rsi.128.0029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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46
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Jutterström L, Hörnsten Å, Sandström H, Stenlund H, Isaksson U. Nurse-led patient-centered self-management support improves HbA1c in patients with type 2 diabetes-A randomized study. PATIENT EDUCATION AND COUNSELING 2016; 99:1821-1829. [PMID: 27372525 DOI: 10.1016/j.pec.2016.06.016] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 05/11/2016] [Accepted: 06/16/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate the effect of a patient-centered self-management support, in type 2 diabetes (T2D) with regard to metabolic changes. METHODS 182 patients were randomized into group intervention (GI), individual intervention (II) or internal controls (IC). An external control (EC) group was recruited from another county council. The intervention consisted of six sessions that featured themes, which regarded different views of their illness experiences. Data were collected in 2010 and 2011. RESULTS HbA1c was significantly decreased at 12-month follow-up with 5mmol/mol in the GI and 4mmol/mol in the II. In the IC group, the HbA1c was close to baseline. The EC group had increased HbA1c, though not significantly. When the HbA1c difference at baseline was adjusted, there was a significant difference between intervention groups and the EC-group. CONCLUSION Patient-centered self-management support, led by nurses, can lower HbA1c among patients with type 2 diabetes. PRACTICE IMPLICATIONS It is possible to train diabetes specialist nurses in clinical patient-centered care, and simultaneously influence patients' metabolic balance positively.
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Affiliation(s)
- L Jutterström
- Department of Nursing, Umeå University, Umeå, Sweden.
| | - Å Hörnsten
- Department of Nursing, Umeå University, Umeå, Sweden.
| | - H Sandström
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden.
| | - H Stenlund
- Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences, Umeå University, Umeå, Sweden.
| | - U Isaksson
- Department of Nursing, Umeå University, Umeå, Sweden.
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Viglund K, Jonsén E, Lundman B, Nygren B, Strandberg G. Sources and expressions of inner strength among old people who have experienced a crisis in life associated with a disease. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/2057158516659839] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Inner strength is reported as an important resource associated with aging, health, and disease management. The aim was to explore inner strength in people ( n = 12) aged 65 years and older, who had experienced a crisis in life associated with a disease. The participants had self-rated their inner strength as high. We found that sources of inner strength were mutual love and support, and the fact that tough times have been managed before. Expressions of inner strength comprised focusing on possibilities instead of brooding, facing and take an active part in care and treatment, and being able to confront reality and pick yourself up again. Inner strength is a complex phenomenon. Increased knowledge of inner strength can serve as an aid in efforts to identify the need to promote inner strength.
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Affiliation(s)
| | | | - Berit Lundman
- Department of Nursing, Umeå University, Umeå, Sweden
| | - Björn Nygren
- Department of Nursing, Umeå University, Umeå, Sweden
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Olano-Lizarraga M, Oroviogoicoechea C, Errasti-Ibarrondo B, Saracíbar-Razquin M. The personal experience of living with chronic heart failure: a qualitative meta-synthesis of the literature. J Clin Nurs 2016; 25:2413-29. [DOI: 10.1111/jocn.13285] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2016] [Indexed: 01/09/2023]
Affiliation(s)
| | - Cristina Oroviogoicoechea
- Faculty of Nursing; University of Navarra; Navarra's Health Research Institute (IdiSNA); Pamplona Spain
| | - Begoña Errasti-Ibarrondo
- Faculty of Nursing; University of Navarra; Navarra's Health Research Institute (IdiSNA); Pamplona Spain
| | - Maribel Saracíbar-Razquin
- Faculty of Nursing; University of Navarra; Navarra's Health Research Institute (IdiSNA); Pamplona Spain
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49
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White C, Lentin P, Farnworth L. Multimorbidity and the process of living with ongoing illness. Chronic Illn 2016; 12:83-97. [PMID: 26467444 DOI: 10.1177/1742395315610392] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2015] [Accepted: 08/12/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Living with two or more health conditions, or multimorbidity, is associated with higher rates of disability and lower quality of life. To overcome the challenges associated with multimorbidity, person-centred health care is essential. However, to provide person-centred health care, health professionals first need to understand how people with multiple health conditions experience their illness. METHODS Sixteen adult participants, with one or more health conditions, were recruited from hospital outpatient and community health services and interviewed twice. Qualitative data from interview transcripts and field notes were inductively analysed using constructivist grounded theory and life chart methods. FINDINGS 'Living with ongoing illness' describes a process involving four interrelated experiences. Participants described, 'recognising something is not right,' 'working out what is wrong,' 'getting things under control' and 'getting on with life.' A case example is used to illustrate and compare the process across a participant's first and subsequent health conditions. DISCUSSION Participants with different health conditions shared similar illness experiences. Yet, the process of living with ongoing illness was unique and differed according to participants' health conditions and life context. By understanding the experiences, needs, and priorities of people with multimorbidity, health professionals can provide timely and relevant health care.
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Affiliation(s)
- Carolynne White
- Department of Occupational Therapy, Monash University, Frankston, Australia Manningham Community Health Services Limited, Doncaster East, Australia
| | - Primrose Lentin
- Department of Occupational Therapy, Monash University, Frankston, Australia
| | - Louise Farnworth
- Department of Occupational Therapy, Monash University, Frankston, Australia
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50
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Zoffmann V, Hörnsten Å, Storbækken S, Graue M, Rasmussen B, Wahl A, Kirkevold M. Translating person-centered care into practice: A comparative analysis of motivational interviewing, illness-integration support, and guided self-determination. PATIENT EDUCATION AND COUNSELING 2016; 99:400-407. [PMID: 26547303 DOI: 10.1016/j.pec.2015.10.015] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 09/16/2015] [Accepted: 10/18/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Person-centred care [PCC] can engage people in living well with a chronic condition. However, translating PCC into practice is challenging. We aimed to compare the translational potentials of three approaches: motivational interviewing [MI], illness integration support [IIS] and guided self-determination [GSD]. METHODS Comparative analysis included eight components: (1) philosophical origin; (2) development in original clinical setting; (3) theoretical underpinnings; (4) overarching goal and supportive processes; (5) general principles, strategies or tools for engaging peoples; (6) health care professionals' background and training; (7) fidelity assessment; (8) reported effects. RESULTS Although all approaches promoted autonomous motivation, they differed in other ways. Their original settings explain why IIS and GSD strive for life-illness integration, whereas MI focuses on managing ambivalence. IIS and GSD were based on grounded theories, and MI was intuitively developed. All apply processes and strategies to advance professionals' communication skills and engagement; GSD includes context-specific reflection sheets. All offer training programs; MI and GSD include fidelity tools. CONCLUSION Each approach has a primary application: MI, when ambivalence threatens positive change; IIS, when integrating newly diagnosed chronic conditions; and GSD, when problem solving is difficult, or deadlocked. PRACTICE IMPLICATIONS Professionals must critically consider the context in their choice of approach.
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Affiliation(s)
- Vibeke Zoffmann
- The Research Unit Women's and Children's Health, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; Institute of Clinical Medicine, Copenhagen University, Copenhagen, Denmark.
| | - Åsa Hörnsten
- Department of Nursing, Umeå University, Umeå, Sweden
| | - Solveig Storbækken
- Competence Center for Substance Abuse, the Bergen Clinics Foundation, Bergen, Norway
| | - Marit Graue
- Centre for Evidence-Based Practice, Bergen University College, Bergen, Norway; Department of Paediatrics, Haukeland University Hospital, Bergen, Norway
| | - Bodil Rasmussen
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Melbourne, Australia
| | - Astrid Wahl
- Department of Health Sciences, Institute of Health and Society, University of Oslo, Norway
| | - Marit Kirkevold
- Centre for Evidence-Based Practice, Bergen University College, Bergen, Norway; Department of Nursing Science, Institute of Health and Society, University of Oslo, Norway
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