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Jara AG, Sema FD, Tekele MT, Ergena AE, Belachew EA, Tesfaye AH, Tafese AM, Mekonen BT, Gebremariam SN, Mihiretie EA, Mehari EA. Self-efficacy of PLHIV for self-management at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia: a cross-sectional study. BMC PRIMARY CARE 2024; 25:255. [PMID: 39009959 PMCID: PMC11247812 DOI: 10.1186/s12875-024-02502-5] [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: 01/10/2024] [Accepted: 06/27/2024] [Indexed: 07/17/2024]
Abstract
BACKGROUND Self-efficacy is the ability to execute, and it is a critical predictor of health-related outcomes among people living with human immunodeficiency virus (PLHIV). Self-efficacy directly determines treatment outcome. However, there is no evidence on the self-efficacy of PLHIV for self-management in Ethiopia. Currently, HIV is considered a manageable chronic disease. However, the burden remains high despite all the taken measures. OBJECTIVES This study aimed to assess the self-efficacy of PLHIV for self-management at the University of Gondar Comprehensive Specialized Hospital (UOGCSH), northwest Ethiopia, 2022. METHODS A cross-sectional study was conducted on PLHIV selected by a systematic random sampling technique using an interviewer-administered questionnaire at the UOGCSH from August 10 to September 30, 2022. The data was entered and analyzed using the Statically Package for Social Science version 25.0. Categorical variables were summarized as frequency (percentage) of the total. Both descriptive and inferential statistics, such as the Kruskal-Wallis H test and Mann-Whitney U test were performed to detect difference. P-value < 0.05 was considered to indicate statistically significance. RESULTS Overall, 405 PLHIV participated in the study, giving a 96% response rate. The overall median (Interquartile range) self-efficacy score of PLHIV for self-management was 22 (4) and 67.4% of the PLHIV self-efficacy score was above the median. A statistically significant difference was detected between the social support groups (χ2 (2) = 37.17, p < 0.0001), education background (U = 10,347, Z = 2.279, P = 0.023, r = 0.113), living conditions (U = 12,338, Z = 2.457, P = 0.014, r = 0.122) and medication adherence (U = 9516.5, Z = 3.699, P < 0.0001, r = 0.184). CONCLUSION Most participants' self-efficacy score was above the median. Statistically significant differences in self-efficacy were observed based on individual, environmental, and clinical factors. We suggest training and workshops for healthcare workers and the hospital and adherence support groups should work to improve the self-efficacy of PLHIV.
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Affiliation(s)
- Abdisa Gemedi Jara
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia.
| | - Faisel Dula Sema
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Masho Tigabe Tekele
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Asrat Elias Ergena
- Department Pharmaceutical Chemistry, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Eyayaw Ashete Belachew
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Amensisa Hailu Tesfaye
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Abenezer Melaku Tafese
- Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Banchamlak Teferi Mekonen
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Saron Naji Gebremariam
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Endalamaw Aschale Mihiretie
- Clinical Pharmacy Unit, Department of Pharmacy, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Eden Abetu Mehari
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
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Curtis K, Fry M, Shaban RZ, Wolf L, Delao A, Kolbuk ME, Kennedy B, Considine J. Emergency nurses' perceptions of the utility, adaptability and feasibility of the emergency nursing framework HIRAID TM for practice change in US: An exploratory study. Int Emerg Nurs 2023; 71:101377. [PMID: 37972519 DOI: 10.1016/j.ienj.2023.101377] [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: 06/12/2023] [Revised: 10/03/2023] [Accepted: 10/17/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Patient assessment is a core component of nursing practice and underpins safe, high-quality patient care. HIRAIDTM, an evidence-informed emergency nursing framework, provides nurses with a structured approach to patient assessment and management post triage. In Australia, HIRAIDTM resulted in significant improvements to nurse-led communication and reduced adverse patient events. OBJECTIVES First, to explore United States (US) emergency nurses' perceptions of the evidence-informed emergency nursing framework, HIRAIDTM; second, to determine factors that would influence the feasibility and adaptability of HIRAIDTM into nursing clinical practice in EDs within the US. METHODS A cross-sectional cohort study using a survey method with a convenience sample was conducted. A 4-hour workshop introduced the HIRAIDTM framework and supporting evidence at the Emergency Nurses Association's (ENA) conference, Emergency Nursing 2022. Surveys were tested for face validity and collected information on nurse-nurse communication, self-efficacy, the practice environment and feedback on the HIRAIDTM framework. RESULTS The workshop was attended by 48 emergency nurses from 17 US States and four countries. Most respondents reported that all emergency nurses should use the same standardised approach in the assessment of patients. However, the greatest barriers to change were a lack of staff and support from management. The most likely interventions reported to enable change were face-to-face education, the opportunity to ask questions and support in the clinical environment. CONCLUSION HIRAIDTM is an acceptable and suitable emergency nursing framework for consideration in the US. Successful uptake will depend on training methods and organizational support. HIRAIDTM training should incorporate face-to-face interactive workshops.
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Affiliation(s)
- Kate Curtis
- Emergency and Trauma Nursing RC Mills Building, Susan Wakil School of Nursing, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2006, Australia; Emergency Services, Illawarra Shoalhaven Local Health District, Wollongong Hospital, Crown St, Wollongong, NSW, Australia.
| | - Margaret Fry
- Emergency and Critical Care, Conjoint Clinical Chair, Northern Sydney Local Health District, Australia; University of Technology Sydney Faculty of Health School of Nursing and Midwifery, PO Box 123 Broadway, NSW 2007, Australia.
| | - Ramon Z Shaban
- Communicable Diseases Control and Infection Prevention, Sydney Institute for Infectious Diseases and Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2006, Australia; Communicable Diseases Control, Public Health Unit, Centre for Population Health. Director and Chief Infection Control Practitioner Western Sydney LHD, Building 68, 5 Fleet Street, North Parramatta, NSW 2151, Australia; New South Wales Biocontainment Centre, Australia.
| | - Lisa Wolf
- Emergency Nursing Research, Emergency Nurses Association, Schaumburg, IL, USA; Elaine Marieb College of Nursing, University of Massachusetts, Amherst, MA, USA.
| | - Altair Delao
- Research, Emergency Nurses Association, 930 Woodfield Rd., Schaumburg, IL 60173, USA.
| | - Monica Escalante Kolbuk
- Novice Nurse Education Programs, Emergency Nurses Association, 930 E. Woodfield Road, Schaumburg, IL 60173, USA.
| | - Belinda Kennedy
- The University of Sydney, Rm 169, RC Mills, Camperdown, NSW 2006, Australia.
| | - Julie Considine
- Chair in Nursing (Eastern Health), Deakin University, 1 Gheringhap Street, Geelong, Victoria 3220, Australia.
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Areri HA, Marshall A, Harvey G. Self-efficacy for self-management and its influencing factors among adults living with HIV on antiretroviral therapy in northwest Ethiopia. AIDS Care 2022; 34:1595-1601. [PMID: 34851784 DOI: 10.1080/09540121.2021.2007839] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Previous research has identified that self-efficacy is an essential factor in the process of self-management; however, the evidence is lacking concerning factors influencing self-efficacy in low-income countries. Therefore, this study examined factors influencing self-efficacy. A validated survey tool was orally administered to 415 adults living with HIV. Many of the respondents, 82.4%, do not have a regular job while one-fourth (25.5%) of the respondents were from a rural area. A mean self-efficacy score, 19.76 ± 0.12 out of a maximum of 24 was identified. This self-efficacy score was positively correlated with age, educational level, income and job status, but negatively correlated with gender, residency and drug side effects. Income, residency in rural, and experiencing drug side effects were significant predictors of self-efficacy and explained 5.4% of the variance. Better income (β = 0.514, p = 0.029) was associated with a higher self-efficacy score but living in rural areas (β = -0.520, p = 0.043) and experiencing drug side effects (β = -1.246, p = 0.001) were associated with a lower self-efficacy score. The use of Individual and Family Self-Management Theory helps clinician and patients to work together to identify factors influencing self-efficacy and to intervene.
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Affiliation(s)
- Habtamu Abera Areri
- Adelaide Nursing School, The University of Adelaide, Adelaide, Australia.,School of Nursing and Midwifery, Addis Ababa University, Addis Ababa, Ethiopia
| | - Amy Marshall
- Adelaide Nursing School, The University of Adelaide, Adelaide, Australia.,College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Gillian Harvey
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
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Byrne G, Keogh B, Daly L. Self-management support for older adults with chronic illness: implications for nursing practice. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2022; 31:86-94. [PMID: 35094539 DOI: 10.12968/bjon.2022.31.2.86] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Self-management is a key skill that older adults with multiple comorbidities require. Self-management interventions include medication management, self-monitoring and self-awareness and self-management often requires the older adult to manage the emotional consequences of having multiple comorbidities. The benefits of self-management for older adults include reduced reliance on the health system, enhanced quality of life, empowerment of the individual and reduction in the burden associated with chronic illness. Many factors can influence an older adult's ability to self-manage, including health literacy, mental health difficulties and socio-economic factors. Self-management support is the provision of structures, services and programmes to support and enhance the skills of older adults in managing their own conditions. Nurses are in a pivotal position across the continuum of care, using both person-centred care and the 'Making Every Contact Count' approach, to support older adults to self-manage their conditions.
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Affiliation(s)
- Gobnait Byrne
- Assistant Professor, School of Nursing and Midwifery, Trinity College Dublin, Ireland
| | - Brian Keogh
- Assistant Professor, School of Nursing and Midwifery, Trinity College Dublin, Ireland
| | - Louise Daly
- Assistant Professor, School of Nursing and Midwifery, Trinity College Dublin, Ireland
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Batalha APDB, Ponciano IC, Chaves G, Felício DC, Britto RR, da Silva LP. Behavior change interventions in patients with type 2 diabetes: a systematic review of the effects on self-management and A1c. J Diabetes Metab Disord 2021; 20:1815-1836. [PMID: 34900827 PMCID: PMC8630317 DOI: 10.1007/s40200-021-00846-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 06/23/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE This study aimed to identify the characteristics of interventions employed to promote behavior change in people with type 2 diabetes mellitus (T2DM) and their impact on disease self-management and glycated hemoglobin (A1c). METHODS The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were used to guide the protocol development for this systematic review. Randomized controlled clinical trials which compared behavior change interventions to controls in adults with T2DM and investigated disease self-management and glycated hemoglobin (A1c) measured by validated methods were eligible for this study. The risk of bias and quality of evidence was assessed respectively by Cochrane's tool and grading of recommendations, assessment, development, and evaluation (GRADE). RESULTS A total of 27 studies were included involving 4464 participants. Behavior change was mainly promoted by education sessions on diabetes care delivered face-to-face, monthly, or every other month, lasting more than 60 min, involving blood glucose monitoring, healthy eating, exercise, and medication. Four studies showed significant improvement in both disease self-management and A1c. The risk of bias was classified as high in most studies. A meta-analysis could not be performed for A1c and self-management due to the high differences in intervention parameters (delivery mode, number, duration, and frequency) and self-management assessments. CONCLUSION Low evidence of improvement in disease self-management and A1c considering only validated assessment methods were found for behavior change interventions, mainly promoted by education sessions on diabetes care. The quality of studies and probably the differences in intervention protocols contributed to this finding. PROSPERO NUMBER CRD42020161162.
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Affiliation(s)
- Ana Paula Delgado Bomtempo Batalha
- Graduate Program in Rehabilitation and Physical-Functional Performance Sciences, Federal University of Juiz de Fora (UFJF), Juiz de Fora, MG Brazil
| | - Isabela Coelho Ponciano
- Graduate Program in Rehabilitation and Physical-Functional Performance Sciences, Federal University of Juiz de Fora (UFJF), Juiz de Fora, MG Brazil
| | | | - Diogo Carvalho Felício
- Graduate Program in Rehabilitation and Physical-Functional Performance Sciences, Federal University of Juiz de Fora (UFJF), Juiz de Fora, MG Brazil
- Faculty of Physical Therapy, UFJF, Juiz de Fora, MG Brazil
| | - Raquel Rodrigues Britto
- Graduate Program in Rehabilitation and Physical-Functional Performance Sciences, Federal University of Juiz de Fora (UFJF), Juiz de Fora, MG Brazil
- Graduate Program in Rehabilitation Science, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG Brazil
| | - Lilian Pinto da Silva
- Graduate Program in Rehabilitation and Physical-Functional Performance Sciences, Federal University of Juiz de Fora (UFJF), Juiz de Fora, MG Brazil
- Faculty of Physical Therapy, UFJF, Juiz de Fora, MG Brazil
- Cardiovascular Research and Exercise Physiology Unit, University Hospital, UFJF, Juiz de Fora, MG Brazil
- Faculty of Physiotherapy, Federal University of Juiz de Fora, Av. Eugenio do Nascimento S/N Bairro Dom Bosco, Juiz de Fora, MG CEP: 36038-330 Brazil
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Kırca K, Kutlutürkan S. The effect of progressive relaxation exercises on treatment-related symptoms and self-efficacy in patients with lung cancer receiving chemotherapy. Complement Ther Clin Pract 2021; 45:101488. [PMID: 34619419 DOI: 10.1016/j.ctcp.2021.101488] [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: 04/28/2020] [Revised: 09/12/2021] [Accepted: 09/27/2021] [Indexed: 01/06/2023]
Abstract
BACKGROUND Patients with lung cancer receiving chemotherapy experience many symptoms, simultaneously or separately, that limit their daily living activities. This study aimed to determine the effect of progressive relaxation exercises on treatment-related symptoms and self-efficacy in patients with lung cancer receiving chemotherapy. MATERIALS AND METHODS This randomized controlled experimental study was conducted in a university hospital chemotherapy outpatient clinic in Turkey. The study sample consisted of 84 patients, randomly allocated to an experimental group (n = 42) and a control group (n = 42). The experimental group received applied training in progressive relaxation exercises using an MP3 player. The control group received only standard nursing interventions in the chemotherapy unit. Data were collected from patients using a personal information form, a telephone counseling follow-up form, the Memorial Symptom Assessment Scale and the Strategies Used by People to Promote Health Scale. Data collection tools were administered at four different times (at first interview and three times on the seventh day of the end of the chemotherapy cycle) and weekly telephone follow-ups were performed. RESULTS The symptom scores (frequency, severity and level of distress) significantly decreased in the experimental group, compared with the control group (p = 0.0001). Similarly, self-efficacy scores significantly improved in the experimental group (p = 0.001). CONCLUSION Progressive relaxation exercises were potentially effective in promoting symptom management and improving the level of self-efficacy.
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Affiliation(s)
- Kamile Kırca
- Kırıkkale University, Faculty of Health Sciences, Nursing Department, Kırıkkale, Turkey.
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Kolk D, Kruiswijk AF, MacNeil-Vroomen JL, Ridderikhof ML, Buurman BM. Older patients' perspectives on factors contributing to frequent visits to the emergency department: a qualitative interview study. BMC Public Health 2021; 21:1709. [PMID: 34544405 PMCID: PMC8454044 DOI: 10.1186/s12889-021-11755-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 09/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Older patients are at high risk of unplanned revisits to the emergency department (ED) because of their medical complexity. To reduce the number of ED visits, we need more knowledge about the patient-level, environmental, and healthcare factors involved. The aim of this study was to describe older patients' perspectives and experiences before and after an ED visit, and to identify factors that possibly contribute to frequent ED revisits. METHODS This was a qualitative description study. We performed semi-structured individual interviews with older patients who frequently visited the ED and were discharged home after an acute visit. Patients were enrolled in the ED of a university medical centre using purposive sampling. Interviews were recorded, transcribed, and coded independently by two researchers. Theoretical analysis was used to identify recurring patterns and themes in the data. Interviews were conducted until thematic saturation was reached. RESULTS In-depth interviews were completed with 13 older patients. Three main themes emerged: 1) medical events leading to feelings of crisis, 2) patients' untreated health problems, and 3) persistent problems in health and daily functioning post discharge. Participants identified problems before and after their ED visit that possibly contributed to further ED visits. These problems included increasing symptoms leading to feelings of crisis, the relationship with the general practitioner, incomplete discharge information at the ED, and inadequate follow-up and lack of recovery after an ED visit. CONCLUSIONS This qualitative study identified multiple factors that may contribute to frequent ED visits among older patients. Older patients in need of acute care might benefit from hospital-at-home interventions, or acute care provided by geriatric emergency teams in the primary care setting. Identifying frailty in the ED is needed to improve discharge communication and adequate follow-up is needed to improve recovery after an acute ED visit.
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Affiliation(s)
- Daisy Kolk
- Amsterdam UMC, University of Amsterdam, Emergency Medicine, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, Netherlands. .,Internal Medicine, Section of Geriatric Medicine, Amsterdam UMC, University of Amsterdam, Internal Medicine, Section of Geriatric Medicine, Amsterdam Public Health, Meibergdreef 9, Amsterdam, Netherlands.
| | - Anton F Kruiswijk
- Internal Medicine, Section of Geriatric Medicine, Amsterdam UMC, University of Amsterdam, Internal Medicine, Section of Geriatric Medicine, Amsterdam Public Health, Meibergdreef 9, Amsterdam, Netherlands.,OLVG Hospital, Department of Geriatric Medicine, Amsterdam, the Netherlands
| | - Janet L MacNeil-Vroomen
- Internal Medicine, Section of Geriatric Medicine, Amsterdam UMC, University of Amsterdam, Internal Medicine, Section of Geriatric Medicine, Amsterdam Public Health, Meibergdreef 9, Amsterdam, Netherlands
| | - Milan L Ridderikhof
- Amsterdam UMC, University of Amsterdam, Emergency Medicine, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, Netherlands
| | - Bianca M Buurman
- Internal Medicine, Section of Geriatric Medicine, Amsterdam UMC, University of Amsterdam, Internal Medicine, Section of Geriatric Medicine, Amsterdam Public Health, Meibergdreef 9, Amsterdam, Netherlands.,ACHIEVE - Centre of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
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Loftus AM, Nielsen C, Corti EJ, Starkstein S, Gasson N, Egan SJ. Measuring General Expectations of Advanced Stage Treatment Outcomes in Parkinson's Disease. JOURNAL OF PARKINSONS DISEASE 2021; 11:2017-2026. [PMID: 34366376 DOI: 10.3233/jpd-212777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Recent research suggests that a significant number of those who receive advanced treatments for Parkinson's disease (PD) do not report improvements for some symptoms, which may relate to their pre-treatment expectations. It is important that expectations of treatment are measured and discussed prior to advanced treatment. OBJECTIVE The primary aim of this study was to develop a measure of treatment expectations of two advanced-stage treatments in PD, deep brain stimulation (DBS), and Levodopa/Carbidopa Intestinal Gel (LCIG). A secondary aim was to explore potential predictors of treatment expectations. METHODS The questionnaire-based measure was developed by researchers in conjunction with a highly experienced clinician, and evaluated treatment expectations in 189 people aged 46-91 years (M = 71.35, SD = 8.73; 61% male) with idiopathic PD. RESULTS The overall measure demonstrated excellent internal consistency (α= 0.96). Exploratory factor analysis suggested the scale was unidimensional for both DBS and LCIG. Participant expectations of the two treatments differed significantly, with expectations being higher for DBS. Perceived symptom severity was the strongest predictor of treatment expectations. CONCLUSION This scale has potential to inform clinicians about client expectations prior to advanced stage therapy for PD, with a view to the management of these expectations. Further evaluation of the scale is required across different treatment contexts.
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Affiliation(s)
- Andrea M Loftus
- Discipline of Psychology, School of Population Health, Curtin University, Perth, WA, Australia
| | - Chloe Nielsen
- Discipline of Psychology, School of Population Health, Curtin University, Perth, WA, Australia
| | - Emily J Corti
- Discipline of Psychology, School of Population Health, Curtin University, Perth, WA, Australia
| | - Sergio Starkstein
- Faculty of Health and Medical Sciences, University of Western Australia, UWA Health Campus (QEII), Monash Avenue, Nedlands, WA, Australia
| | - Natalie Gasson
- Discipline of Psychology, School of Population Health, Curtin University, Perth, WA, Australia
| | - Sarah J Egan
- Discipline of Psychology, School of Population Health, Curtin University, Perth, WA, Australia.,enAble Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
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Hounkpatin HO, Leydon GM, Veighey K, Armstrong K, Santer M, Taal MW, Annells P, May C, Roderick PJ, Fraser SD. Patients' and kidney care team's perspectives of treatment burden and capacity in older people with chronic kidney disease: a qualitative study. BMJ Open 2020; 10:e042548. [PMID: 33310810 PMCID: PMC7735091 DOI: 10.1136/bmjopen-2020-042548] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 10/17/2020] [Accepted: 11/16/2020] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Chronic kidney disease (CKD) is often a multimorbid condition and progression to more severe disease is commonly associated with increased management requirements, including lifestyle change, more medication and greater clinician involvement. This study explored patients' and kidney care team's perspectives of the nature and extent of this workload (treatment burden) and factors that support capacity (the ability to manage health) for older individuals with CKD. DESIGN Qualitative semistructured interview and focus group study. SETTING AND PARTICIPANTS Adults (aged 60+) with predialysis CKD stages G3-5 (identified in two general practitioner surgeries and two renal clinics) and a multiprofessional secondary kidney care team in the UK. RESULTS 29 individuals and 10 kidney team members were recruited. Treatment burden themes were: (1) understanding CKD, its treatment and consequences, (2) adhering to treatments and management and (3) interacting with others (eg, clinicians) in the management of CKD. Capacity themes were: (1) personal attributes (eg, optimism, pragmatism), (2) support network (family/friends, service providers), (3) financial capacity, environment (eg, geographical distance to unit) and life responsibilities (eg, caring for others). Patients reported poor provision of CKD information and lack of choice in treatment, whereas kidney care team members discussed health literacy issues. Patients reported having to withdraw from social activities and loss of employment due to CKD, which further impacted their capacity. CONCLUSION Improved understanding of and measures to reduce the treatment burden (eg, clear information, simplified medication, joined up care, free parking) associated with CKD in individuals as well as assessment of their capacity and interventions to improve capacity (social care, psychological support) will likely improve patient experience and their engagement with kidney care services.
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Affiliation(s)
- Hilda O Hounkpatin
- Primary Care, Population Sciences and Medical Education, University of Southampton Faculty of Medicine, Southampton, Southampton, UK
| | - Geraldine M Leydon
- Primary Care, Population Sciences and Medical Education, University of Southampton Faculty of Medicine, Southampton, Southampton, UK
| | - Kristin Veighey
- Southampton Academy of Research, University Hospital Southampton NHS Foundation Trust, Southampton, Southampton, UK
| | - Kirsten Armstrong
- Renal Medicine and Nephrology, University Hospital Southampton NHS Foundation Trust, Southampton, Southampton, UK
| | - Miriam Santer
- Primary Care, Population Sciences and Medical Education, University of Southampton Faculty of Medicine, Southampton, Southampton, UK
| | - Maarten W Taal
- Renal Medicine, Royal Derby Hospital, Derby, UK
- Centre for Kidney Research and Innovation, University of Nottingham, Derby, UK
| | | | - Carl May
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine Faculty of Epidemiology and Population Health, London, London, UK
| | - Paul J Roderick
- Primary Care, Population Sciences and Medical Education, University of Southampton Faculty of Medicine, Southampton, Southampton, UK
| | - Simon Ds Fraser
- Primary Care, Population Sciences and Medical Education, University of Southampton Faculty of Medicine, Southampton, Southampton, UK
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Self-management behaviour and knowledge of patients with musculoskeletal complaints attending an Australian osteopathy clinic: A consecutive sampling design. INT J OSTEOPATH MED 2020. [DOI: 10.1016/j.ijosm.2020.05.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Kitamura S, Igarashi A, Yamauchi Y, Senjyu H, Horie T, Yamamoto-Mitani N. Self-management activities of older people with chronic obstructive pulmonary disease by types of healthcare services utilised: A cross-sectional questionnaire study. Int J Older People Nurs 2020; 15:e12316. [PMID: 32216095 DOI: 10.1111/opn.12316] [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: 07/27/2019] [Revised: 02/02/2020] [Accepted: 03/04/2020] [Indexed: 11/30/2022]
Abstract
AIMS AND DESIGN Various healthcare services in Japan provide self-management interventions for older people with chronic obstructive pulmonary disease (COPD). To examine the influence of healthcare service utilisation on self-management activities, we conducted a cross-sectional survey of older people with COPD who received care through outpatient clinics (OC), outpatient rehabilitation centres (OR) or home care (HC) services. METHODS The survey consisted of 34 originally developed self-report questions about three types of self-management activities: (a) strategies to minimise dyspnoea, (b) appropriate activities to maintain physical and mental health status and (c) communication with healthcare professionals or family members. We compared self-management activities in each setting (OC, OR and HC) using logistic regression analyses, controlling for dyspnoea level and age, which we chose as representative variables of disease severity. RESULTS Among the total sample (n = 81; mean age: 78.2 years old), participants in the HC group (n = 25) had the most severe level of COPD, followed by those in the OR (n = 31) and OC (n = 12) groups. Compared with participants from the OC group, more participants from the OR and HC groups reported self-management activities, such as "moving body corresponding to breathing" (OR: adjusted odds ratio [AOR], 6.71; HC: AOR, 6.98), "trying not to move quickly" (OR: AOR, 5.46), "avoiding suffocating movements" (HC: AOR, 7.37), "getting an influenza vaccination"(OR: AOR, 8.12; HC: AOR, 7.81), "stretching exercise" (OR: AOR, 6.42; HC: AOR, 16.76), "muscle training" (OR: AOR, 8.49; HC: AOR, 9.73) and "discussing lifestyle goals with healthcare professionals" (HC: AOR, 5.75) after controlling for dyspnoea level and age. CONCLUSIONS Some self-management activities (such as breathing techniques and home exercise) were associated with the use of OR or HC services, an effect persisting after adjusting for degree of breathlessness and age. IMPLICATIONS FOR PRACTICE Findings suggest that we should provide additional services such as OR and HC besides OC to older people with COPD who are unable to practice self-management activities. We need to consider strategies to provide effective self-management intervention in each healthcare service setting according to the unique characteristics of each setting.
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Affiliation(s)
- Satomi Kitamura
- Department of Gerontological Home Care and Long-term Care Nursing/Palliative Care Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ayumi Igarashi
- Department of Gerontological Home Care and Long-term Care Nursing/Palliative Care Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yasuhiro Yamauchi
- Department of Respiratory Medicine, The University of Tokyo, Tokyo, Japan
| | - Hideaki Senjyu
- Department of Clinical Mycobacteriosis, Unit of Mycobacteriosis, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.,Department of Respiratory Care and Rehabilitation Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Takeo Horie
- Department of Pulmonary Medicine, Maebashi Redcross Hospital, Gunma, Japan
| | - Noriko Yamamoto-Mitani
- Department of Gerontological Home Care and Long-term Care Nursing/Palliative Care Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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12
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Curtis K, Munroe B, Van C, Elphick TL. The implementation and usability of HIRAID, a structured approach to emergency nursing assessment. Australas Emerg Care 2019; 23:62-70. [PMID: 31699613 DOI: 10.1016/j.auec.2019.10.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 08/23/2019] [Accepted: 10/02/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Emergency nurses are responsible for the initial assessment, management and safety of critically ill patients. HIRAID, an evidence-informed emergency nursing assessment framework, is known to improve emergency nursing patient-assessment in the simulated environment however has not been evaluated in the clinical setting. METHODS A pre-post design was used to assess the usability and impact of HIRAID on emergency nurses self-efficacy in the emergency department (ED). Nursing and medical staff from three Australian EDs were surveyed. Descriptive and optimal pooled sample t-tests statistics were conducted. RESULTS One hundred and two emergency nurses completed the pre-intervention self-efficacy survey and 63 completed the post-intervention self-efficacy and satisfaction survey. Forty-two and 17 medical officers completed the pre- and post-intervention satisfaction surveys, respectively. Nursing staff self-efficacy levels were unchanged pre- and post-HIRAID implementation (Mean (SD): 8.8 (0.21) vs. 8.7 (0.20)) as was medical staff satisfaction (Mean (SD):7.5 (1.43) vs. 7.8 (1.07)), although there was a trend towards improved communication. CONCLUSION The HIRAID structured approach to patient assessment is acceptable, feasible, practical and appropriate for use in the clinical environment. Further research will demonstrate the direct effects of HIRAID on clinical performance.
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Affiliation(s)
- Kate Curtis
- Susan Wakil School of Nursing and Midwifery, Sydney Nursing School, Faculty of Health and Medicine, The University of Sydney, 88 Mallett Street, Camperdown, NSW 2006, Australia; Illawarra Shoalhaven Local Health District, Wollongong Hospital, Loftus Street, Wollongong, NSW 2500, Australia; Illawarra Health and Medical Research Institute, Building 32, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia; The George Institute for Global Health, Level 5, 1 King Street, Newtown, NSW 2042, Australia
| | - Belinda Munroe
- Illawarra Shoalhaven Local Health District, Wollongong Hospital, Loftus Street, Wollongong, NSW 2500, Australia
| | - Connie Van
- Susan Wakil School of Nursing and Midwifery, Sydney Nursing School, Faculty of Health and Medicine, The University of Sydney, 88 Mallett Street, Camperdown, NSW 2006, Australia
| | - Tiana-Lee Elphick
- Illawarra Shoalhaven Local Health District, Wollongong Hospital, Loftus Street, Wollongong, NSW 2500, Australia.
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13
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Wulfovich S, Fiordelli M, Rivas H, Concepcion W, Wac K. " I Must Try Harder": Design Implications for Mobile Apps and Wearables Contributing to Self-Efficacy of Patients With Chronic Conditions. Front Psychol 2019; 10:2388. [PMID: 31749733 PMCID: PMC6842939 DOI: 10.3389/fpsyg.2019.02388] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Accepted: 10/07/2019] [Indexed: 12/12/2022] Open
Abstract
Background Diverse wellness-promoting mobile health technologies, including mobile apps and wearable trackers, became increasingly popular due to their ability to support patients' self-management of health conditions. However, the patient's acceptance and use depend on the perceived experience and the app appropriateness to the patient's context and needs. We have some understating of the experience and factors influencing the use of these technologies in the general public, but we have a limited understanding of these issues in patients. Objective By presenting results from an explorative study, this paper aims to identify implications for the design of mobile apps and wearables to effectively support patients' efforts in self-management of health with a special emphasis on support for self-efficacy of activities contributing to health. Methods An explorative mixed-method study involving 200 chronically ill patients of Stanford Medical Center (Stanford, CA, United States) was conducted between mid-2016 and end of 2018. Amongst these, 20 patients were involved in a 4-weeks study, in which we collected the underlying wearable device use logs (e.g., Fitbit) and subjective use experience [via an Ecological Momentary Assessment (EMA)], as well as patients' momentary perception of general self-efficacy in their natural environments and different daily contexts. Results The results indicate that mobile apps for health and wearables have the potential to enable better self-management and improve patients' wellbeing but must be further refined to address different human aspects of their use. Specifically, the apps/wearables should be easier to use, more personalized and context-aware for the patient's overall routine and lifestyle choices, as well as with respect to the momentary patient state (e.g., location, type of people around) and health(care) needs. Additionally, apps and devices should be more battery efficient and accurate; providing timely, non-judgmental feedback and personalized advice to the patients anywhere-anytime-anyhow. These results are mapped on major sources of the individuals' self-efficacy. Conclusion Our results show how the apps/wearables that are aimed at supporting the patients' self-management should be designed to leverage and further improve the patients' general self-efficacy and self-efficacy of activities contributing to chronic disease management.
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Affiliation(s)
| | - Maddalena Fiordelli
- Faculty of Communication Sciences, Institute of Communication and Health, Università della Svizzera Italiana, Lugano, Switzerland
| | - Homero Rivas
- Department of Surgery, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Waldo Concepcion
- Department of Surgery - Multi-Organ Transplantation, Stanford University, Stanford, CA, United States
| | - Katarzyna Wac
- Department of Surgery - Multi-Organ Transplantation, Stanford University, Stanford, CA, United States.,Department of Computer Science, University of Copenhagen, Copenhagen, Denmark.,Department of Computer Science, Université de Genève, Geneva, Switzerland
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14
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Pelle T, Bevers K, van der Palen J, van den Hoogen FHJ, van den Ende CHM. Development and evaluation of a tailored e-self-management intervention (dr. Bart app) for knee and/or hip osteoarthritis: study protocol. BMC Musculoskelet Disord 2019; 20:398. [PMID: 31472687 PMCID: PMC6717645 DOI: 10.1186/s12891-019-2768-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 08/19/2019] [Indexed: 12/29/2022] Open
Abstract
Background This paper describes (the development of) an eHealth tool (dr. Bart app) to enhance self-management and to optimize non-surgical health care utilization in patients with knee and/or hip osteoarthritis (OA) and presents a study aiming 1) to study the effectiveness of the dr. Bart app on health care use 2) to explore differences in use, usability and the clinical outcomes of the dr. Bart app between the Netherlands and Germany. Methods The dr. Bart app is a fully automated eHealth application and is based on the Fogg model for behavioural change, augmented with reminders, rewards and self-monitoring to reinforce app engagement and health behaviour. The dr. Bart app propose goals to a healthier lifestyle based on machine learning techniques fed by data collected in a personal profile and choosing behaviour of the app user. Patients ≥50 years with self-reported knee and/or hip OA will be eligible to participate. Participants will be recruited in the community through advertisements in local newspapers and campaigns on social media. This protocol presents a study with three arms, aiming to include 161 patients in each arm. In the Netherlands, patients are randomly allocated to usual care or dr. Bart app and in Germany all patients receive the dr. Bart app. The primary outcome of the first research question is the number of self-reported consultations in secondary health care. The primary outcome of the second research question (comparison between the Netherlands and Germany) is self-management behaviour assessed by the patient activation measure (PAM-13) questionnaire. Secondary outcomes are costs, health-related quality of life, physical functioning and activity, pain, use and usability of the dr. Bart app. Data will be collected through three online questionnaires (at baseline and after 3 and 6 months after inclusion). Discussion This study will gain insight into the effectiveness of the dr. Bart app in the (conservative) treatment of patients with knee and/or hip OA and differences in the use and usability of the dr. Bart app between the Netherlands and Germany. Trial registration Dutch Trial Register (Trial Number NTR6693 / NL6505). Registration date: 4 September 2017.
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Affiliation(s)
- Tim Pelle
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, the Netherlands. .,Department of Rheumatology, Radboud University Medical Center, Nijmegen, the Netherlands.
| | - Karen Bevers
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, the Netherlands
| | - Job van der Palen
- Department of Research Methodology, Measurement, and Data-Analysis, Behavioural, Management and Social Sciences, University of Twente, Enschede, The Netherlands.,Medical School Twente, Medisch Spectrum Twente, Enschede, the Netherlands
| | - Frank H J van den Hoogen
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, the Netherlands.,Department of Rheumatology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Cornelia H M van den Ende
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, the Netherlands.,Department of Rheumatology, Radboud University Medical Center, Nijmegen, the Netherlands
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15
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Smith D, Fairweather-Schmidt AK, Harvey P, Bowden J, Lawn S, Battersby M. Does the Partners in Health scale allow meaningful comparisons of chronic condition self-management between men and women? Testing measurement invariance. J Adv Nurs 2019; 75:3126-3137. [PMID: 31236969 DOI: 10.1111/jan.14124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 04/04/2019] [Accepted: 05/09/2019] [Indexed: 11/30/2022]
Abstract
AIMS To determine if the Partners in Health scale, pertinent to assessing patient chronic condition self-management, operates equivalently for men and women. BACKGROUND There are distinct gender-based differences in self-management behaviours and health perceptions. This may introduce non-invariance in self-report measures. Testing of measurement invariance is a recommended practice in nursing science to ensure robust metrics. DESIGN A representative cross-sectional population survey in South Australian. METHOD In 2014, 940 people responded to the South Australian Health Omnibus Survey, a battery of health-related questions. MI and estimation of heterogeneity was tested using Bayesian confirmatory factor analysis. RESULTS Findings showed self-management constructs were interpreted equivalently between men and women. Observed population heterogeneity associated lower education levels with poorer illness and treatment knowledge, smokers with poorer treatment partnerships and mental health problems with lower coping capacity. CONCLUSION Approximate measurement invariance was achieved between men and women for Partners in Health scale. IMPACT There is a lack of well-validated generic instruments, including investigation into gender variability, for measuring chronic condition self-management behaviours. Lower education levels were found to connect with poorer knowledge of health condition and treatment. Mental health problems attenuated ability to cope with the effect of the condition. Findings can facilitate the development of better tailored interventions for self-management of patients' chronic condition/s.
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Affiliation(s)
- David Smith
- College of Medicine & Public Health, Flinders University, Adelaide, SA, Australia
| | | | - Peter Harvey
- College of Medicine & Public Health, Flinders University, Adelaide, SA, Australia
| | - Jacqueline Bowden
- South Australian Health and Medical Research Institute, Population Health, North Terrace, Adelaide, SA, Australia
| | - Sharon Lawn
- College of Medicine & Public Health, Flinders University, Adelaide, SA, Australia
| | - Malcolm Battersby
- College of Medicine & Public Health, Flinders University, Adelaide, SA, Australia
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16
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Gobeil-Lavoie AP, Chouinard MC, Danish A, Hudon C. Characteristics of self-management among patients with complex health needs: a thematic analysis review. BMJ Open 2019; 9:e028344. [PMID: 31129599 PMCID: PMC6538095 DOI: 10.1136/bmjopen-2018-028344] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE There is a gap of knowledge among healthcare providers on characteristics of self-management among patients with chronic diseases and complex healthcare needs. Consequently, the objective of this paper was to identify characteristics of self-management among patients with chronic diseases and complex healthcare needs. DESIGN Thematic analysis review of the literature. METHODS We developed search strategies for the MEDLINE and CINAHL databases, covering the January 2000-October 2018 period. All articles in English or French addressing self-management among an adult clientele (18 years and older) with complex healthcare needs (multimorbidity, vulnerability, complexity and frequent use of health services) were included. Studies that addressed self-management of a single disease or that did not have any notion of complexity or vulnerability were excluded. A mixed thematic analysis, deductive and inductive, was performed by three evaluators as described by Mileset al. RESULTS Twenty-one articles were included. Patients with complex healthcare needs present specific features related to self-management that can be exacerbated by deprived socioeconomic conditions. These patients must often prioritise care based on one dominant condition. They are at risk for depression, psychological distress and low self-efficacy, as well as for receiving contradictory information from healthcare providers. However, the knowledge and experiences acquired in the past in relation to their condition may help them improve their self-management skills. CONCLUSIONS This review identifies challenges to self-management for patients with complex healthcare needs, which are exacerbated in contexts of socioeconomic insecurity and proposes strategies to help healthcare providers better adapt their self-management support interventions to meet the specific needs of this vulnerable clientele.
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Affiliation(s)
- Annie-Pier Gobeil-Lavoie
- Département des sciences de la santé, Université du Québec à Chicoutimi, Chicoutimi, Québec, Canada
| | - Maud-Christine Chouinard
- Département des sciences de la santé, Université du Québec à Chicoutimi, Chicoutimi, Québec, Canada
| | - Alya Danish
- Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Catherine Hudon
- Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Sherbrooke, Quebec, Canada
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17
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Menichetti J, De Luca L, Dordoni P, Donegani S, Marenghi C, Valdagni R, Bellardita L. Making Active Surveillance a path towards health promotion: A qualitative study on prostate cancer patients' perceptions of health promotion during Active Surveillance. Eur J Cancer Care (Engl) 2019; 28:e13014. [PMID: 30761643 DOI: 10.1111/ecc.13014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 10/18/2018] [Accepted: 01/17/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Health promotion is a key aspect for health outcomes of prostate cancer (PCa) patients. However, it has been poorly explored among patients following monitoring programmes, for example Active Surveillance (AS). This study aimed to explore PCa patients' perceptions of health promotion during AS. METHODS An explorative qualitative research design was adopted. Four focus groups were used to collected data from 24 men enrolled in the Prostate Cancer Research International: AS (PRIAS) protocol. A thematic analysis with an inductive approach was performed. RESULTS Participants described promoting health during AS as challenged by mental, age-related, informational and organisational issues. It was reported as an effort to stay in the present with a positive outlook, despite the worries for the future ("the mental theme"). It was perceived as impacted by being older and having to manage physical and mental struggles related to age ("the life-course theme"). It depended, in their accounts, on obtaining reliable information and personalised education ("the educational theme"). Finally, it was related on taking responsibility on the care process ("the organisational theme"). CONCLUSION This study suggested ways of promoting health during AS that can help healthcare professionals and organisations building a "health-promoting AS," able to improve overall health outcomes.
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Affiliation(s)
- Julia Menichetti
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milano, Italy.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Letizia De Luca
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milano, Italy
| | - Paola Dordoni
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milano, Italy
| | - Simona Donegani
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milano, Italy
| | - Cristina Marenghi
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milano, Italy
| | - Riccardo Valdagni
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milano, Italy.,Department of Radiation Oncology, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milano, Italy.,Department of Oncology and Haemato-Oncology, Università degli Studi di Milano, Milano, Italy
| | - Lara Bellardita
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milano, Italy
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18
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Convery E, Hickson L, Keidser G, Meyer C. The Chronic Care Model and Chronic Condition Self-Management: An Introduction for Audiologists. Semin Hear 2019; 40:7-25. [PMID: 30728646 PMCID: PMC6363546 DOI: 10.1055/s-0038-1676780] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Hearing health care is biomedically focused, device-centered, and clinician-led. There is emerging evidence that these characteristics-all of which are hallmarks of a health care system designed to address acute, rather than chronic, conditions-may contribute to low rates of help-seeking and hearing rehabilitation uptake among adults with hearing loss. In this review, we introduce audiologists to the Chronic Care Model, an organizational framework that describes best-practice clinical care for chronic conditions, and suggest that it may be a viable model for hearing health care to adopt. We further introduce the concept of chronic condition self-management, a key component of chronic care that refers to the knowledge and skills patients use to manage the effects of a chronic condition on all aspects of daily life. Drawing on the chronic condition evidence base, we demonstrate a link between the provision of effective self-management support and improved clinical outcomes and discuss validated methods with which clinicians can support the acquisition and application of self-management skills in their patients. We examine the extent to which elements of chronic condition self-management have been integrated into clinical practice in audiology and suggest directions for further research in this area.
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Affiliation(s)
- Elizabeth Convery
- HEARing Cooperative Research Centre, Melbourne, Australia
- National Acoustic Laboratories, Sydney, Australia
- School of Health and Rehabilitation Sciences, University of Queensland, St. Lucia, Australia
| | - Louise Hickson
- HEARing Cooperative Research Centre, Melbourne, Australia
- School of Health and Rehabilitation Sciences, University of Queensland, St. Lucia, Australia
| | - Gitte Keidser
- HEARing Cooperative Research Centre, Melbourne, Australia
- National Acoustic Laboratories, Sydney, Australia
- School of Health and Rehabilitation Sciences, University of Queensland, St. Lucia, Australia
| | - Carly Meyer
- HEARing Cooperative Research Centre, Melbourne, Australia
- School of Health and Rehabilitation Sciences, University of Queensland, St. Lucia, Australia
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19
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Selinheimo S, Vasankari T, Jokela M, Kanervisto M, Pirkola S, Suvisaari J, Paunio T. The association of psychological factors and healthcare use with the discrepancy between subjective and objective respiratory-health complaints in the general population. Psychol Med 2019; 49:121-131. [PMID: 29554990 DOI: 10.1017/s0033291718000582] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND We examined the prevalence of self-perceived respiratory symptoms (SRS) in the absence of any objective findings of respiratory pathology, and the association of such prevalence with psychological factors and healthcare use in the general population. METHODS The study was conducted among a nationally representative sample of Finnish adults (BRIF8901). Respiratory functioning was measured by a spirometry test. Structured questionnaires were used to measure SRS, physician visits and psychological factors of alexithymia, sense of coherence, illness worry and common mental disorders. Individuals with a diagnosed respiratory disease or a severe psychiatric disorder, determined in a diagnostic interview, were excluded, giving a sample comprising 4544 participants. RESULTS Twenty-six per cent of the general population and 36% of those with no diagnosed severe psychiatric disorder or respiratory disease experienced SRS despite a normal spirometry result. Psychological factors were associated with SRS (0.0001 < p < 0.032), and on the number of physician visit explaining 42.7% of the difference in visits between individuals with and without SRS, respectively. Illness worry was associated most strongly with SRS [odds ratio (OR) 1.29, 95% confidence interval (CI) 1.19-1.41, p < 0.0001] and higher numbers of physician visits (OR 1.35, CI 1.32-1.38, p < 0.00001), even after several adjustments. CONCLUSIONS Respiratory symptoms without objective findings are common in the general population. The study results underline the role of psychological factors in the reporting of respiratory symptoms and the associated medical burden, thereby indicating the functional nature of the symptomatology.
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Affiliation(s)
| | | | - Markus Jokela
- Department of Psychology and Logopedics,Faculty of Medicine,University of Helsinki,Helsinki,Finland
| | | | - Sami Pirkola
- Health Sciences, andUniversity Hospital Psychiatric Department,University of Tampere,Tampere,Finland
| | - Jaana Suvisaari
- Department of Health,National Institute for Health and Welfare,Helsinki,Finland
| | - Tiina Paunio
- Finnish Institute of Occupational Health,Helsinki,Finland
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Odajima Y, Sumi N. Factors related to sense of coherence in adult patients with Type 2 diabetes. NAGOYA JOURNAL OF MEDICAL SCIENCE 2018; 80:61-71. [PMID: 29581615 PMCID: PMC5857502 DOI: 10.18999/nagjms.80.1.61] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The influence of a diabetic person's sense of burden and blood sugar control through sense of coherence (SOC) on self-management has yet to be sufficiently clarified. The purpose of this study was to examine the utility of salutogenesis, which has sense of coherence at its core, for the self-management of patients with type 2 diabetes. A total of 258 questionnaires were distributed to patients who were seen at one of three hospitals in an urban area in Japan, after obtaining consent from the patient. They were between 20 and 75 years old and regularly received care. Of the 185 responses, 177 were valid. The responses were analyzed by referring to the framework of salutogenesis, and the relationship between patient characteristics, SOC, the Problem Areas In Diabetes survey (PAID), and glycosylated hemoglobin (HbA1c) were studied with structural equation modeling (SEM). SOC had a main effect on PAID scores and an indirect effect on HbA1c. Moreover, age influenced SOC positively. The SOC of patients with type 2 diabetes in the present study was comparatively high. These observations suggest a direct effect of SOC on reducing the sense of burden from having diabetes and an indirect effect on decreasing HbA1c. This research suggested the possibility that diabetes can be controlled by improving SOC.
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Affiliation(s)
- Yuki Odajima
- School of Nursing, Nagoya City University, Nagoya, Japan
| | - Naomi Sumi
- Department of Fundamental Nursing, Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
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21
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New-graduate Physical Therapists' Self-efficacy to Perform Patient Education Is Influenced by Entry-level Training Experiences. ACTA ACUST UNITED AC 2018. [DOI: 10.1097/jte.0000000000000022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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22
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Kreitschmann-Andermahr I, Siegel S, Gammel C, Campbell K, Edwin L, Grzywotz A, Kuhna V, Koltowska-Häggström M, Müller O, Buchfelder M, Kleist B. Support Needs of Patients with Cushing's Disease and Cushing's Syndrome: Results of a Survey Conducted in Germany and the USA. Int J Endocrinol 2018; 2018:9014768. [PMID: 30402098 PMCID: PMC6198616 DOI: 10.1155/2018/9014768] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Accepted: 09/03/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Cushing's disease (CD) and Cushing's syndrome (CS) are chronic illnesses, characterized by symptoms of prolonged hypercortisolism, which often changes to hypocortisolism after successful treatment. In view of the high disease burden of CD/CS patients and long-term impaired quality of life, the present survey was conducted to gain information about subjective illness distress and patients' specific needs in terms of supportive measures beyond medical interventions. PATIENTS AND METHODS Cross-sectional questionnaire study including patients with CD treated in 2 German neurosurgical tertiary referral centers and CD/CS patient members of a US-based patient support group completed a survey inquiring about disease burden, coping strategies, and support needs. Additionally, the degree of interest in different offers, e.g., internet-based programs and seminars, was assessed. RESULTS 84 US and 71 German patients answered the questionnaire. Patients in both countries indicated to suffer from Cushing-related symptoms, reduced performance, and psychological problems. 48.8% US patients and 44.4% German patients stated that good medical care and competent doctors helped them the most in coping with the illness. US patients were more interested in support groups (p = 0.035) and in courses on illness coping (p = 0.008) than the German patients, who stated to prefer brochures (p = 0.001). 89.3% of US patients would attend internet-based programs compared to 75.4% of German patients (p = 0.040). There were no differences between groups for the preferred duration of and the willingness to pay for such a program, but US patients would travel longer distances to attend a support meeting (p = 0.027). CONCLUSION Patients in both countries need skilled physicians and long-term medical care in dealing with the effects of CD/CS, whereas other support needs differ between patients of both countries. The latter implies that not only disease-specific but also culture-specific training programs would need to be considered to satisfy the needs of patients in different countries.
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Affiliation(s)
| | - Sonja Siegel
- Department of Neurosurgery, University of Duisburg-Essen, 45147 Essen, Germany
| | - Christa Gammel
- Department of Neurosurgery, University Hospital Erlangen, 91054 Erlangen, Germany
| | - Karen Campbell
- Cushing's Support and Research Foundation, Plymouth, MA 02360, USA
| | - Leslie Edwin
- Cushing's Support and Research Foundation, Plymouth, MA 02360, USA
| | - Agnieszka Grzywotz
- Department of Neurosurgery, University of Duisburg-Essen, 45147 Essen, Germany
| | - Victoria Kuhna
- Department of Neurosurgery, Ev. Hospital Oldenburg, 26121 Oldenburg, Germany
| | - Maria Koltowska-Häggström
- Department of Women's and Children's Health, Uppsala University, Akademiska Sjukhuset, SE-751 85 Uppsala, Sweden
| | - Oliver Müller
- Department of Neurosurgery, University of Duisburg-Essen, 45147 Essen, Germany
| | - Michael Buchfelder
- Department of Neurosurgery, University Hospital Erlangen, 91054 Erlangen, Germany
| | - Bernadette Kleist
- Department of Neurosurgery, University of Duisburg-Essen, 45147 Essen, Germany
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Ferrajão PC. Pathways Between Combat Stress and Physical Health Among Portuguese War Veterans. QUALITATIVE HEALTH RESEARCH 2017; 27:1640-1651. [PMID: 28799471 DOI: 10.1177/1049732317701404] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
In this study, I explored the experience of both physical and psychological chronic illnesses among a sample of Portuguese war veterans. Twenty suffered from chronic posttraumatic stress disorder (PTSD; unrecovered) and 20 had remission from PTSD (recovered), and all participants suffered from a chronic physician-diagnosed medical disorder. Two semistructured interviews were conducted. Analysis of the interviews was conducted using the Thematic and Categorical Analysis. Unrecovered participants reported higher moral injury, discrepancy between pre- and postwar identity, medication side effects, and lower repertoire of coping strategies, and verbalized that treatment care plan triggers posttraumatic symptoms. Recovered participants reported stronger moral repair, sense of continuity between pre- and postwar identity, and wider repertoire of coping strategies, well-being. Veterans' adjustment to chronic physician-diagnosed medical disorders is related to the accommodation of war traumatic experiences within existing self-schemas to restore a sense of continuity between veterans' pre- and postwar identity.
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Li Z, Liu T, Han J, Li T, Zhu Q, Wang A. Confrontation as a Mediator between Sense of Coherence and Self-management Behaviors among Elderly Patients with Coronary Heart Disease in North China. Asian Nurs Res (Korean Soc Nurs Sci) 2017; 11:201-206. [PMID: 28991601 DOI: 10.1016/j.anr.2017.08.003] [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] [Received: 01/21/2017] [Revised: 08/02/2017] [Accepted: 08/02/2017] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Self-management is critical to improve health outcomes of elderly patients with coronary heart disease (CHD). Sense of coherence (SOC) is found to be linked with self-management behaviors. However, their deeper relationship is not clear. The purposes of this study were to investigate the association between SOC and self-management behaviors among elderly CHD patients in China, and whether confrontation mediates this association. METHODS A cross-sectional design was used. A total of 275 elderly patients with CHD recruited from the cardiology department in a general hospital in North China were surveyed from October 2015 to April 2016. SOC, confrontation, and self-management behaviors were measured using the Chinese version of the SOC scale, subscale of Medical Coping Modes Questionnaire-Confrontation, and the CHD self-management scale, respectively. Correlation analysis and path analysis were conducted to analyze the data. RESULTS The mean (±standard deviation) scores of SOC, confrontation, and self-management behaviors were 62.20 (±9.61), 19.55 (±3.15), and 76.17 (±10.63), respectively. Correlation analysis showed that SOC, confrontation, and self-management behaviors were significantly correlated with each other. Path analysis indicated that SOC exerted a direct effect on self-management behaviors, whereas could affect self-management indirectly via confrontation. Bootstrap test result showed that confrontation played a mediating role (β = .20, p < .001) in the relationship between SOC and self-management behaviors. CONCLUSION SOC was related to self-management behaviors, whereas confrontation mediated the effect of SOC on self-management behaviors. In practice, the role of confrontation coping should be valued when developing strategies to strengthen SOC and to improve self-management practice among elderly CHD patients.
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Affiliation(s)
- Zhenyun Li
- School of Nursing, Qingdao University, Qingdao, Shandong, China
| | - Ting Liu
- School of Nursing, Qingdao University, Qingdao, Shandong, China
| | - Jing Han
- School of Nursing, Qingdao University, Qingdao, Shandong, China
| | - Ting Li
- School of Nursing, Qingdao University, Qingdao, Shandong, China
| | - Qina Zhu
- School of Nursing, Qingdao University, Qingdao, Shandong, China
| | - Aimin Wang
- School of Nursing, Qingdao University, Qingdao, Shandong, China.
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Olesen K, Jensen TM, Diaz LJ, Møller ACL, Willaing I, Lyssenko V. Sense of Coherence is associated with LDL-cholesterol in patients with type 1 diabetes - The PROLONG-Steno study. JOURNAL OF CLINICAL AND TRANSLATIONAL ENDOCRINOLOGY 2017; 8:1-5. [PMID: 29067252 PMCID: PMC5651341 DOI: 10.1016/j.jcte.2017.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 01/29/2017] [Indexed: 01/13/2023]
Abstract
SOC was compared to clinical biomarkers in 125 people with type 1 diabetes. No association between SOC and HbA1c was found. An independent association between high SOC and lower LDL-C was found.
Aim It is a constant challenge for people with type 1 diabetes to maintain appropriate levels of HbA1c, blood pressure and blood lipids in order to prevent or delay deleterious effects of their illness. This study sought to investigate if Sense of Coherence (SOC) is associated with clinical risk factors in people with type 1 diabetes. Methods Questionnaire data, including measure of SOC, was collected from 125 patients with long duration of type 1 diabetes and linked to electronic patient records to obtain clinical measures on HbA1c, blood pressure, and blood lipids. Linear regressions and generalized additive models were applied to explore the associations between SOC and clinical biomarkers. Results Mean age of the participants was 60.7 years (standard deviation = 10.0), 44.0% were men. Medium and high SOC were associated with lower levels of LDL-cholesterol (p = 0.005). This association was non-linear with medium and high levels of SOC being advantageous whereas low SOC was associated with elevated levels of LDL-cholesterol. Moreover, we observed non-significant tendencies to associations between low SOC and low HDL-cholesterol, and elevated HbA1c. Conclusions Findings from this study suggest that high SOC may be protective against elevated LDL-cholesterol among people with type 1 diabetes. Interventions to improve self-management among people with low SOC may prove effective to prevent deterioration of metabolic risk factors.
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Affiliation(s)
- Kasper Olesen
- Steno Diabetes Center A/S, Gentofte, Denmark.,Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Troels Mygind Jensen
- Steno Diabetes Center A/S, Gentofte, Denmark.,Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | | | | | - Ingrid Willaing
- Steno Diabetes Center A/S, Gentofte, Denmark.,Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Valeriya Lyssenko
- Steno Diabetes Center A/S, Gentofte, Denmark.,KG Jebsen Center for Diabetes Research, University of Bergen, Bergen, Norway.,Diabetes and Endocrinology, Lund University Diabetes Center, Malmö, Sweden
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Irwan AM, Kato M, Kitaoka K, Ueno E, Tsujiguchi H, Shogenji M. Development of the salt-reduction and efficacy-maintenance program in Indonesia. Nurs Health Sci 2016; 18:519-532. [DOI: 10.1111/nhs.12305] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 06/08/2016] [Accepted: 07/07/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Andi Masyitha Irwan
- School of Nursing; Hasanuddin University; Makassar Indonesia
- Graduate School of Medical, Pharmaceutical and Health Sciences; Kanazawa University; Ishikawa Japan
| | - Mayumi Kato
- Graduate School of Medical, Pharmaceutical and Health Sciences; Kanazawa University; Ishikawa Japan
| | - Kazuyo Kitaoka
- Graduate School of Medical, Pharmaceutical and Health Sciences; Kanazawa University; Ishikawa Japan
| | - Eiichi Ueno
- School of Nursing; Fukui University; Fukui Japan
| | - Hiromasa Tsujiguchi
- Graduate School of Medical, Pharmaceutical and Health Sciences; Kanazawa University; Ishikawa Japan
| | - Miho Shogenji
- Graduate School of Medical, Pharmaceutical and Health Sciences; Kanazawa University; Ishikawa Japan
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Measuring chronic condition self-management in an Australian community: factor structure of the revised Partners in Health (PIH) scale. Qual Life Res 2016; 26:149-159. [PMID: 27432251 DOI: 10.1007/s11136-016-1368-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2016] [Indexed: 12/27/2022]
Abstract
PURPOSE To evaluate the factor structure of the revised Partners in Health (PIH) scale for measuring chronic condition self-management in a representative sample from the Australian community. METHODS A series of consultations between clinical groups underpinned the revision of the PIH. The factors in the revised instrument were proposed to be: knowledge of illness and treatment, patient-health professional partnership, recognition and management of symptoms and coping with chronic illness. Participants (N = 904) reporting having a chronic illness completed the revised 12-item scale. Two a priori models, the 4-factor and bi-factor models were then evaluated using Bayesian confirmatory factor analysis (BCFA). Final model selection was established on model complexity, posterior predictive p values and deviance information criterion. RESULTS Both 4-factor and bi-factor BCFA models with small informative priors for cross-loadings provided an acceptable fit with the data. The 4-factor model was shown to provide a better and more parsimonious fit with the observed data in terms of substantive theory. McDonald's omega coefficients indicated that the reliability of subscale raw scores was mostly in the acceptable range. CONCLUSION The findings showed that the PIH scale is a relevant and structurally valid instrument for measuring chronic condition self-management in an Australian community. The PIH scale may help health professionals to introduce the concept of self-management to their patients and provide assessment of areas of self-management. A limitation is the narrow range of validated PIH measurement properties to date. Further research is needed to evaluate other important properties such as test-retest reliability, responsiveness over time and content validity.
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van Schie D, Castelein S, van der Bijl J, Meijburg R, Stringer B, van Meijel B. Systematic review of self-management in patients with schizophrenia: psychometric assessment of tools, levels of self-management and associated factors. J Adv Nurs 2016; 72:2598-2611. [DOI: 10.1111/jan.13023] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2016] [Indexed: 10/21/2022]
Affiliation(s)
- Dayenne van Schie
- Parnassia Psychiatric Institute; Bavo Europoort; Rotterdam The Netherlands
| | | | | | - Robert Meijburg
- Parnassia Psychiatric Institute; Parnassia Academy; The Hague The Netherlands
| | - Barbara Stringer
- GGZ inGeest; Research Group Recovery and Rehabilitation; Amsterdam The Netherlands
| | - Berno van Meijel
- Inholland University of Applied Sciences; Amsterdam The Netherlands
- Parnassia Psychiatric Institute; Parnassia Academy; The Hague The Netherlands
- VU University Medical Center; Amsterdam The Netherlands
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Chiu TML, Tam KTW, Siu CF, Chau PWP, Battersby M. Validation study of a Chinese version of Partners in Health in Hong Kong (C-PIH HK). Qual Life Res 2016; 26:199-203. [PMID: 27216940 DOI: 10.1007/s11136-016-1315-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND The Partners in Health (PIH) scale is a measure designed to assess the generic knowledge, attitudes, behaviors, and impacts of self-management. A cross-cultural adaptation of the PIH for use in Hong Kong was evaluated in this study. This paper reports the validity and reliability of the Chinese version of PIH (C-PIH[HK]). METHOD A 12-item PIH was translated using forward-backward translation technique and reviewed by individuals with chronic diseases and health professionals. A total of 209 individuals with chronic diseases completed the scale. The construct validity, internal consistency, and test-retest reliability were evaluated in two waves. RESULTS The findings in Wave 1 (n = 73) provided acceptable psychometric properties of the C-PIH(HK) but supported the adaptation of question 5 to improve the cultural relevance, validity, and reliability of the scale. An adapted version of C-PIH(HK) was evaluated in Wave 2. The findings in Wave 2 (n = 136) demonstrated good construct validity and internal consistency of C-PIH(HK). A principal component analysis with Oblimin rotation yielded a 3-factor solution, and the Cronbach's alphas of the subscales ranged from 0.773 to 0.845. Participants were asked whether they perceived the self-management workshops they attended and education provided by health professionals as useful or not. The results showed that the C-PIH(HK) was able to discriminate those who agreed and those who disagreed related to the usefulness of individual health education (p < 0.0001 in all subscales) and workshops (p < 0.001 in the knowledge subscale) as hypothesized. The test-retest reliability was high (ICC = 0.818). CONCLUSION A culturally adapted version of PIH for use in Hong Kong was evaluated. The study supported good construct validity, discriminate validity, internal consistency, and test-retest reliability of the C-PIH(HK).
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Affiliation(s)
| | | | - Choi Fong Siu
- Hong Kong Society for Rehabilitation, Hong Kong, China
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The impact of HIRAID on emergency nurses' self-efficacy, anxiety and perceived control: A simulated study. Int Emerg Nurs 2016; 25:53-8. [DOI: 10.1016/j.ienj.2015.08.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Revised: 07/23/2015] [Accepted: 08/17/2015] [Indexed: 12/22/2022]
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Lee H, Cho SH, Kim JH, Kim YK, Choo HI. [Influence of self efficacy, social support and sense of community on health-related quality of life for middle-aged and elderly residents living in a rural community]. J Korean Acad Nurs 2015; 44:608-16. [PMID: 25608539 DOI: 10.4040/jkan.2014.44.6.608] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
PURPOSE The purpose of this study was to examine the relationship between self-efficacy, social support, sense of community and health-related quality of life (HRQoL), including the direct and indirect effects of the variables on HRQoL. METHODS A cross-sectional survey was conducted with a convenience sample of 249 middle-aged and elderly residents living in a rural community in A-County, K Province. The structured questionnaire included 4 scales from the Euro Quality of life-5 Dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression), and measures of General Self-Efficacy, Social Support, and Sense of Community. Data were analyzed using SPSS WIN 20.0 and AMOS 21.0 program. RESULTS The mean HRQoL score for the participants was 0.87±0.13. Self-efficacy (β=.13, p=.039) and age (β= -.38, p<.001) were significantly associated with HRQoL, explaining 21% of the variance. In the path analysis, self-efficacy showed a significant direct effect on HRQoL (β=.14, p=.040) and significantly mediating relationships between both social support (β=.05, p=.030) and sense of community (β=.02, p=.025) and HRQoL. CONCLUSION Although self-efficacy was found to be the main predictor for HRQoL, the findings imply that social environmental factors such as social support and sense of community need to be considered when developing interventions to increase HRQoL in middle-aged and elderly residents in rural communities.
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Affiliation(s)
| | - Sung Hye Cho
- College of Nursing, Yonsei University, Seoul, Korea.
| | - Jung Hee Kim
- Nursing Policy Research Institute, Yonsei University, Seoul, Korea
| | - Yune Kyong Kim
- Department of Nursing, Masan University, Changwon, Korea
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Garvey J, Connolly D, Boland F, Smith SM. OPTIMAL, an occupational therapy led self-management support programme for people with multimorbidity in primary care: a randomized controlled trial. BMC FAMILY PRACTICE 2015; 16:59. [PMID: 25962515 PMCID: PMC4438474 DOI: 10.1186/s12875-015-0267-0] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 04/24/2015] [Indexed: 12/27/2022]
Abstract
BACKGROUND We investigated the effectiveness of an occupational therapy led self-management support programme, OPTIMAL, designed to address the challenges of living with multiple chronic conditions or multimorbidity in a primary care setting. METHODS Pragmatic feasibility randomised controlled trial including fifty participants with multimorbidity recruited from family practice and primary care settings. OPTIMAL is a six-week community-based programme, led by occupational therapy facilitators and focuses on problems associated with managing multimorbidity. The primary outcome was frequency of activity participation. Secondary outcomes included self-perception of, satisfaction with and ability to perform daily activities, independence in activities of daily living, anxiety and depression, self-efficacy, health-related quality of life, self-management support, healthcare utilisation and individualised goal attainment. Outcomes were collected within two weeks of intervention completion. RESULTS There was a significant improvement in frequency of activity participation, measured using the Frenchay Activities Index, for the intervention group compared to the control group (Adjusted Mean Difference at follow up 4.22. 95% Confidence Interval 1.59-6.85). There were also significant improvements in perceptions of activity performance and satisfaction, self-efficacy, independence in daily activities and quality of life. Additionally, the intervention group demonstrated significantly higher levels of goal achievement, following the intervention. No significant differences were found between the two groups in anxiety, depression, self-management scores or healthcare utilisation. CONCLUSIONS OPTIMAL significantly improved frequency of activity participation, self-efficacy and quality of life for patients with multimorbidity. Further work is required to test the sustainability of these effects over time but this study indicates that it is a promising intervention that can be delivered in primary care and community settings. TRIAL REGISTRATION TRIAL NUMBER ISRCTN67235963.
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Affiliation(s)
- Jess Garvey
- Department of Occupational Therapy, Trinity College Dublin, Trinity Centre, St James's Hospital, Dublin 8, Ireland.
| | - Deirdre Connolly
- Department of Occupational Therapy, Trinity College Dublin, Trinity Centre, St James's Hospital, Dublin 8, Ireland.
| | - Fiona Boland
- HRB Centre for Primary Care Research, Department of General Practice, Royal College of Surgeon's in Ireland, Beaux Lane House, Lower Mercer Street, 2, 123 St Stephen's Green, Dublin 2, Ireland.
| | - Susan M Smith
- HRB Centre for Primary Care Research, Department of General Practice, Royal College of Surgeon's in Ireland, Beaux Lane House, Lower Mercer Street, 2, 123 St Stephen's Green, Dublin 2, Ireland.
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Chow SKY, Wong FKY. A randomized controlled trial of a nurse-led case management programme for hospital-discharged older adults with co-morbidities. J Adv Nurs 2014; 70:2257-71. [PMID: 24617755 PMCID: PMC4263097 DOI: 10.1111/jan.12375] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2014] [Indexed: 11/29/2022]
Abstract
AIM To examine the effects of a nurse-led case management programme for hospital-discharged older adults with co-morbidities. BACKGROUND The most significant chronic conditions today involve diseases of the cardiovascular, respiratory, endocrine and renal systems. Previous studies have suggested that a nurse-led case management approach using either telephone follow-ups or home visits was able to improve clinical and patient outcomes for patients having a single, chronic disease, while the effects for older patients having at least two long-term conditions are unknown. A self-help programme using motivation and empowerment approaches is the framework of care in the study. DESIGN Randomized controlled trial. METHOD The study was conducted from 2010-2012. Older patients having at least two chronic diseases were included for analysis. The participants were randomized into three arms: two study groups and one control group. Data were collected at baseline and at 4 and 12 weeks later. RESULTS Two hundred and eighty-one patients completed the study. The interventions demonstrated significant differences in hospital readmission rates within 84 days post discharge. The two intervention groups had lower readmission rates than the control group. Patients in the two study arms had significantly better self-rated health and self-efficacy. There was significant difference between the groups in the physical composite score, but no significant difference in mental component score in SF-36 scale. CONCLUSION The postdischarge interventions led by the nurse case managers on self-management of disease using the empowerment approach were able to provide effective clinical and patient outcomes for older patients having co-morbidities.
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Hofstede J, de Bie J, van Wijngaarden B, Heijmans M. Knowledge, use and attitude toward eHealth among patients with chronic lung diseases. Int J Med Inform 2014; 83:967-74. [PMID: 25269992 DOI: 10.1016/j.ijmedinf.2014.08.011] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Accepted: 08/31/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Despite high expectations and numerous initiatives in the area of eHealth, implementation and use of eHealth applications on a national level is no common practice yet. There is no full understanding of patients' attitude on eHealth yet. Aim of this study is to gain insight into the level of knowledge and experiences with eHealth of people with chronic lung diseases. METHOD A telephone survey among 400 people with a medical diagnosis of asthma or COPD was conducted. All patients participated in the larger research program National Panel of people with Chronic diseases or Disabilities (NPCD) conducted by NIVEL. RESULTS Eight percent of the asthma and COPD patients knew of the term eHealth. Knowledge of specific eHealth applications (e.g. electronic medical record, electronic consultations, monitoring from a distance) was higher and ranged from 21 to 88%. Most available applications were used by less than 20% of the patients, although figures differ by age and educational level. People who have used applications were in general rather positive about their use. Non-users did not see clear advantages of using eHealth applications. A majority thought that eHealth decreases human contact in health care and will not contribute to a higher quality of care. On the contrary, almost half of the patients considered eHealth as a possibility to take more responsibility in their own care. Asthma and COPD patients were unanimous that the use of eHealth should always be a free choice. CONCLUSION Although most asthma and COPD patient know of one or more eHealth applications, actual use remains low. Patients who do have experience with the use of eHealth are on the whole positive. However, patients without experience have no clear ideas about the advantages. They should be convinced first, and stressing the possibilities for more personal control might be an important argument to persuade them.
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Affiliation(s)
- J Hofstede
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.
| | - J de Bie
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | | | - M Heijmans
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
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Sangster-Gormley E, Frisch N, Schreiber R. Articulating new outcomes of nurse practitioner practice. J Am Assoc Nurse Pract 2013; 25:653-8. [DOI: 10.1002/2327-6924.12040] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Sense of coherence: effect on adherence and response to resistance training in older people with hip fracture history. J Aging Phys Act 2013; 22:138-45. [PMID: 23538559 DOI: 10.1123/japa.2012-0229] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Our aim was to study the effects of sense of coherence (SOC) on training adherence and interindividual changes in muscle strength, mobility, and balance after resistance training in older people with hip fracture history. These are secondary analyses of a 12-week randomized controlled trial of progressive resistance training in 60- to 85-year-old community-dwelling people 0.5-7 years after hip fracture (n = 45; ISRCTN34271567). Pre- and posttrial assessments included SOC, knee extension strength, walking speed, timed up-and-go (TUG), and Berg Balance Scale (BBS). Group-by-SOC interaction effects (repeated-measures ANOVA) were statistically significant for TUG (p = .005) and BBS (p = .040), but not for knee extension strength or walking speed. Weaker SOC was associated with poorer training adherence (mixed model; p = .009). Thus, more complicated physical tasks did not improve in those with weaker SOC, independently of training adherence. Older people with weaker SOC may need additional psychosocial support in physical rehabilitation programs to optimize training response.
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Shao JH, Chang AM, Edwards H, Shyu YIL, Chen SH. A randomized controlled trial of self-management programme improves health-related outcomes of older people with heart failure. J Adv Nurs 2013; 69:2458-69. [PMID: 23488859 DOI: 10.1111/jan.12121] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2013] [Indexed: 11/28/2022]
Abstract
AIMS This paper is a report on the effectiveness of a self-management programme based on the self-efficacy construct, in older people with heart failure. BACKGROUND Heart failure is a major health problem worldwide, with high mortality and morbidity, making it a leading cause of hospitalization. Heart failure is associated with a complex set of symptoms that arise from problems in fluid and sodium retention. Hence, managing salt and fluid intake is important and can be enhanced by improving patients' self-efficacy in changing their behaviour. DESIGN Randomized controlled trial. METHODS Heart failure patients attending cardiac clinics in northern Taiwan from October 2006-May 2007 were randomly assigned to two groups: control (n = 46) and intervention (n = 47). The intervention group received a 12-week self-management programme that emphasized self-monitoring of salt/fluid intake and heart failure-related symptoms. Data were collected at baseline as well as 4 and 12 weeks later. Data analysis to test the hypotheses used repeated-measures anova models. RESULTS Participants who received the intervention programme had significantly better self-efficacy for salt and fluid control, self-management behaviour and their heart failure-related symptoms were significantly lower than participants in the control group. However, the two groups did not differ significantly in health service use. CONCLUSION The self-management programme improved self-efficacy for salt and fluid control, self-management behaviours, and decreased heart failure-related symptoms in older Taiwanese outpatients with heart failure. Nursing interventions to improve health-related outcomes for patients with heart failure should emphasize self-efficacy in the self-management of their disease.
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Affiliation(s)
- Jung-Hua Shao
- School of Nursing, College of Medicine, Chang Gung University, Taiwan
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39
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Chidzambwa L. The social considerations for moving health services into the home: A telecare perspective. HEALTH POLICY AND TECHNOLOGY 2013. [DOI: 10.1016/j.hlpt.2012.12.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Tung HH, Lien RY, Wei J, Clinciu DL, Lee JY, Huang HC. The role of adherence in the relationship between self-efficacy and self-management in diabetic patients undergoing CABG in Taiwan. HEART ASIA 2012; 4:114-9. [PMID: 27326045 DOI: 10.1136/heartasia-2012-010155] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/22/2012] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To determine the role of adherence and its significance in the relationship between self-efficacy and self-management of diabetic patients undergoing coronary artery bypass graft (CABG) in Taiwan. DESIGN Descriptive and correlational survey design. SETTING Three outpatient clinics in Taiwan. PARTICIPANTS Patients diagnosed with diabetes undergoing CABG at least 6 months before the study, 18 years of age or older, able to communicate verbally without any psychiatric problems, and with a life expectancy longer than 1 year. MAIN OUTCOME MEASURES Self-management assessment (self-efficacy for managing disease and adherence to guidelines and medication measured on a scale of 0-8), the higher aspects of self-management (keeping appointments, taking medication properly and keeping follow-up appointments) and the lower aspects of self-management (inability to share decisions with primary physician, inability to take correct actions when symptoms worsen and inability to adapt habits to improve health). RESULTS The mean score obtained for self-management among the 166 participants was 6.48, with 57 (34.3%) of them showing non-adherent behaviour. Self-efficacy accounts for 38% (R(2)=0.380, F(1,103)=63.124, p < 0.001), and 54% of good self-management was explained by self-efficacy and adherence in managing disease (R(2)=0.540, F(2,102)=56.937, p<0.001). Adherence accounts for 16% of better self-management, age and education combined account for 4.9% (R(2)=0.589, F(6.98)=23.399, p<0.001), and lifestyle items account for 5.2% (R(2)=0.641, F(14,90)=11.457, p<0.001). Disease-related variables contribute 3.4% (R(2)=0.674, F(17,87)=10.599, p<0.001). Thus self-efficacy, adherence, age, education, primary care provider and systolic pressure are considered significant predictors of self-management. With the exception of adherence, none of the variables had a statistically significant mediating effect. CONCLUSIONS The results confirm strong relationships between self-efficacy, adherence and self-management, with adherence having a significant mediating effect in post-CABG patients with diabetes in Taiwan.
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Affiliation(s)
- Heng-Hsin Tung
- Nursing School, National Taipei University of Nursing and Health Science, Taiwan, ROC; Nursing Department, Tungs' Taichung MetroHabor Hospital, Taiwan, ROC
| | - Ru-Yu Lien
- Nursing Department of Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Jeng Wei
- Heart Center of Chen-Hsin Hospital, Taipei, Taiwan, ROC
| | - Daniel L Clinciu
- Feng Chia University, National Taipei University of Nursing and Health Science, Taichung City, Taiwan, ROC
| | - Jyun-Yi Lee
- Cardiovascular Department, Mackay Memorial Hospital, Taipei City, Taiwan, ROC
| | - Hui-Chuan Huang
- Nursing Department, Cardinal Tien College of Healthcare & Management, Taipei, Taiwan, ROC
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Laisné F, Lecomte C, Corbière M. Biopsychosocial predictors of prognosis in musculoskeletal disorders: a systematic review of the literature (corrected and republished). Disabil Rehabil 2012; 34:1912-41. [DOI: 10.3109/09638288.2012.729362] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Stein-Parbury J, Gallagher R, Chenoweth L, Luscombe GM. Factors associated with good self-management in older adults with a schizophrenic disorder compared with older adults with physical illnesses. J Psychiatr Ment Health Nurs 2012; 19:146-53. [PMID: 22070648 DOI: 10.1111/j.1365-2850.2011.01767.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The number of older people living with a schizophrenic disorder (SD) is increasing yet little attention paid has been paid to the needs of this population relative to people with other chronic illnesses. In order to achieve optimal functioning people with a SD need to manage their illness and its impact; therefore, this study set out to determine the factors associated with self-management in this population. The illness management of people over 50 years of age and living with schizophrenia (n= 84) was compared with their peers who were diagnosed with a chronic physical illness (n= 216). Participants completed a survey that included an illness management inventory, self-rated health and sense of coherence. The results demonstrated that participants with a SD had lower illness management levels, particularly for understanding their symptoms and taking appropriate actions in relation to health care. Poor self-rated health and the presence of comorbid conditions had a pervasive negative effect on self-management factors in the SD group, whereas being married, having a greater sense of coherence and being voluntary to treatment had a positive effect. Nurses need to develop strategies to address general health and self-management in older adults living with a SD.
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Affiliation(s)
- J Stein-Parbury
- Faculty of Nursing, Midwifery and Health, University of Technology Sydney, Lindfield, Australia.
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Laisné F, Lecomte C, Corbière M. Biopsychosocial predictors of prognosis in musculoskeletal disorders: a systematic review of the literature. Disabil Rehabil 2011; 34:355-82. [DOI: 10.3109/09638288.2011.591889] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Söderhamn U, Dale B, Söderhamn O. Narrated lived experiences of self-care and health among rural-living older persons with a strong sense of coherence. Psychol Res Behav Manag 2011; 4:151-8. [PMID: 22241954 PMCID: PMC3255462 DOI: 10.2147/prbm.s27228] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Sense of coherence (SOC), with its components comprehensibility, manageability, and meaningfulness, is a major factor in the ability to cope successfully with stressors and is closely related to health. Qualitative studies related to SOC are scarce, and in this phenomenological interview study, self-care is investigated in relation to SOC. The aim of this study was to describe the lived experiences of self-care and features that may influence health and self-care among older home-dwelling individuals living in rural areas and who have a strong SOC. Eleven persons with a mean age of 73.5 years and a SOC value in the range of 153–188, measured by Antonovsky’s 29-item SOC scale, were interviewed. The interviews were recorded, transcribed verbatim, and analyzed with a phenomenological descriptive method. The findings showed that successful self-care involves having, when needed, contact with the health care system, being conscious of a sound lifestyle, being physically and mentally active, being engaged, having social contacts with family and/or others, and being satisfied and positive and looking forward. Formal and informal caregivers should be conscious of the importance of motivating and supporting older individuals with respect to these dimensions of self-care.
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Affiliation(s)
- Ulrika Söderhamn
- Faculty of Health and Sport Sciences, University of Agder, Centre for Caring Research - Southern Norway, Grimstad, Norway
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45
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Yoo H, Kim CJ, Jang Y, You MA. Self-efficacy associated with self-management behaviours and health status of South Koreans with chronic diseases. Int J Nurs Pract 2011; 17:599-606. [DOI: 10.1111/j.1440-172x.2011.01970.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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LeRouge C, Ma J, Sneha S, Tolle K. User profiles and personas in the design and development of consumer health technologies. Int J Med Inform 2011; 82:e251-68. [PMID: 21481635 DOI: 10.1016/j.ijmedinf.2011.03.006] [Citation(s) in RCA: 141] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2010] [Revised: 08/17/2010] [Accepted: 03/10/2011] [Indexed: 11/27/2022]
Abstract
BACKGROUND "The graying of the globe" has resulted in exponential rise in health care expenses, over-worked health care professionals and a growing patient base suffering from multiple chronic diseases, one of which is diabetes. Consumer health technologies (CHT) are considered important catalysts for empowering health care consumers to take a proactive role in managing their health and related costs. Adoption rate and usability of such devices among the aging is far from being satisfactory. Past studies noted the motivation for adoption by the aging is dependent on the suitability/relevance, perceived usability and anticipated benefits associated with usage of technological innovation. Traditional information technology (IT) development adopts a systematic approach without necessarily using a specific user model that personalizes the system to the aging user groups. The aging patient population has unique needs arising from progressive deterioration in both physiological and psychological abilities. These needs are often ignored in the design, development, trial and adoption of consumer health products resulting in low adoption and usage. OBJECTIVES The main objective of this research is to investigate the user-centered design (UCD), specifically user profiles and personas, as methodological tools to inform the design and development of CHT devices for an aging population. The adoption of user profile and persona has not received much attention in health care informatics research and, in particular, research involving CHT. Our work begins to fill this void in three ways. We (1) illuminate the process of developing CHT user profiles and personas for a Chinese elder population with a demanding health care needs, i.e., self-management of chronic diabetes, with the hope that the resulting profiles and personas may be used as foundational material for informing the design, development and evaluation of CHT in other similar contexts; (2) call attention to how to further enhance and complement traditional user profile and persona techniques for CHT design by integrating cognitive structures and present behavior that drive health care thinking, future behavior and demand; (3) show how the profiles and personas can be used to inform requirements, design and implementation decisions for a technology aimed at facilitating CHT adoption and diffusion for the elderly. METHODOLOGY To exemplify process and application, we use an action-research methodology, where user profiles and personas of an aging patient population were developed. The resultant profiles and personas were leveraged to improve the design, development and implementation plans of a smart phone application to assist chronically ill aging Chinese diabetic population capable of disease self-management. RESULTS The results from the study show that user profile and persona can be a valuable methodological approach in capturing the conceptual model of the aging and informing the design and development decisions of CHT. The demonstration of techniques used in this study can serve as a guideline to CHT developers in bringing conceptual user modeling into the design of software interfaces targeted for users with specific health care needs. Specifically, the study provides guidance on the creation and use of profiles and personas to tap into the conceptual models of the targeted elderly population reflecting their preferences, capabilities and attitudes towards using technology in self-management care in general and the smart phone diabetes management application in particular. Insight into the mental model of the aging group has been shown to inform later stages of UCD development (e.g., the creation of prototypes and usability testing) as well as implementation and adoption strategies. The World Health Organization (WHO) predicts that by 2025, 80% of all new cases of diabetes are expected to appear in the developing countries. In fact, the number of diabetic patients in China is estimated to rise to 42.3 million in 2030 from 20.8 million in 2000. Thus, we investigate the Chinese aging population in order to demonstrate the process of developing and using user profile and persona. We hope that the resultant conceptual model of the Chinese aging diabetic population can be used in future research to guide CHT designers interested in designing health care devices for this vulnerable user group.
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Affiliation(s)
- Cynthia LeRouge
- Decision Sciences/IT Management Department - John Cook School of Business, Joint Appointment Health Care Management and Policy - School of Public Health, Saint Louis University, 3674 Lindell Avenue, DS 459, Saint Louis, MO 63108, United States.
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Gallagher R, Warwick M, Chenoweth L, Stein-Parbury J, Milton-Wildey K. Medication knowledge, adherence and predictors among people with heart failure and chronic obstructive pulmonary disease. ACTA ACUST UNITED AC 2011. [DOI: 10.1111/j.1752-9824.2010.01077.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Martin F, Caramlau IO, Sutcliffe P, Martin S, Bayley J, Choudhry K. Self-management interventions for people living with HIV/AIDS. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2010. [DOI: 10.1002/14651858.cd008731] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Warwick M, Gallagher R, Chenoweth L, Stein-Parbury J. Self-management and symptom monitoring among older adults with chronic obstructive pulmonary disease. J Adv Nurs 2010; 66:784-93. [PMID: 20423366 DOI: 10.1111/j.1365-2648.2009.05238.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS To describe self-management, symptom monitoring and the associated influences among older adults with chronic obstructive pulmonary disease. BACKGROUND Optimal self-management and monitoring of key symptoms in patients with chronic obstructive pulmonary disease reduces dyspnoea and preventable hospitalizations. METHOD A prospective, descriptive survey design was used and data collected from patients with moderate severity chronic obstructive pulmonary disease during home interviews between April 2005 and June 2006. Predictors of self-management and symptom monitoring were determined by linear regression analyses. RESULTS Patients' (n = 78) mean age was 73.37 years (SD 7.52); 55.1% were male and 66.7% were married. Most (92.3%) had concurrent illnesses, and 48.7% had been admitted to hospital for chronic obstructive pulmonary disease in the past 6 months. Self-management was good to very good, with poorer self-management predicted by lower self-efficacy (beta = -0.21), a weaker sense of coherence (beta = -0.03), and no hospitalization in the past 6 months (beta = -05). Symptom monitoring was not ideal, with more than 20% of patients not monitoring any of the key symptoms. More frequent symptom monitoring occurred among participants who were married (beta = 5.14) and had more severe disease (beta = 0.79). CONCLUSION As self-management and symptom monitoring ensure better outcomes among patients with chronic obstructive pulmonary disease, health professionals should encourage these behaviours. Involving partners, promoting self-efficacy and understanding of sense of coherence are helpful in this process.
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Affiliation(s)
- Melannie Warwick
- Faculty of Nursing, Midwifery & Health University of Technology, Sydney, Australia
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Nahlén C, Saboonchi F. Coping, Sense of Coherence and the Dimensions of Affect in Patients with Chronic Heart Failure. Eur J Cardiovasc Nurs 2010; 9:118-25. [DOI: 10.1016/j.ejcnurse.2009.11.006] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2009] [Revised: 11/19/2009] [Accepted: 11/23/2009] [Indexed: 11/27/2022]
Affiliation(s)
- Catarina Nahlén
- Department of Cardiology Danderyd Hospital AB, S-182 88 Stockholm, Sweden
| | - Fredrik Saboonchi
- Sophiahemmet University College, Stockholm, Sweden
- Department of Clinical Sciences Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
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