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Samwiri Nkambule E, Msiska G. Chronic illness experience in the context of resource-limited settings: a concept analysis. Int J Qual Stud Health Well-being 2024; 19:2378912. [PMID: 39007854 PMCID: PMC11251436 DOI: 10.1080/17482631.2024.2378912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 07/08/2024] [Indexed: 07/16/2024] Open
Abstract
AIM This review describes the ways in which individuals experience chronic illnesses in resource-limited settings; to define the concept and understand its attributes, antecedents and consequences. METHODS A comprehensive analysis of the databases CINAHL, PubMed and Google Scholar was conducted. During literature search the following limits were applied: articles published in English with available full-text; articles that focused on living with chronic illness in adults from the patient's perspective. RESULTS The following three attributes of chronic illness experience were identified: transformational experience, acceptance and self-management. Prominent predisposing factors (antecedents) were: genetic inheritance, malnutrition and poverty, high levels of stress and unhealthy lifestyle. The most dominant consequences were as follows: impact on quality of life; self-management burden; burden to others and economic stressors. CONCLUSIONS The findings underscore the need for health-care professionals to understand the chronic illness experience in the context of resource-limited settings and its consequences. The greater insights into the concept of chronic illness experience in resource-limited settings will guide nurses to support people in the realities of chronic illness experience in resource-limited settings in developing countries. This knowledge can guide nurses in providing competent care to chronically ill individuals, including meeting their individual needs with such illnesses.
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Affiliation(s)
| | - Gladys Msiska
- School of Nursing, Kamuzu University of Health Sciences, Lilongwe, Malawi
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Kuang A, Xu C, Southern DA, Sandhu N, Quan H. Validated administrative data based ICD-10 algorithms for chronic conditions: A systematic review. JOURNAL OF EPIDEMIOLOGY AND POPULATION HEALTH 2024; 72:202744. [PMID: 38971056 DOI: 10.1016/j.jeph.2024.202744] [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: 04/19/2024] [Revised: 05/21/2024] [Accepted: 05/22/2024] [Indexed: 07/08/2024]
Abstract
OBJECTIVE This systematic review aimed to identify ICD-10 based validated algorithms for chronic conditions using health administrative data. METHODS A comprehensive systematic literature search using Ovid MEDLINE, Embase, PsycINFO, Web of Science and CINAHL was performed to identify studies, published between 1983 and May 2023, on validated algorithms for chronic conditions using administrative health data. Two reviewers independently screened titles and abstracts and reviewed full text of selected studies to complete data extraction. A third reviewer resolved conflicts arising at the screening or study selection stages. The primary outcome was validated studies of ICD-10 based algorithms with both sensitivity and PPV of ≥70 %. Studies with either sensitivity or PPV <70 % were included as secondary outcomes. RESULTS Overall, the search identified 1686 studies of which 54 met the inclusion criteria. Combining a previously published literature search, a total of 61 studies were included for data extraction. The study identified 40 chronic conditions with high validity and 22 conditions with moderate validity. The validated algorithms were based on administrative data from different countries including Canada, USA, Australia, Japan, France, South Korea, and Taiwan. The algorithms identified included several types of cancers, cardiovascular conditions, kidney diseases, gastrointestinal disorders, and peripheral vascular diseases, amongst others. CONCLUSION With ICD-10 prominently used across the world, this up-to-date systematic review can prove to be a helpful resource for research and surveillance initiatives using administrative health data for identifying chronic conditions.
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Affiliation(s)
- Angela Kuang
- Centre for Health Informatics, Cumming School of Medicine, University of Calgary, AB, Canada
| | - Claire Xu
- Centre for Health Informatics, Cumming School of Medicine, University of Calgary, AB, Canada
| | - Danielle A Southern
- Centre for Health Informatics, Cumming School of Medicine, University of Calgary, AB, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Namneet Sandhu
- Centre for Health Informatics, Cumming School of Medicine, University of Calgary, AB, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
| | - Hude Quan
- Centre for Health Informatics, Cumming School of Medicine, University of Calgary, AB, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Karcz K, Schwegler U, Schiffmann B, Finger ME. Risk factors and service gaps affecting a sustainable work: a qualitative multi-stakeholder analysis in the context of persons with acquired brain injury living in Switzerland. BMC Health Serv Res 2024; 24:753. [PMID: 38902701 PMCID: PMC11188514 DOI: 10.1186/s12913-024-11128-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 05/21/2024] [Indexed: 06/22/2024] Open
Abstract
INTRODUCTION Along with the social and economic challenges posed by an aging society, creating work conditions that allow persons to stay healthy and work into old age has become a major task of Western societies. Retaining employment after returning to work is particularly difficult for individuals with a disability, as evidenced by the high rate of premature labor market dropout. Individuals with acquired brain injury (ABI) exemplify this challenge, as it often impairs cognitive, technical, and interpersonal abilities that are crucial in today's labor market. To effectively support these individuals, vocational integration practitioners require comprehensive knowledge of risk factors for premature labor market dropout and effective strategies for sustainable work. OBJECTIVE This study aimed to identify perceived risk factors and related service gaps regarding sustainable work for people with ABI, as reported by affected individuals, employers, vocational integration professionals, and health professionals. METHODS Secondary data analysis. Data that was originally collected through seven focus groups and two interviews with persons with ABI, 15 interviews with employers, and 13 interviews with vocational integration and health professionals in the context of the project 'Sustainable employment' was re-analysed thematically. RESULTS Two major themes of risk factors were identified: (1) person-related factors (including the subthemes: post-ABI impairments; lack of understanding of post-ABI impairments; poor health management) and (2) environment-related factors (including the subthemes: challenges related to the service structure; insufficient knowledge and education about ABI; challenges at the workplace; difficulties in private life). While stakeholders noted the variety of the currently available services, they particularly pointed to the missing long-term monitoring and counseling services for persons with ABI following the initial return-to-work, reflecting a major challenge for sustainable work. An overarching gap related to the fragmentation of the service structure and the lack of case coordination along the working life. CONCLUSIONS Multiple stakeholders emphasized the importance of empowering individuals, ensuring easy access to professional support, and providing a suitable work environment to address key risk factors and facilitate sustainable work for individuals with ABI. Continuous coaching, long-term monitoring and counseling following return-to-work, were identified as potential strategies to achieve these goals.
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Affiliation(s)
- Katarzyna Karcz
- Swiss Paraplegic Research, Guido A. Zäch Strasse 4, Nottwil, 6207, Switzerland.
| | - Urban Schwegler
- Swiss Paraplegic Research, Guido A. Zäch Strasse 4, Nottwil, 6207, Switzerland
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Barbara Schiffmann
- Swiss Paraplegic Research, Guido A. Zäch Strasse 4, Nottwil, 6207, Switzerland
| | - Monika E Finger
- Swiss Paraplegic Research, Guido A. Zäch Strasse 4, Nottwil, 6207, Switzerland
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Crites S, Neto K, Lee M, Louie K, Boone S, Fitzpatrick B, Silva D, Carvalho do Nascimento P, Bakaa N, Macedo L. Experiences and perceptions of adults pre- and/or post-lumbar spine surgery: a meta-ethnography. Disabil Rehabil 2024; 46:2477-2495. [PMID: 37475154 DOI: 10.1080/09638288.2023.2233895] [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: 05/01/2022] [Accepted: 07/04/2023] [Indexed: 07/22/2023]
Abstract
STUDY DESIGN Qualitative meta-ethnography. Pre-registered with OSF:10.17605/OSF.IO/UTZE6. PURPOSE To understand the patient experience pre- and/or post-lumbar spine surgery. METHODS Literature search: A literature search was conducted in MEDLINE, EMBASE, EmCare and CINAHL from inception to October 17, 2022. Study selection criteria: Peer-reviewed qualitative or mixed-method studies of English text investigating the beliefs, perceptions, or experiences of adults (≥18 years old) pre- and/or post-lumbar spine surgery for degenerative, non-traumatic or non-infectious concerns. Data synthesis: The eMERGE meta-ethnography reporting guidelines were followed to create themes and subthemes from the original themes of the included studies. A quality appraisal was performed using the McMaster Quality Appraisal tool. RESULTS We included 18 studies and identified five themes that were separated into pre- and post-operative categories. The two pre-operative themes included [1]: the influence of physiotherapy interventions on patients' experiences, and [2] the importance of education/the power of communication, and the three post-operative themes included [1]: psychosocial coping [2], redefining oneself post-operatively, and [3] experience with the healthcare system. CONCLUSIONS These findings emphasize the complexity of the peri-operative experience for individuals undergoing lumbar spine surgery. Future research should focus on addressing psychosocial factors that may optimize patient experiences and recovery following LSS.
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Affiliation(s)
- Stephanie Crites
- Faculty of Health Sciences, School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Kajal Neto
- Faculty of Health Sciences, School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Meaghan Lee
- Faculty of Health Sciences, School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Kristen Louie
- Faculty of Health Sciences, School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Stephanie Boone
- Faculty of Health Sciences, School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Barrett Fitzpatrick
- Faculty of Health Sciences, School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Diego Silva
- Faculty of Health Sciences, School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada
| | | | - Nora Bakaa
- Faculty of Health Sciences, School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Luciana Macedo
- Faculty of Health Sciences, School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada
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Demirci PY, Yeşilot SB, Eskimez Z. The Influence of Loneliness and Anxiety Levels on MG-Specific Quality of Life in Patients with Myasthenia Gravis during the COVID-19 Pandemic. Int J Behav Med 2024; 31:414-421. [PMID: 37851275 DOI: 10.1007/s12529-023-10234-6] [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] [Accepted: 10/04/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND Myasthenia gravis (MG) is one of the most common autoimmune diseases and can occur at any age. The study aimed to evaluate the influence of loneliness and anxiety levels on MG-specific quality of life in patients with myasthenia gravis during the COVID-19. METHODS This was a cross sectional study and the population consisted of patients with MG throughout Turkey between August 1 and October 31, 2021. The study was completed with 149 patients who met the inclusion criteria and agreed to participate in the research. RESULTS The mean MG-specific quality of life score was 44.15 ± 13.77, the mean UCLA loneliness scale was 56.13 ± 11.55, and the mean Beck Anxiety Inventory score was 24.63 ± 13.78. There was a moderately positive linear relationship between the participants' MG-specific quality of life (r = 0.589; p < 0.001) and the Beck Anxiety Inventory, and there was a weak negative linear relationship with the UCLA loneliness scale (r = 0.323; p < 0.001). The variables affecting the MG-specific quality of life were the following: anxiety, loneliness, employment status, income level, symptom levels, and having another chronic disease; a multiple regression model was created with these variables, and it was observed that anxiety and loneliness affected participants' MG-specific quality of life. The variables in the model explained 52.9% of the MG-specific quality of life, and the model was statistically significant (p < 0.001). CONCLUSION The study determined that the participants had intense loneliness, moderate anxiety, and a moderate MG-specific quality of life. The participants' MG-specific quality of life has decreased as their anxiety has increased, and the participants' MG-specific quality of life has increased as their loneliness has increased.
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Affiliation(s)
- Pınar Yeşil Demirci
- Nursing Department, Faculty of Health Sciences, Cukurova University, Adana, Turkey.
| | | | - Zehra Eskimez
- Nursing Department, Faculty of Health Sciences, Cukurova University, Adana, Turkey
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Harazneh L, Malak MZ, Ayed A. Adolescents and type 1 diabetes: A grounded theory on adolescents' experiences of adaptation to type 1 diabetes. J Pediatr Nurs 2024; 76:e159-e166. [PMID: 38453544 DOI: 10.1016/j.pedn.2024.02.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 12/27/2023] [Accepted: 02/24/2024] [Indexed: 03/09/2024]
Abstract
PURPOSE Type 1 diabetes influences adolescents' health status and therapeutic management. Adaptation for adolescents with type 1 diabetes is considered a significant issue for this cohort group and is based on many factors, including availability of resources, and family and community support. Thus, this study aimed to explore Palestinian adolescents' experiences of adaptation to type 1 diabetes in the West Bank. DESIGN AND METHODS A qualitative grounded theory approach was adopted. The purposive sample consisted of fourteen adolescents aged from 12 to 18 years and diagnosed with type 1 diabetes. The data were collected using semi-structured and face-to-face individual interviews during the period from March to June 2023. A constant comparative method was used to analyze data. FINDINGS The core category had emerged with categories and subcategories. There were three categories and ten subcategories including difficulties in the management of type 1 diabetes, for example, "insulin injections, dietary management, and control of HbA1c levels", burdens of type1 diabetes, for example, "burden regarding follow-up treatment, the burden of interaction and communication, emotional burden, and economic burden", and fears and worries of unexpected future life, for example, "worries about disease complications, worries regarding social relationships, and worries about marriage and parenthood". CONCLUSION Adolescents diagnosed with type 1 diabetes suffer from difficult experiences influencing their adaptation to this disease. PRACTICE IMPLICATIONS Counseling programs concerning self-care management for those adolescents need to be developed in addition to support programs. Health education programs are needed to develop their adaptation and coping skills to these experiences.
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Affiliation(s)
- Lobna Harazneh
- Psychiatric and Mental Health Nursing, Faculty of Nursing, Arab American University, Jenin, Palestine
| | - Malakeh Z Malak
- Community Health Nursing, Faculty of Nursing, Al-Zaytoonah University of Jordan, Amman, Jordan.
| | - Ahmad Ayed
- Pediatric Health Nursing, Faculty of Nursing, Arab American University, Jenin, Palestine
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Graham T, Sooriah S, Chang YS, Hashimdeen S, Meydan T, Grocott P. Translating patient needs into medical device development: co-design of a photoprotection visor for Xeroderma Pigmentosum using qualitative interviews. Orphanet J Rare Dis 2024; 19:64. [PMID: 38351060 PMCID: PMC10865654 DOI: 10.1186/s13023-023-03002-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 12/19/2023] [Indexed: 02/16/2024] Open
Abstract
INTRODUCTION People with Xeroderma Pigmentosum (XP) have a heightened sensitivity to ultraviolet radiation (UVR) and are advised to wear photoprotective clothing including a visor covering the face and neck. Photoprotective visors are homemade and predominately worn by children with decreasing frequency as age increases. To improve upon the current design and efficacy we were tasked with developing a prototype visor to meet patients' needs. METHODS Adopting a codesign methodology, patients' experiences of wearing a visor and patient and carer views of emerging prototypes were explored during interviews. A thematic analysis was conducted in parallel with data collection and themes were interpreted into design cues; desirable attributes of a visor that would counteract the negative user experiences and meet the requirements described by patients and carers. The design cues guided the iterative development of prototypes by academic engineers. RESULTS Twenty-four interviews were conducted with patients and carers. Thematic analysis resulted in the following five themes: Being safe from UVR exposure; self-consciousness; temperature effects; acoustic difficulties; and material properties. The following design cues were developed from the themes respectively; materials and design with high UVR protection; ability to customise with own headwear; ventilation to reduce steaming up; acoustic functionality to enable hearing and speech; foldable, portable, and easy to put on and take off. CONCLUSIONS It is important to understand people's experiences of using medical devices to improve their safety, efficiency and user satisfaction. The user experience themes and design cues, informed the iterative development of low fidelity visor prototypes as part of a codesign process. These design cues and responses to the prototypes are guiding commercial manufacturing and regulatory approval. The visor can then be prescribed to patients, providing an equitable service of care.
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Affiliation(s)
- Tanya Graham
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Kings College London, James Clerk Maxwell Building, 57 Waterloo Road, London, SE1 8WA, UK.
| | - Sangeeta Sooriah
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Kings College London, James Clerk Maxwell Building, 57 Waterloo Road, London, SE1 8WA, UK
- Healthwatch Camden, 85-87 Bayham Street, London, NW1 0AG, UK
| | - Yan-Shing Chang
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Kings College London, James Clerk Maxwell Building, 57 Waterloo Road, London, SE1 8WA, UK
| | - Shaikh Hashimdeen
- University of Wales Trinity Saint David, Centre for Advanced Batch Manufacture (CBM), Waterfront, Innovation Quarter Campus, Heol Ynys, Kings Road, Swansea, SA1 8EW, UK
- Cardiff School of Engineering, Cardiff University, Queen's Buildings, The Parade, Cardiff, CF24 3AA, UK
| | - Turgut Meydan
- Cardiff School of Engineering, Cardiff University, Queen's Buildings, The Parade, Cardiff, CF24 3AA, UK
| | - Patricia Grocott
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Kings College London, James Clerk Maxwell Building, 57 Waterloo Road, London, SE1 8WA, UK
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Stacherl B, Sauzet O. Chronic disease onset and wellbeing development: longitudinal analysis and the role of healthcare access. Eur J Public Health 2024; 34:29-34. [PMID: 37802926 PMCID: PMC10843952 DOI: 10.1093/eurpub/ckad167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND Experiencing the onset of a chronic disease is a serious health event impacting living conditions and wellbeing. Investigating wellbeing development and its predictors is crucial to understand how individuals adapt to chronic illnesses. This study (i) analyzed the impact of a chronic disease on wellbeing development, and (ii) explored spatial healthcare access as potential moderating factor. METHODS Data were obtained from the German Socio-economic Panel, a nationally representative household survey. A prospective sample of 3847 individuals was identified for whom the onset of cancer, cardiopathy, diabetes or stroke was observed between 2008 and 2020. Mixed models using an interrupted time series approach were performed to identify immediate level changes and longitudinal trend changes in wellbeing (operationalized with health and life satisfaction) after disease onset. Further, spatial access to healthcare (operationalized by two-stage floating catchment area measures) as potential moderating factor was examined using interaction effects. RESULTS Chronic disease onset had an immediate negative level impact on health and life satisfaction. For health satisfaction, a negative pre-onset wellbeing trend was offset (but not reversed). A small positive trend was observed for life satisfaction after disease onset. Spatial access to healthcare was not associated with the magnitude of wellbeing reduction at onset. CONCLUSIONS Health and life satisfaction levels drop with the onset of a chronic disease with no recovery trend for health and little recovery for life satisfaction, implying persistently lower wellbeing levels after a chronic illness onset. Spatial access to healthcare does not affect the wellbeing change after disease onset.
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Affiliation(s)
- Barbara Stacherl
- Socio-economic Panel, German Institute for Economic Research (DIW Berlin), Berlin, Germany
| | - Odile Sauzet
- Department of Epidemiology and International Public Health, Bielefeld School of Public Health (BiSPH), Bielefeld University, Bielefeld, Germany
- Department of Business Administration and Economics, Bielefeld University, Bielefeld, Germany
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Code J. At the Heart of Resilience: Empowering Women's Agency in Navigating Cardiovascular Disease. CJC Open 2024; 6:473-484. [PMID: 38487058 PMCID: PMC10935683 DOI: 10.1016/j.cjco.2023.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 12/13/2023] [Indexed: 03/17/2024] Open
Abstract
Cardiovascular disease (CVD) is the leading cause of death among women globally, emphasizing the need for a healthcare approach that empowers women through agency. This review focuses on the critical role of women's agency in navigating CVD, integrating insights from various fields, including medicine, education, psychology, and sociology. The review highlights the shift toward patient-centred care, a framework in which women are recognized as key decision-makers, a crucial change given the historical underemphasis on women's health issues in medical practice. The diagnosis of CVD in women often involves emotional and psychological challenges. Unexpected diagnoses significantly disrupt perceived well-being, and prolonged diagnostic processes lead to professional skepticism and neglect of symptoms, resulting in delayed or inaccurate diagnoses and strained healthcare relationships. Effective management of CVD necessitates continuous self-management and a holistic approach to care, particularly for those with trauma who are at increased risk of cardiac incidents. Empowerment for women with CVD involves promoting self-confidence, autonomy, and active patient participation in healthcare. Implementing comprehensive care models is crucial for improving chronic CVD management, highlighting the need for healthcare systems that prioritize patient agency and empowerment. From the perspective of a woman with lived experience, this article examines the impact of CVD on women's agency throughout the diagnostic journey. By highlighting women's agency rather than particular behavioural changes, this review offers a comprehensive analysis that can shape policy, stimulate new research, and foster a more equitable, efficient, and empathetic healthcare system for women with CVD.
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Affiliation(s)
- Jillianne Code
- Woman with Lived Experience, Victoria, British Columbia, Canada
- HeartLife Foundation of Canada, Vancouver, British Columbia, Canada
- Faculty of Education, University of British Columbia, Vancouver, British Columbia, Canada
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Ambrosio L, Hislop-Lennie K, Serrano-Fuentes N, Driessens C, Portillo MC. Psychometric properties of the living with long term conditions scale in an English-speaking population living with long term conditions in the UK. BMJ Open 2024; 14:e077978. [PMID: 38199640 PMCID: PMC10806636 DOI: 10.1136/bmjopen-2023-077978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 12/12/2023] [Indexed: 01/12/2024] Open
Abstract
OBJECTIVE To present the psychometric properties of the living with long-term condition (LwLTCs) scale in an English-speaking population of people with different LTCs. DESIGN An observational and cross-sectional study, with retest was conducted. Psychometric properties including feasibility, internal consistency, confirmatory factor analysis, reproducibility and content validity were tested. SETTING The study took place across the UK via primary care surgeries and voluntary organisations, between December 2021 and June 2022. PARTICIPANTS The study included 577 patients living with different LTCs, as chronic obstructive pulmonary disease, arthritis, chronic heart failure, Parkinson's disease, chronic kidney disease and type 2 diabetes mellitus. Inclusion criteria included: (a) having been diagnosed with one or more of the conditions; (b) being able to read, understand and answer written questionnaires; (c) being fluent in English and (d) being able to provide written informed consent. Patients were involved in the design and pilot study of the scale. RESULTS A total sample of 577 people with an age range of 37-97 years (98±9.65) were recruited. Internal consistency of the total 26-item LwLTCs scale score was excellent (ordinal alpha=0.90) but confirmatory factor analysis showed better fit indices (Normed Fit Index=0.96; standardised root mean square residual=0.051; Goodness of Fit Index=0.98) for a 20-item LwLTCs scale. CONCLUSIONS A shorter version of the LwLTCs scale, with just 20 items and with excellent psychometric properties, is recommended. Having a short scale is key when considering the implementation of the scale in clinical practice to develop person-centred pathways and more comprehensive care plans.
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Affiliation(s)
- Leire Ambrosio
- School of Health Sciences, University of Southampton, Southampton, UK
- National Institute for Health and Care Research, Applied Research Collaboration Wessex, Southampton, UK
| | | | - Nestor Serrano-Fuentes
- School of Health Sciences, University of Southampton, Southampton, UK
- National Institute for Health and Care Research, Applied Research Collaboration Wessex, Southampton, UK
| | - Corine Driessens
- National Institute for Health and Care Research, Applied Research Collaboration Wessex, Southampton, UK
| | - Mari Carmen Portillo
- School of Health Sciences, University of Southampton, Southampton, UK
- National Institute for Health and Care Research, Applied Research Collaboration Wessex, Southampton, UK
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Miller D, Doering J. Process of Maintaining Self in Individuals Living With Systemic Sclerosis: A Grounded Theory Study of American Women. West J Nurs Res 2024; 46:26-35. [PMID: 37982345 DOI: 10.1177/01939459231214600] [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] [Indexed: 11/21/2023]
Abstract
BACKGROUND People with chronic illnesses may struggle to adapt psychologically to the illness experience and have feelings of identity loss, self-diminishment, and biographical disruption. This may limit people's ability to engage in optimal self-management. Systemic sclerosis is a debilitating, stigmatizing, and life-limiting progressive chronic illness with significant disfiguring effects. Little is known about the identity management process in people with disfiguring and debilitating conditions such as systemic sclerosis. PURPOSE The purpose of this study was to generate a grounded theory explicating the process of maintaining a sense of self in people living with systemic sclerosis. METHODS Fifteen women with systemic sclerosis were recruited to ensure representation of a range of illness duration and progression. Semi-structured interviews were conducted, transcribed, and analyzed using open, selective, and theoretical coding. RESULTS A basic social process of "maintaining self" was generated from the data that explained the women's experience of living with systemic sclerosis and how they tried to hold on to their identity. Three core categories were identified. Adapting to changes are the behaviors that participants struggled through to carry on with their everyday lives. Dismantling of self was a distressing internal process where participants lost their sense of self and purpose. Restoring self was a transformative process that allowed participants to rewrite and rebuild their biographies. CONCLUSIONS Findings suggest that the management of identity was important for understanding how people adapt to life with systemic sclerosis. This study can help nurses better understand how to support patients holistically with the management of systemic sclerosis.
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Moreels T, Cruyt E, De Baets S, Andries L, Arts-Tielemans M, Rodriguez-Bailon M, Bergström A, Boete K, Bormans I, Costa U, Declercq H, Dekelver S, Dekyvere V, Delooz E, Engels C, Helderweirt S, Jarrey M, Lenaerts A, Leyman A, Lim KH, Meynen L, Satink T, Schoenmakers F, Senn D, Slembrouck L, Van Meensel E, Vangenechten D, Van Paepeghem B, De Vriendt P, Van de Velde D. Self-Management Analysis in Chronic Conditions (SMACC) checklist: an international consensus-based tool to develop, compare and evaluate self-management support programmes. BMJ Open 2023; 13:e075676. [PMID: 38128945 DOI: 10.1136/bmjopen-2023-075676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVES The Self-Management Analysis in Chronic Conditions (SMACC) checklist was developed as a guidance tool to support the development, comparison and evaluation of self-management support programmes for persons with a chronic condition. The checklist was based on a previously performed concept analysis of self-management. The aim of this study was to validate its content using an international Delphi study and to deliver a final version. DESIGN A two-round Delphi study was conducted between October 2022 and January 2023. Using the researchers' networks, professionals with research or clinical expertise in self-management support and chronic conditions were recruited via online purposive snowball sampling. Participants were asked to score each item of the checklist (16 items total) on 3 content validity indicators: (1) clarity and comprehensibility, (2) relevance and importance and (3) degree of alignment with the overall goal of the checklist to promote adequate and comprehensive self-management support programmes. A consensus threshold of 75% agreement was used. The participants were also asked general questions about the checklist as a whole and were asked to provide feedback considering its refinement. RESULTS Fifty-four professionals with an average 14.5 years of experience participated in round 1, 48 with an average 12.5 years of experience participated in round 2. The majority of professionals were from Western Europe. For the majority of items consensus was reached after round 1. In round 2, 3 of the 4 remaining items reached consensus, 1 last item was retained based on highly recurring feedback. CONCLUSIONS The SMACC checklist was considered a valid and comprehensive tool to aid the development, evaluation and comparison of self-management support programmes. It was acknowledged as a useful instrument to supplement existing frameworks and was seen as feasible to implement in both research and clinical settings. Further validation in the field, with input from patients and peer experts, will be valuable.
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Affiliation(s)
- Timothy Moreels
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
- Department of Nephrology, Ghent University Hospital, Ghent, Belgium
| | - Ellen Cruyt
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Stijn De Baets
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
- Department of Gerontology and Frailty in Ageing Research Group, Vrije Universiteit Brussel, Brussel, Belgium
| | - Lore Andries
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Magelien Arts-Tielemans
- Department of Occupational Therapy, HAN University of Applied Science, Nijmegen, The Netherlands
| | | | - Aileen Bergström
- Karolinska Institutet Department of Neurobiology Care Sciences and Society, Stockholm, Sweden
| | - Kyara Boete
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Iris Bormans
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Ursula Costa
- Occupational Science, Health University of Applied Science Tyrol, Tyrol, Austria
| | - Hanne Declercq
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Sari Dekelver
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Virginie Dekyvere
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Eva Delooz
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Cynthia Engels
- Clinical Epidemiology and Ageing Unit, Université Paris Est Créteil (UPEC), Créteil, France
| | - Sam Helderweirt
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Mike Jarrey
- Occupational Therapy, Artevelde University College, Ghent, Belgium
| | - Anneleen Lenaerts
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Anneleen Leyman
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Kee Hean Lim
- Department of Health Sciences, St Mary's Hospital Medical School, London, UK
| | - Louise Meynen
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Ton Satink
- Department of Occupational Therapy, HAN University of Applied Science, Nijmegen, The Netherlands
| | | | - Daniela Senn
- Occupational Therapy, ZHAW School of Health Professions, Winterthur, Switzerland
| | - Lise Slembrouck
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Emma Van Meensel
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Dani Vangenechten
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | | | - Patricia De Vriendt
- Department of Gerontology and Frailty in Ageing Research Group, Vrije Universiteit Brussel, Brussel, Belgium
- Occupational Therapy, Artevelde University College, Ghent, Belgium
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Johnsson N, Strandberg S, Tuvesson H, Fagerström C, Ekstedt M, Lindberg C. Delineating and clarifying the concept of self-care monitoring: a concept analysis. Int J Qual Stud Health Well-being 2023; 18:2241231. [PMID: 37506372 PMCID: PMC10392281 DOI: 10.1080/17482631.2023.2241231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 07/22/2023] [Indexed: 07/30/2023] Open
Abstract
AIM To delineate and clarify the meaning of the concept of self-care monitoring from a patient perspective. METHODS A systematic search was performed in the databases ASSIA, CINAHL, PsycInfo, and PubMed (January 2016-September 2021). A selection of 46 peer-reviewed articles was included in the study and analysed using Rodgers' Evolutionary Method for Concept Analysis. RESULTS The following four attributes were identified: Tracking symptoms, signs, and actions, Paying attention, Being confident, and Needing routines, creating a descriptive definition: "Self-care monitoring is an activity that means a person has to pay attention and be confident and needs routines for tracking symptoms, signs, and action." The antecedents of the concept were shown to be Increased knowledge, Wish for independence, and Commitment. The concepts' consequences were identified as Increased interaction, Perceived burden, and Enhanced well-being. CONCLUSIONS This concept analysis provides extensive understanding of self-care monitoring from a patient perspective. It was shown that the concept occurs when a person practices self-care monitoring at home either with or without devices. A descriptive definition was constructed and presented with exemplars to encourage practice of the concept in various healthcare settings and could be of relevance to people with chronic illnesses or other long-term conditions.
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Affiliation(s)
- Natali Johnsson
- Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden
| | | | - Hanna Tuvesson
- Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden
| | - Cecilia Fagerström
- Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden
| | - Mirjam Ekstedt
- Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden
- Department of Learning, Informatics, Management, and Ethics, Karolinska Institutet, Stockholm, Sweden
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Brown O, Newton-John TRO. The influence of the significant other on treatment adherence in chronic pain management: a qualitative analysis. Psychol Health 2023; 38:1572-1586. [PMID: 35094627 DOI: 10.1080/08870446.2022.2032058] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 10/04/2021] [Accepted: 01/15/2022] [Indexed: 10/19/2022]
Abstract
Objectives. Adherence to treatment recommendations is critical for optimising quality of life for individuals with chronic pain, however adherence rates are low. This study explores the role that significant others are perceived to play in supporting or impeding treatment adherence, as well as examining patient views of the impact of their adherence regimes on their significant others.Design. 25 treatment seeking adults with chronic pain, who were currently living with a romantic partner or adult family member, took part in individual semi-structured interviews.Main outcome measures Interviews were transcribed verbatim and analysed using thematic analysis.Results. Three treatment adherence support themes emerged: social support (emotional, instrumental), positive social control, and supporting autonomy. Participants did not perceive significant others as having any negative influence on their adherence. By contrast, patients perceived that their adherence behaviors had both positive and negative effects on their significant others.Conclusions. These data present an encouraging perspective on the interpersonal context of coping with chronic pain. Significant others facilitated adherence in a range of ways. Future research identifying how best to integrate significant other support into patient self-management programs is needed, in order to lift the poor treatment adherence rates that are noted in the literature.
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Affiliation(s)
- Olivia Brown
- Graduate School of Health, University of Technology Sydney, Sydney, Australia
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15
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Sánchez E, Ciudin A, Sánchez A, Gutiérrez-Medina S, Valdés N, Flores L, Marí-Sanchis A, Goñi F, Sánchez M, Nicolau J, Muñoz C, Díaz-Trastoy O, Cuatrecasas G, Cañizares S, Comas M, López-Cano C, Lecube A. Assessment of obesity stigma and discrimination among Spanish subjects with a wide weight range: the OBESTIGMA study. Front Psychol 2023; 14:1209245. [PMID: 37799531 PMCID: PMC10548879 DOI: 10.3389/fpsyg.2023.1209245] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 09/04/2023] [Indexed: 10/07/2023] Open
Abstract
Introduction This study aims to assess the extent of rejection and instances of stigmatization linked to obesity within the Spanish population, encompassing a diverse spectrum of weights ranging from normal weight to morbid obesity. Additionally, the study seeks to identify the primary factors influencing these experiences and further examines the impact of bariatric surgery on such dynamics. Materials and methods Multicenter observational study with involving a total of 1,018 participants who were recruited from various Obesity Units. Negatives attitudes towards people with obesity were assessed through three questionnaires: (i) Antifat Attitudes Scale (AFA), (ii) Stigmatizing Situations Inventory (SSI) and (iii) Weight Bias Internalization Scale (WBIS). Subjects were categorized into four groups based on their BMI and history of prior bariatric surgery. Results The cumulative score across all questionnaires (AFA, SSI and WBIS) exhibited a progressive increase, from participants with normal weight to those with obesity (p < 0.001 for all). Within the AFA questionnaire, males showed more rejection towards people with obesity than women, also perceiving obesity as a disease linked to a lack of willpower (p = 0.004 and p = 0.030, respectively). The overall SSI score was negatively associated with age (r = -0.080, p = 0.011), with young participants encountering more stigmatizing experiences than their adult counterparts. Neither employment status nor educational demonstrated a significant association with any of the questionnaires. Interestingly, patients who underwent lost weight following bariatric surgery did not exhibit improved outcomes. Conclusion Individuals with obesity demonstrate a heightened level of aversion towards the disease compared to those with normal weight. Concurrently, the incidence of stigmatizing encounters displays a concerning escalation among younger individuals.
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Affiliation(s)
- Enric Sánchez
- Obesity Unit, Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova de Lleida, Obesity, Diabetes and Metabolism (ODIM) Research Group, IRBLleida, University of Lleida, Lleida, Spain
| | - Andreea Ciudin
- Obesity Unit, Endocrinology and Nutrition Department, Hospital Universitari Vall d’Hebrón, Vall d’Hebron Research Institute, Autonomous University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Ana Sánchez
- Obesity Unit, Endocrinology and Nutrition Department, Complejo Hospitalario Universitario de Ferrol, Ferrol, Spain
| | - Sonsoles Gutiérrez-Medina
- Obesity Unit, Endocrinology and Nutrition Department, Hospital Universitario Rey Juan Carlos, Madrid, Spain
| | - Nuria Valdés
- Obesity Unit, Endocrinology and Nutrition Department, Hospital Universitario de Cabueñes, Gijón, Spain
| | - Lilliam Flores
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Obesity Unit, Endocrinology and Nutrition Department, Hospital Clínic Barcelona, Barcelona, Spain
| | - Amelia Marí-Sanchis
- Obesity Unit, Endocrinology and Nutrition Department, Hospital Universitario de Navarra, Pamplona, Spain
| | - Fernando Goñi
- Obesity Unit, Endocrinology and Nutrition Department, Hospital Universitario de Basurto, Bilbao, Spain
| | - Marta Sánchez
- Obesity Unit, Endocrinology and Nutrition Department, Hospital Universitario Doctor Negrín, Las Palmas de Gran Canaria, Spain
| | - Joana Nicolau
- Obesity Unit, Endocrinology and Nutrition Department, Hospital Universitario Son Llàtzer, Palma, Spain
| | - Concepción Muñoz
- Obesity Unit, Endocrinology and Nutrition Department, Hospital Universitario Reina Sofia de Córdoba, Córdoba, Spain
| | - Olaia Díaz-Trastoy
- Obesity Unit, Endocrinology and Nutrition Department, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, Spain
| | - Guillem Cuatrecasas
- Obesity Unit, Endocrinology and Nutrition Department, Clínica Sagrada Familia-CPEN Barcelona, Health Science Department, UOC University, Barcelona, Spain
| | - Silvia Cañizares
- Obesity Unit, Psychiatry and Psycology Department, Hospital Clínic Barcelona, Barcelona, Spain
- Clinical Psycology and Psycobiology Department, Universitat de Barcelona, Barcelona, Spain
| | - Marta Comas
- Obesity Unit, Endocrinology and Nutrition Department, Hospital Universitari Vall d’Hebrón, Vall d’Hebron Research Institute, Autonomous University of Barcelona, Barcelona, Spain
| | - Carolina López-Cano
- Obesity Unit, Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova de Lleida, Obesity, Diabetes and Metabolism (ODIM) Research Group, IRBLleida, University of Lleida, Lleida, Spain
| | - Albert Lecube
- Obesity Unit, Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova de Lleida, Obesity, Diabetes and Metabolism (ODIM) Research Group, IRBLleida, University of Lleida, Lleida, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
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Rønne PF, Esbensen BA, Brødsgaard A, Biering-Sørensen B, Hansen CA. Patients' and Family Members' Experiences of a Novel Nurse-Led Intervention Using Family Conversations Targeting Families Afflicted by Chronic Non-Cancer Pain. J Pain Res 2023; 16:3029-3043. [PMID: 37693340 PMCID: PMC10492541 DOI: 10.2147/jpr.s412721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 08/01/2023] [Indexed: 09/12/2023] Open
Abstract
Purpose To explore patients' and family members' experiences of participating in an intervention using nurse-led family nursing conversations (NLFCs) targeting families affected by chronic non-cancer pain (CNCP), including the perceived impact of the intervention on the individual and the family. CNCP substantially impacts patients and families. Due to a lack of simple treatment solutions, the condition needs to be managed rather than cured. Family involvement seems a promising tool, but research evaluating specific approaches is limited. Interventions based on the family systems nursing framework by Wright and Leahey have been helpful in other populations. Nonetheless, the approach warrants further investigation and evaluation in patients with CNCP. Patients and Methods A phenomenological hermeneutical design was applied, and individual interviews were conducted with ten patients and ten family members who received the intervention. The analysis was inspired by Ricoeur's philosophy of text interpretation. Findings Three themes emerged during the analysis. "Taking part in the intervention while being affected by previous experiences" showed that patients and family members were affected by different experiences and burdens and therefore entered the intervention with varied starting points. "Being empowered through validation and understanding" showed that participants mainly viewed the intervention as beneficial, increasing patients' and family members' mutual understanding and underpinning acceptance of the chronic pain condition. "Being receptive to the intervention - mechanisms contributing to achieving benefit" identified contributing mechanisms influencing patients' and family members' experiences of the intervention. These mechanisms included confidence in the nurses' facilitation of the intervention, the timing of the intervention, the participant's level of acceptance, and readiness to engage in the intervention. Conclusion and Relevance to Clinical Practice The intervention was mainly experienced as helpful. Thus, healthcare settings treating CNCP should consider implementing NLFC in clinical practice with adjustments to meet the vulnerability of the CNCP population.
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Affiliation(s)
- Pernille Friis Rønne
- The Multidisciplinary Pain Center and Department of Anaesthesia, Pain and Respiratory Support, The Neuroscience Centre, Copenhagen University Hospital Rigshospitalet, Glostrup, Denmark
| | - Bente Appel Esbensen
- The University of Copenhagen, Department of Clinical Medicine, Faculty of Health and Medical Sciences, Copenhagen, Denmark
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Copenhagen University Hospital Rigshospitalet, Glostrup, Denmark
| | - Anne Brødsgaard
- Roskilde University, Department of People and Technology, Roskilde, Denmark
- Aarhus University, The Faculty of Health, Department of Public Health, Aarhus, Denmark
- Department of Paediatrics and Adolescent Medicine, and Department of Gynaecology and Obstetrics, Copenhagen University Hospital Amager Hvidovre, Hvidovre, Denmark
| | - Bo Biering-Sørensen
- Department of Neurology, The Neuroscience Centre, Copenhagen University Hospital Rigshospitalet, Glostrup, Denmark
| | - Carrinna Aviaja Hansen
- The University of Southern Denmark, the Faculty of Health Sciences, Department of Regional Health Research, Odense, Denmark
- Department of Orthopaedic Surgery, Zealand University Hospital, Koege, Denmark
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Ambrosio L, Morris J, Lambrick D, Faulkner J, Compton E, Portillo MC. Physical activity and mental health experiences of people living with long term conditions during COVID-19 pandemic: A qualitative study. PLoS One 2023; 18:e0285785. [PMID: 37428782 PMCID: PMC10332610 DOI: 10.1371/journal.pone.0285785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 05/01/2023] [Indexed: 07/12/2023] Open
Abstract
INTRODUCTION Regular physical activity is a strategy that is effective in the physical management of long term conditions. The COVID-19 pandemic, led to disruption of physical activity routines for many people with long term conditions. It is important, to understand the experiences of people with long term conditions regarding physical activity during COVID-19 to enable future identification of strategies to mitigate the impact of restrictions on health. OBJECTIVE To explore perceptions and experiences of people with long term conditions of the impact of the UK Government physical distancing restrictions on their physical activity participation during the COVID-19 pandemic. METHODS A qualitative study, with in depth videoconference semi-structured interviews were conducted between January and April 2022, with 26 adults living with at least one long term condition in the UK. Data were managed in analytical matrices within Excel and data analysis was conducted using thematic analysis. RESULTS Two main themes were developed, explaining how participants managed their physical activity during COVID19 lockdowns, and based on those experiences, what they considered should be in place should another lockdown occur:1) COVID-19 and physical activity: Losses, opportunities and adapting to new formats; and 2) Micro, meso, and macro contexts: creating the right conditions for physical activity support in future pandemics. CONCLUSIONS This study provides information on how people with long term conditions managed their condition during the COVID-19 pandemic and generates new understanding of how physical activity routines changed. These findings will be used to inform stakeholder engagement meetings with individuals with long term conditions and local, regional, and national policy makers, to co-produce recommendations that will help people living with long term conditions remain active during and after COVID-19 and other pandemics.
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Affiliation(s)
- Leire Ambrosio
- NIHR ARC Wessex, Health and Life Sciences, University of Southampton, Southampton, United Kingdom
| | - Jacqui Morris
- School of Health Sciences, University of Dundee, Dundee, United Kingdom
| | - Danielle Lambrick
- School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - James Faulkner
- Department of Sport, Exercise and Health, University of Winchester, United Kingdom
| | - Eric Compton
- Person with Long Term Conditions, Public and Patient Involvement, Southampton, United Kingdom
| | - Mari Carmen Portillo
- NIHR ARC Wessex, Health and Life Sciences, University of Southampton, Southampton, United Kingdom
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Ambrosio L, Hislop-Lennie K, Serrano-Fuentes N, Driessens C, Portillo MC. First validation study of the living with long term conditions scale (LwLTCs) among English-speaking population living with Parkinson's disease. Health Qual Life Outcomes 2023; 21:69. [PMID: 37430315 DOI: 10.1186/s12955-023-02154-6] [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: 10/11/2022] [Accepted: 06/26/2023] [Indexed: 07/12/2023] Open
Abstract
INTRODUCTION Parkinson's disease is the second most prevalent neurodegenerative disease, affecting 10 million people worldwide. Health and social care professionals need to have personalised tools to evaluate the process of living with Parkinson's disease and consequently, plan individualised and targeted interventions. Recently, the English version of the Living with Long term conditions (LwLTCs) scale has been developed filling an important gap related to person-centred tools to evaluate the process of living with long term conditions among English-speaking population. However, no validation studies for testing its psychometric properties have been conducted. AIM To analyse the psychometric properties of the LwLTCs scale in a wide English-speaking population living with Parkinson's disease. METHODS Validation study, with an observational and cross-sectional design. The sample was composed of individuals living with Parkinson's disease from non-NHS services in the community. Psychometric properties including feasibility and acceptability, internal consistency, reproducibility, and construct, internal and known-groups validity were tested. RESULTS A total sample of 241 people living with Parkinson's disease were included. 6 individuals did not complete 1 or 2 items on the scale. Ordinal alpha was 0.89 for the total scale. The intraclass correlation coefficient for the total scale was 0.88. The LwLTCs scale is strongly correlated with scales measuring satisfaction with life (rs=0.67), quality of life (rs=0.54), and moderately correlated with social support (rs=0.45). Statistically significant difference just for therapy and co-morbidity, yet no for gender, employment situation, or lifestyle changes. CONCLUSIONS The LwLTCs scale is a valid scale to evaluate how the person is living with Parkinson's disease. Future validation studies to prove the repeatability of the total scale and particularly, domains 3-Self-management, and 4-Integration and internal consistency will be needed. Developing further studies on the English version of the LwLTC in people with other long term conditions is also proposed.
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Affiliation(s)
- Leire Ambrosio
- School of Health Sciences and NIHR Applied Research Collaboration Wessex, University of Southampton, Hampshire, UK.
| | | | | | | | - Mari Carmen Portillo
- School of Health Sciences and NIHR Applied Research Collaboration Wessex, University of Southampton, Hampshire, UK
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Lai C, Ye Z, Shao J, Wu J, Zhao B, Fu Y, Xue E. Development and testing of the reliability and validity of a Chinese version of the Long-Term Conditions Questionnaire. Zhejiang Da Xue Xue Bao Yi Xue Ban 2023; 52:371-378. [PMID: 37476948 PMCID: PMC10409922 DOI: 10.3724/zdxbyxb-2023-0029] [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: 01/19/2023] [Accepted: 05/31/2023] [Indexed: 07/22/2023]
Abstract
OBJECTIVES To develop a Chinese version of the Long-Term Conditions Questionnaire (LTCQ) and to test its reliability and validity in Chinese patients with chronic diseases. METHODS With the consent of the original authors, a Chinese version of LTCQ was developed according to the cultural adjustment guidelines. A questionnaire survey was conducted on 319 patients with chronic diseases in Sir Run Run Shaw Hospital, Wuyi County First People's Hospital and Hangzhou Gongchen Bridge Street Health Service Center. The questionnaire was evaluated by item analysis (including frequency analysis, total question correlation method and critical ratio method), reliability analysis (Cronbach's alpha coefficient) and validity analysis [including content validity (expert scoring method) and structural validity (exploratory factor analysis)]. RESULTS The Chinese version of the LTCQ included 20 entries, with a Cronbach's alpha coefficient of 0.926, a retest reliability of 0.829, a split-half reliability of 0.878, an entry content validity index of 1, and a content validity index at the questionnaire level of 1. Four common factors were extracted by exploratory factor analysis, namely physical state and daily life, psychological state, support and coping, and safe environment, with a cumulative variance contribution rate of 67.244%. Discussion: The Chinese version of the LTCQ developed in this study has good reliability and validity and it may be used to assess the long-term conditions of patients with chronic diseases in China.
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Affiliation(s)
- Chuyang Lai
- Department of Nursing, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China.
| | - Zhihong Ye
- Department of Nursing, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China.
| | - Jing Shao
- Institute of Nursing Research, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Jingjie Wu
- Department of Nursing, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
| | - Binyu Zhao
- Institute of Nursing Research, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Yujia Fu
- Institute of Nursing Research, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Erxu Xue
- Department of Nursing, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
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Soilemezi D, Roberts HC, Navarta-Sánchez MV, Kunkel D, Ewings S, Reidy C, Portillo MC. Managing Parkinson's during the COVID-19 pandemic: Perspectives from people living with Parkinson's and health professionals. J Clin Nurs 2023; 32:1421-1432. [PMID: 35581711 PMCID: PMC9348155 DOI: 10.1111/jocn.16367] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 04/21/2022] [Accepted: 05/03/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The aim of this study was to understand how people living with Parkinson's and healthcare professionals perceived their care management and interactions with health services were affected during the COVID-19 pandemic. BACKGROUND During the COVID-19 pandemic, many governments introduced restrictions and services that support Parkinson's care management had to cease or be delivered remotely. These changes may have had an impact on the well-being of people living with Parkinson's. METHODS A qualitative exploratory UK study was carried out. Semi-structured individual interviews with people living with Parkinson's and health professionals were recorded, transcribed verbatim and analysed using Braun´s and Clarke´s thematic analysis. Eleven patients and 10 health professionals were recruited between April and September 2020. The study was reported using the COREQ. RESULTS Two main themes were identified. In the first theme, many patients and professionals reported that the COVID-19 pandemic made some people living with Parkinson's feel isolated and vulnerable due to disruptions to their social networks and usual activities related to Parkinson's disease care. However, other patients remained connected with their networks. In the second theme, patients and most professionals mentioned that some clinical practices were cancelled, delayed or transformed to remote consultation. CONCLUSION The COVID-19 restrictions had an impact on how people living with Parkinson's managed their care and in their interactions with healthcare services. Health professionals should assess the risk of vulnerability, social isolation, physical inactivity and confidence with remote consultations in people living with Parkinson's. This might inform a rethinking of existing clinical interactions with people living with Parkinson's towards a flexible, sustainable, person-centred care model. RELEVANCE TO CLINICAL PRACTICE This study has shown that Parkinson's care management and interactions with healthcare services should provide personalised and flexible support. To meet this challenge, the design of the organisation of health services should include greater involvement of patients and person-centred care models.
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Affiliation(s)
| | - Helen C Roberts
- Faculty of Medicine, University of Southampton, Southampton, UK
| | | | | | | | | | - Mari Carmen Portillo
- NIHR Applied Research Collaboration Wessex, School of Health Sciences, University of Southampton, Southampton, UK
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Umgang mit subjektiv erlebten Coronarisiken: Sichtweisen junger chronisch kranker Erwachsener. PRA¨VENTION UND GESUNDHEITSFO¨RDERUNG 2023. [PMCID: PMC10022562 DOI: 10.1007/s11553-023-01020-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
Abstract
Hintergrund Junge Erwachsene mit chronischen Erkrankungen gelten als Gruppe, die durch Corona gefährdet ist. Ob und wie die Betroffenen sich zu schützen versuchen, welche Risikowahrnehmungen sie verdeutlichen und wie der Lockdown erlebt wird, dazu mangelt es an Erkenntnissen primär im deutschen Sprachraum. Ziele und Fragestellung Im Beitrag wird analysiert, welches Coronaschutzverhalten junge chronisch kranke Erwachsene berichten, welche Risikowahrnehmungen sie aufweisen und wie sie den Lockdown erleben. Material und Methoden Mit n = 59 jungen Erwachsenen (häufig Studierende oder Auszubildende), die von Typ‑1-Diabetes (n = 16), Krebs (n = 18), chronisch-entzündlichen Darmerkrankungen (n = 21) oder von bestimmten seltenen, komplexen Erkrankungen (n = 4) betroffen sind, wurden episodische Interviews geführt. Die Datenauswertung erfolgt mittels thematischen Kodierens. Ergebnisse Wenige Befragte meinen, durch Corona kaum persönlich gefährdet zu sein, so dass auch Schutzmaßnahmen wie Impfungen sekundär sind. Die meisten Interviewten jedoch berücksichtigen Schutzmaßnahmen penibel. Sie können sich hierzu entweder verpflichtet fühlen, um z. B. andere vulnerable Personen zu schützen, oder sie erleben sich als sehr anfällig für schwere Coronainfektionen. Ungeachtet von erlebten Einschränkungen im Lockdown ist dieser für viele Interviewte auch mit neuen Möglichkeiten verbunden. Online-Formate erleichtern ihnen, Studium/Ausbildung trotz chronischer Erkrankung fortzusetzen und Kontakte mit Freund*innen zu halten. Schlussfolgerung Coronarisikowahrnehmungen und Schutzverhalten junger chronisch kranker Erwachsener sollten in ihrem subjektiven Sinn verstärkt in der Versorgung und Begleitung dieser Zielgruppen berücksichtigt werden. Hybride Lehre sollte über den Lockdown hinaus beibehalten werden, damit die jungen Erwachsenen trotz ihrer chronischen Erkrankung sozial teilhaben können und zugleich vor Corona- und weiteren Infektionen geschützt sind.
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Woelfel I, Faulkner D, Wong S, Washburn K, Schenk A. A “Return to Normalcy” or Establishing a “New Normal”: The Patient Experience of Liver Transplantation. JOURNAL OF LIVER TRANSPLANTATION 2023. [DOI: 10.1016/j.liver.2023.100149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/14/2023] Open
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Risotto-Urbanowicz E, Vega T, Caron R, Hasan R. "They were an advocate for me": A Qualitative Study Exploring Medical Student Longitudinal Relationships and Patient Well-Being. J Gen Intern Med 2023; 38:648-652. [PMID: 36085210 PMCID: PMC9971537 DOI: 10.1007/s11606-022-07773-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 08/17/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Patient navigators, community health workers, and care management teams improve patient experience and health outcomes. Medical student involvement in these roles is limited. Evaluation of these programs focuses on the student experience with less attention to patient participants. OBJECTIVES We sought (1) to understand the experience of being a participant in a medical education program; (2) to explore the patient-medical student relationship; and (3) to describe the impact of this relationship on patient health and well-being. DESIGN This was a qualitative study that utilized in-depth semi-structured interviews. PARTICIPANTS Participants were selected based on enrollment in a preceptorship program at an urban academic medical center between 2017 and 2020. Participants worked with a medical student during an 18-month period in which the medical student was embedded in a primary care medical home, serving as a health systems navigator for 1-2 medically and socially complex patients. APPROACH Nine participants completed 1-h compensated phone interviews. This study was deemed IRB exempt. KEY RESULTS Three themes and eight subthemes were identified, including Navigators Were Key to Accessing the System, Interpersonal Partnerships Improved Health, and Fulfillment in Teaching of Lived Experience. Navigators eased the burden of chronic illness by being a point of contact in the health system, which improved participants' overall experience. Participants also described the relationship as therapeutic, citing improvement and stability in both mental and physical health. Lastly, participants found meaning in chronic illness by teaching their students empathy. CONCLUSIONS Longitudinal patient-medical student relationships may provide stability and health benefits. These partnerships have the possibility of adding value to patients' healthcare experiences. This study complements current literature highlighting the value of these relationships for pre-clinical medical students. As such, additional opportunities for and additional research regarding the value of longitudinal patient connection should be incorporated in undergraduate medical education.
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Affiliation(s)
- Erin Risotto-Urbanowicz
- Department of General Surgery, University of New Mexico, Albuquerque, NM, USA.
- MSC10 5610, 1 University of New Mexico, Albuquerque, NM, 87131, USA.
| | - Taylor Vega
- Department of Anesthesiology, Brigham and Women's Hospital, Boston, MA, USA
| | - Rachel Caron
- Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Reem Hasan
- Department of Pediatrics and Internal Medicine, Oregon Health and Science University, Portland, OR, USA
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Rosenburg M, Fagerström C, Tuvesson H, Lindqvist G. Daily life after healing of a venous leg ulcer: A lifeworld phenomenological study. Int J Qual Stud Health Well-being 2022; 17:2054080. [PMID: 35306967 PMCID: PMC8942520 DOI: 10.1080/17482631.2022.2054080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Purpose Venous leg ulcer is a recognized condition, affecting people globally. Ulcers mainly affect the elderly and recurrences are not uncommon. There is knowledge about life with venous leg ulcers, but the situation after healing is unexplored. This paper explores and describes meanings of experiences of daily life after healing of a hard-to-heal venous leg ulcer. Methods Lived experiences of 15 individuals with healed hard-to-heal venous leg ulcers generated data for this study. Interviews were recorded for analysis using a reflective lifeworld research approach. An essence emerged, further described by its constituents. Results Memories of a difficult time with leg ulcer were ever present, in a way becoming part of the self. A striving for control in daily life entailed a struggle to do what was best for the own body. After healing, a new normal emerged in daily life, a reality that encompassed the risk for a new ulcer. The body had changed physically, with marks alongside those from ageing, in a life that still went on. Conclusions For those who had healed from a venous leg ulcer, life had changed. Even if they referred to life as normal, it was not the same normal as before.
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Affiliation(s)
- Marcus Rosenburg
- Faculty of Health and Life Sciences, Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
- School of Health and Welfare, Department of Health and Nursing, Halmstad University, Halmstad, Sweden
| | - Cecilia Fagerström
- Department of Research, Region Kalmar County, Sweden
- Faculty of Health and Life Sciences, Departement of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden
| | - Hanna Tuvesson
- Faculty of Health and Life Sciences, Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
| | - Gunilla Lindqvist
- Faculty of Health and Life Sciences, Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
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Müller R, Aghdassi AA, Kruse J, Lerch MM, Rach C, Simon P, Salloch S. Lived Experience of Hereditary Chronic Pancreatitis - A Qualitative Interview Study. Chronic Illn 2022; 18:818-833. [PMID: 34559012 PMCID: PMC9643816 DOI: 10.1177/17423953211039774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Hereditary chronic pancreatitis is a rare condition characterized by intermittent acute episodes of pancreatitis and long-term impairment of pancreatic functions. However, the subjective perspective of individuals affected by hereditary chronic pancreatitis has been little studied. This qualitative study investigates the experience of hereditary chronic pancreatitis patients and their relatives because the awareness of the needs of those affected is an essential component of a patient-centered management of chronic conditions. METHODS Semi-structured qualitative interviews were conducted with hereditary chronic pancreatitis patients and their relatives. Data were analysed using qualitative content analysis. The concepts of 'biographical contingency,' 'biographical disruption' and the 'shifting perspectives model' served as theoretical frameworks. RESULTS A total of 24 participants (17 patients, 7 relatives) were interviewed individually. Four main themes were identified: (1) The unpredictable clinical course of hereditary chronic pancreatitis; (2) hereditary chronic pancreatitis as a devastating experience; (3) hereditary chronic pancreatitis as part of a normal life; and (4) being reduced to hereditary chronic pancreatitis. DISCUSSION The 'shifting perspectives model' of chronic illness covers the four dimensions adequately and can serve as a theoretical model to explain hereditary chronic pancreatitis patients' experience. A better understanding of the patients and their families' experience and the shifting character of hereditary chronic pancreatitis can help healthcare professionals to tailor the care to meet the needs of those affected.
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Affiliation(s)
- Regina Müller
- Institute of Ethics and History of Medicine, University of Tuebingen, Tübingen, Germany.,Institute of Ethics and History of Medicine, 60634University Medicine Greifswald, Greifswald, Germany
| | - Ali A Aghdassi
- Department of Medicine A, 221223University Medicine Greifswald, Greifswald, Germany
| | - Judith Kruse
- Institute of Ethics and History of Medicine, 60634University Medicine Greifswald, Greifswald, Germany
| | - Markus M Lerch
- Department of Medicine A, 221223University Medicine Greifswald, Greifswald, Germany
| | - Christoph Rach
- Department of Psychiatry, Psychotherapy and Psychosomatics, 84491Agaplesion Markus Hospital, Frankfurt am Main, Germany
| | - Peter Simon
- Department of Medicine A, 221223University Medicine Greifswald, Greifswald, Germany
| | - Sabine Salloch
- Institute of Ethics, 88782History and Philosophy of Medicine, Hannover Medical School, Hannover, Germany
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Corchón S, Sánchez-Martínez V, Cauli O. Perceived mental health and emotional trajectories of long-term family caregivers of persons with mental conditions: A mixed-methods study. Arch Psychiatr Nurs 2022; 41:105-113. [PMID: 36428037 DOI: 10.1016/j.apnu.2022.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 06/10/2022] [Accepted: 07/03/2022] [Indexed: 11/02/2022]
Abstract
AIMS AND OBJECTIVES To explore the emotional experience and the perceived mental health of experienced family caregivers of people with mental disorders. BACKGROUND Family caregiving for individuals with mental disorders differs from other health conditions, as it implies a burden, deterioration in physical and mental health, stigma and a perceived lack of support from mental health services. METHODS A mixed-method study was undertaken with family caregivers of people diagnosed with mental disorders. RESULTS A total of 13 experienced family caregivers were included in the study. The qualitative data were classified into two major themes: emotions and perceived mental health. Emotions included five categories: irritability, painful emotions, pressure, emotions orientated towards coping, and positive emotions. The perceived mental health status embraced five categories: anxiety, burden and exhaustion, needing psychological or psychiatric treatment, insomnia and suicidal thoughts. An emotional path could be constructed from their discourses, starting with lack of control or irritation that evolved towards resignation, peace or satisfaction. The quantitative analysis partially replicated the qualitatively reported anxiety, depressive symptoms and insomnia. CONCLUSION Past and present emotions related to caregiving described by experienced family caregivers were identified. Their emotional trajectories converged in that negative emotions gave way to emotions towards coping, which in turn were followed by positive emotions. The participants' descriptions about their mental status were partially reflected through objective mental health measurements. RELEVANCE TO CLINICAL PRACTICE More support from mental health services could help caregivers to progress in their emotional trajectory towards coping, and improve their caregiving knowledge and skills. Mental health nurses have a role in patients and caregivers education and in the promotion of caregivers' psychological wellbeing.
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Affiliation(s)
- Silvia Corchón
- Department of Nursing, Faculty of Nursing and Chiropody, University of Valencia, Spain; Frailty and Cognitive Impairment Group (FROG), University of Valencia, Spain
| | - Vanessa Sánchez-Martínez
- Department of Nursing, Faculty of Nursing and Chiropody, University of Valencia, Spain; Frailty and Cognitive Impairment Group (FROG), University of Valencia, Spain.
| | - Omar Cauli
- Department of Nursing, Faculty of Nursing and Chiropody, University of Valencia, Spain; Frailty and Cognitive Impairment Group (FROG), University of Valencia, Spain
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The longitudinal association between patient empowerment and patient-reported outcomes: What is the direction of effect? PLoS One 2022; 17:e0277267. [DOI: 10.1371/journal.pone.0277267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 10/21/2022] [Indexed: 11/12/2022] Open
Abstract
Background
Theoretical literature and cross-sectional studies suggest empowerment is associated with other patient-reported outcomes (PROs). However, it is not known if patient empowerment is leading to improvements in other PROs or vice versa.
Aims
The present study aimed to examine the direction of effects between patient empowerment and PROs in young persons with congenital heart disease (CHD).
Methods
As part of the STEPSTONES-CHD trial, adolescents with CHD from seven pediatric cardiology centers in Sweden were included in a longitudinal observational study (n = 132). Data were collected when patients were 16 (T0), 17 (T1) and 18 ½ years old (T2). The Gothenburg Young Persons Empowerment Scale (GYPES) was used to measure patient empowerment. Random intercepts cross-lagged panel models between patient empowerment and PROs (communication skills; patient-reported health; quality of life; and transition readiness) were undertaken.
Results
We found a significant cross-lagged effect of transition readiness over patient empowerment between T1 and T2, signifying that a higher level of transition readiness predicted a higher level of patient empowerment. No other significant cross-lagged relationships were found.
Conclusion
Feeling confident before the transition to adult care is necessary before young persons with CHD can feel in control to manage their health and their lives. Clinicians interested in improving patient empowerment during the transitional period should consider targeting transition readiness.
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Sun L, Liu JE, Ji M, Wang Y, Chen S, Wang L. Coping with multiple chronic conditions among Chinese older couples: A community of shared destiny. Geriatr Nurs 2022; 48:214-223. [PMID: 36279804 DOI: 10.1016/j.gerinurse.2022.09.019] [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: 07/16/2022] [Revised: 09/29/2022] [Accepted: 09/30/2022] [Indexed: 12/14/2022]
Abstract
Multiple chronic conditions (MCCs) affect patients and their spouses. We explored the experience of Chinese older couples living with MCCs to gain deeper understanding of how they cope with MCCs as dyads. A qualitative research design using semi-structured in-depth interviews was conducted. Sixteen couples (≥60 years) were included and a thematic analysis was undertaken using NVivo software. Four themes under an overarching theme "A community of shared destiny" were identified: (i) various changes and impacts in normal life; (ii) perceived dynamic stress and dyadic challenges of MCCs; (iii) acceptance and reflection on MCCs influenced by aging and fatalism; (iv) mutual support and dyadic adjustment based on a shared destiny. Coping with MCCs was a dyadic and periodic journey for older couples. They perceived themselves as a community of shared destiny. Our findings are important for healthcare professionals to develop targeted interventions for older couples living with MCCs.
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Affiliation(s)
- Liu Sun
- School of Nursing, Capital Medical University, 10(#), Xitoutiao, You An Men Wai, Feng Tai District, Beijing 100069, China
| | - Jun-E Liu
- School of Nursing, Capital Medical University, 10(#), Xitoutiao, You An Men Wai, Feng Tai District, Beijing 100069, China.
| | - Meihua Ji
- School of Nursing, Capital Medical University, 10(#), Xitoutiao, You An Men Wai, Feng Tai District, Beijing 100069, China
| | - Yanling Wang
- School of Nursing, Capital Medical University, 10(#), Xitoutiao, You An Men Wai, Feng Tai District, Beijing 100069, China
| | - Shaohua Chen
- School of Nursing, Capital Medical University, 10(#), Xitoutiao, You An Men Wai, Feng Tai District, Beijing 100069, China
| | - Lingyun Wang
- Desheng Community Health Service Center, Capital Medical University, 34(#), De Wai street, Beijing, China
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Holmlund L, Hellström Ängerud K, Hörnsten Å, Valham F, Olsson K. Experiences of living with symptomatic atrial fibrillation. Nurs Open 2022; 10:1821-1829. [PMID: 36309946 PMCID: PMC9912440 DOI: 10.1002/nop2.1442] [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: 10/27/2021] [Revised: 08/23/2022] [Accepted: 10/07/2022] [Indexed: 11/07/2022] Open
Abstract
AIM To explore the experiences of living with symptomatic atrial fibrillation. DESIGN This study, with a descriptive qualitative design, was performed using semi-structured individual interviews. METHOD Six women and nine men with symptomatic atrial fibrillation were included. The transcribed interviews were analysed using qualitative content analysis. The COREQ checklist was followed. RESULTS The analysis resulted in a main theme, namely balancing life and included the themes striving for illness control, becoming a receiver or an active partner in care and dealing with changed self-image. The participants strived to understand their illness, prevent attacks and manage anxiety. Some of the participants were not involved in decision-making, were uninformed about self-care measures, reported a lack of continuity in care and felt that the doctors focused on information about the medical part of care.
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Affiliation(s)
| | | | | | - Fredrik Valham
- Department of Public Health and Clinical MedicineUmeå UniversityUmeåSweden
| | - Karin Olsson
- Department of Public Health and Clinical MedicineUmeå UniversityUmeåSweden
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Karcz K, Schiffmann B, Schwegler U, Staubli S, Finger ME. Facilitators and Barriers to Sustainable Employment After Spinal Cord Injury or Acquired Brain Injury: The Person's Perspective. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:872782. [PMID: 36188977 PMCID: PMC9397900 DOI: 10.3389/fresc.2022.872782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 06/13/2022] [Indexed: 11/13/2022]
Abstract
Background Sustaining employment after initial return to work represents a major challenge for people with a disability. While individuals with spinal cord injury (SCI) and acquired brain injury (ABI) make a prime example for this challenge, their view on factors supporting and hindering sustainable employment have rarely been investigated in depth so far. Purpose To examine facilitators and barriers to sustainable employment, as perceived by persons with SCI or ABI. Methods Fourteen focus groups and four individual interviews were conducted and thematically analyzed. Results Perceived facilitators and barriers to sustainable employment reflected the three biopsychosocial areas of personal, impairment-related and environmental factors. For both condition groups, key facilitators included environmental factors (i.e., aspects of the work organization, the workplace, supportive private and work environment) and personal factors (i.e., the ability to self-advocate, to communicate and to learn how to live with one's own disability). Major barriers comprised injury-related impairments, including decreased mobility and pain for people with SCI and fatigue and limited cognitive resources for persons with ABI, as well as environmental factors related to insurance procedures and the social security system for both conditions. Conclusions The biopsychosocial factors identified in our study as well as their interplay should receive particular attention to optimally support sustainable employment in vocational integration and work retention practice. Interventions should particularly focus on the empowerment of those affected as well as on the creation of supportive work environments that match their abilities and needs.
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Affiliation(s)
- Katarzyna Karcz
- Swiss Paraplegic Research, Nottwil, Switzerland
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | | | - Urban Schwegler
- Swiss Paraplegic Research, Nottwil, Switzerland
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | | | - Monika E Finger
- Swiss Paraplegic Research, Nottwil, Switzerland
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
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Levedahl KH, Nilsson A, Ungerstedt J, Hedström M. Living with systemic mastocytosis: Balancing between vulnerability and resilience: A qualitative study. Eur J Oncol Nurs 2022; 60:102172. [DOI: 10.1016/j.ejon.2022.102172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 06/23/2022] [Accepted: 07/03/2022] [Indexed: 01/10/2023]
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Westland H, Page SD, van Rijn M, Aryal S, Freedland KE, Lee C, Strömberg A, Vellone E, Wiebe DJ, Jaarsma T, Riegel B. Self-care management of bothersome symptoms as recommended by clinicians for patients with a chronic condition: A Delphi study. Heart Lung 2022; 56:40-49. [PMID: 35709644 DOI: 10.1016/j.hrtlng.2022.06.001] [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: 03/14/2022] [Revised: 05/27/2022] [Accepted: 06/02/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Chronically medically ill patients often need clinical assistance with symptom management, as well as self-care interventions that can help to reduce the impact of bothersome symptoms. Experienced clinicians can help to guide the development of more effective self-care interventions. OBJECTIVE To create a consensus-based list of common bothersome symptoms of chronic conditions and of self-care management behaviors recommended to patients by clinicians to reduce the impact of these symptoms. METHODS A two-round Delphi study was performed among an international panel of 47 clinicians using online surveys to identify common and bothersome symptoms and related self-care management behaviors recommended to patients with heart failure, chronic obstructive pulmonary disease, asthma, type 2 diabetes, or arthritis. RESULTS A total of 30 common bothersome symptoms and 158 self-care management behaviors across the five conditions were listed. Each chronic condition has its own bothersome symptoms and self-care management behaviors. Consensus was reached on the vast majority of recommended behaviors. CONCLUSIONS The list of common bothersome symptoms and self-care management behaviors reflect consensus across four countries on many points but also disagreement on others, and a few recommendations are inconsistent with current guidelines. Efforts to encourage clinicians to recommend effective self-care management behaviors may reduce symptom impact in chronically ill patient populations.
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Affiliation(s)
- Heleen Westland
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Stratenum 6.131, P.O. Box 85500, Utrecht, the Netherlands.
| | | | - Michelle van Rijn
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Stratenum 6.131, P.O. Box 85500, Utrecht, the Netherlands
| | - Subhash Aryal
- University of Pennsylvania, School of Nursing, Philadelphia, PA, USA
| | | | - Christopher Lee
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia; Boston College William F. Connell School of Nursing, Chestnut Hill, MA, USA
| | - Anna Strömberg
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia; Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden
| | | | | | - Tiny Jaarsma
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Stratenum 6.131, P.O. Box 85500, Utrecht, the Netherlands; Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia; Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden
| | - Barbara Riegel
- University of Pennsylvania, School of Nursing, Philadelphia, PA, USA; Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
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Fidder H, Jaski JJ, Elbertse E, van Loon AM, Monnier AA, de Boer ME, de Groot AJ. Parkinson rehabilitation in nursing homes: a qualitative exploration of the experiences of patients and caregivers. Eur Geriatr Med 2022; 13:1197-1210. [PMID: 35543902 PMCID: PMC9092320 DOI: 10.1007/s41999-022-00647-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 04/07/2022] [Indexed: 10/27/2022]
Abstract
PURPOSE Worldwide, an increasing number of people are diagnosed with atypical Parkinsonism or idiopathic Parkinson's disease (PD). Periods of acute functional decline, triggered by acute disease, are common. Rehabilitation is often necessary to restore functioning. Skilled nursing facilities (SNFs) in the Netherlands have developed evidence-based geriatric rehabilitation for Parkinson (GR-P) programs. However, data on the experiences and needs of patients and their caregivers are lacking. This study aims to address these, in order to propose recommendations for improvement. METHODS We performed a qualitative study, using semi-structured interviews in two Dutch SNFs offering GR-P. Nine patients with PD and six informal caregivers were included. We subjected verbatim transcripts of 15 interviews to qualitative analysis. RESULTS Data saturation was reached after 15 interviews. Three overarching themes emerged: (1) autonomy, (2) sharing information and (3) contact with others. Loss of autonomy was linked to the underlying disease and the rehabilitation environment itself. Patients and caregivers felt overwhelmed by events before and during rehabilitation, expressing a need to receive information and discuss prior experiences. They considered communication between hospitals and SNFs to be poor. Patients did not always appreciate contact with peers. Both patients and caregivers appreciated empathic healthcare personnel with a firm knowledge on PD. CONCLUSIONS Autonomy, sharing information and contact with others are central themes for patients and caregivers during GR-P in SNFs. We recommend actively exploring these three central themes with every patient and caregiver entering a GR-P program and offering staff continuing education on PD, in order to improve care.
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Affiliation(s)
- Hester Fidder
- Department of Medicine for Older People, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, The Netherlands. .,Amsterdam Public Health, Aging and Later Life, Amsterdam, The Netherlands.
| | - Joannina J Jaski
- Department of Medicine for Older People, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, The Netherlands.,Amsterdam Public Health, Aging and Later Life, Amsterdam, The Netherlands.,Beweging 3.0, Geriatric Rehabilitation Center De Pol, Nijkerk, The Netherlands
| | - Eskeline Elbertse
- Vivium Naarderheem Geriatric Rehabilitaton Center, Naarden, The Netherlands
| | - Anouk M van Loon
- Department of Medicine for Older People, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, The Netherlands.,Amsterdam Public Health, Aging and Later Life, Amsterdam, The Netherlands
| | - Annelie A Monnier
- Department of Medicine for Older People, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, The Netherlands.,Amsterdam Public Health, Aging and Later Life, Amsterdam, The Netherlands
| | - Marike E de Boer
- Department of Medicine for Older People, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, The Netherlands.,Amsterdam Public Health, Aging and Later Life, Amsterdam, The Netherlands
| | - Aafke J de Groot
- Department of Medicine for Older People, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, The Netherlands.,Amsterdam Public Health, Aging and Later Life, Amsterdam, The Netherlands.,Vivium Naarderheem Geriatric Rehabilitaton Center, Naarden, The Netherlands
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Hämel K, Röhnsch G, Heumann M, Backes DS, Toso BRGDO, Giovanella L. How do nurses support chronically ill clients' participation and self-management in primary care? A cross-country qualitative study. BMC PRIMARY CARE 2022; 23:85. [PMID: 35436847 PMCID: PMC9014774 DOI: 10.1186/s12875-022-01687-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 04/04/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND In the context of the advancement of person-centered care models, the promotion of the participation of patients with chronic illness and complex care needs in the management of their care (self-management) is increasingly seen as a responsibility of primary care nurses. It is emphasized that nurses should consider the psychosocial dimensions of chronic illness and the client's lifeworld. Little is known about how nurses shape this task in practice. METHODS The aim of this analysis is to examine how primary care nurses understand and shape the participation of patients with chronic illness and complex care needs regarding the promotion of self-management. Guided interviews were conducted with nurses practicing in primary care and key informants in Germany, Spain, and Brazil with a subsequent cross-case evaluation. Interpretive and practice patterns were identified based on Grounded Theory. RESULTS Two interpretive and practice patterns were identified: (1) Giving clients orientation in dealing with chronic diseases and (2) supporting the integration of illness in clients' everyday lives. Nurses in the first pattern consider it their most important task to provide guidance toward health-promoting behavior and disease-related decision-making by giving patients comprehensive information. Interview partners emphasize client autonomy, but rarely consider the limitations chronic disease imposes on patients' everyday lives. Alternatively, nurses in the second pattern regard clients as cooperation partners. They seek to familiarize themselves with their clients' social environments and habits to give recommendations for dealing with the disease that are as close to the client's lifeworld as possible. Nurses' recommendations seek to enable patients and their families to lead a largely 'normal life' despite chronic illness. While interview partners in Brazil or Spain point predominantly to clients' socio-economic disadvantages as a challenge to promoting client participation in primary health care, interview partners in Germany maintain that clients' high disease burden represents the chief barrier to self-management. CONCLUSIONS Nurses in practice should be sensitive to client's lifeworlds, as well as to challenges that arise as they attempt to strengthen clients' participation in care and self-management. Regular communication between clients, nurses, and further professionals should constitute a fundamental feature of person-centered primary care models.
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Affiliation(s)
- Kerstin Hämel
- Department of Health Services Research and Nursing Science, School of Public Health, Bielefeld University, Universitätsstraße 25, 33615, Bielefeld, Germany.
| | - Gundula Röhnsch
- Department of Health Services Research and Nursing Science, School of Public Health, Bielefeld University, Universitätsstraße 25, 33615, Bielefeld, Germany
- Qualitative Social and Education Research, Department of Education and Psychology, Free University of Berlin, Habelschwerdter Allee 45, Berlin, 14195, Germany
| | - Marcus Heumann
- Department of Health Services Research and Nursing Science, School of Public Health, Bielefeld University, Universitätsstraße 25, 33615, Bielefeld, Germany
| | - Dirce Stein Backes
- Franciscan University - UFN, Rua dos Andradas, 1614, Centro, Santa Maria, RS, CEP: 97010-030, Brazil
| | - Beatriz Rosana Gonçalves de Oliveira Toso
- Center of Biological and Health Sciences, Western Paraná State University - UNIOESTE, Rua Universitária, 1619, Jardim Universitário, Cascavel, PR, CEP 85819-110, Brazil
| | - Ligia Giovanella
- National School of Public Health, Fundação Oswaldo Cruz, Av Brasil 4036 s. 1001, Rio de Janeiro, RJ, CEP 21040-361, Brazil
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Lee DS, Lee S. The trajectory of the caring role in Korea: A grounded theory study of mothers of children with blood cancer. Eur J Oncol Nurs 2022; 58:102137. [DOI: 10.1016/j.ejon.2022.102137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 03/06/2022] [Accepted: 03/26/2022] [Indexed: 11/16/2022]
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Zhu LH, Ying QS, Yang M, Zhu LF, Chen HX. The Impact of Chronic Illness on the Patient Experience: Results From a Cross-Sectional Comparative Study in a Comprehensive Tertiary Hospital in China. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2022; 59:469580221090382. [PMID: 35543187 PMCID: PMC9102121 DOI: 10.1177/00469580221090382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 03/05/2022] [Accepted: 03/09/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Improving the satisfaction and medical experience of patients is a basic goal of the comprehensive reform of public hospitals in China. This study aimed to investigate the patient experience and its influencing factors, and to compare medical experiences between patients with and without chronic disease, with a view to providing suggestions for improving the quality of public hospitals in China. METHODS A cross-sectional comparative study involving 102 patients discharged from Taizhou Hospital of Zhejiang Province, a tertiary public hospital in China, was conducted. The patients were invited to participate in a survey comprising the Picker Patient Experience Questionnaire (PPE-15), and an overall satisfaction evaluation (on a scale of 1-10). The patients were divided into two groups according to whether or not they had a chronic disease, and the medical experience and overall satisfaction of the groups were compared. Descriptive statistics (frequency, median, mean), chi-square analysis, and Mann-Whitney U tests were used to analyze the data. RESULTS No statistical significance was found in overall satisfaction between patients with and without chronic diseases, but there were differences in the patient experience score. Chronic illness had negative impacts on the experience of care coordination for patients and respect for patient preferences. Of the seven dimensions of the PPE-15, the scores for emotional support and respect for patient preferences were the lowest in both groups, and the item "want to be more involved in decisions made about care and treatment" scored the lowest among all items. CONCLUSIONS Hospital managers and staff members should pay more attention to the emotional support and preferences of patients. For patients with chronic diseases, the standardization of medical care and patient participation in the medical process should be strengthened. Hospitals should also subdivide patient groups, ascertain the demands and expectations of patients, and carry out targeted evaluation and intervention measures.
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Affiliation(s)
- Lin-Hong Zhu
- Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, China
| | - Qian-Shan Ying
- Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, China
| | - Min Yang
- Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, China
| | - Ling-Feng Zhu
- Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, China
| | - Hai-Xiao Chen
- Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, China
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Welch L, Sadler E, Austin A, Rogers A. Social network participation towards enactment of self-care in people with chronic obstructive pulmonary disease: A qualitative meta-ethnography. Health Expect 2021; 24:1995-2012. [PMID: 34432927 PMCID: PMC8628589 DOI: 10.1111/hex.13340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 07/06/2021] [Accepted: 08/01/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND How people with chronic obstructive pulmonary disease (COPD) engage with supportive social networks to enhance self-care is not understood. The personal rationales for participation in socially directed support have not been addressed in the literature. To determine how people with COPD identify, engage and participate in socially supportive self-care practices, we conducted a systematic review and meta-ethnography of qualitative studies. METHODS A systematic literature search was conducted between June 2010 and June 2021. Of 3536 articles, 8 fulfilled the inclusion criteria. Using a meta-ethnography approach to the qualitative synthesis, new concepts were derived from the data to identify aligning themes and develop a conceptual model. FINDINGS Interpretations from the papers yielded concepts of (1) accountability and personal responsibility in self-care, (2) valued positive relationships with clinicians, (3) understanding of illness through shared and personal experiences and (4) acknowledging social networks in fostering self-care engagement in people with COPD. The independence-experience (Index) model of synthesized (third order) interpretations highlighted the processes of social networks and self-care practices: (a) fear or avoidance of dependency, (b) learning from experiences of adaptive self-care behaviours and (c) including valued practices in self-care. Self-care strategies are formed through illness experiences and relatable social encounters. CONCLUSION The model derived from the third-order interpretations is a framework to describe socially supported self-care and can be used to direct future self-care strategies and target interventions for people with COPD. PATIENT OR PUBLIC CONTRIBUTION The findings and model were presented to the long-term conditions patient and public involvement group. The manuscript is coauthored by a public representative.
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Affiliation(s)
| | - Euan Sadler
- School of Health Sciences, Faculty of Environmental and life sciencesUniversity of SouthamptonSouthamptonUK
| | - Anthony Austin
- Patient and Public Involvement Group Representative, Long Term Conditions PPI groupUniversity Hospital Southampton NHS Foundation TrustSouthamptonUK
| | - Anne Rogers
- School of Health Sciences, Faculty of Environmental and life sciencesUniversity of SouthamptonSouthamptonUK
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Rodriguez‐Blazquez C, Forjaz MJ, Ayala A, Portillo MC, Ambrosio L. Living with Chronic Illness Scale: International validation through the classic test theory and Rasch analysis among Spanish-speaking populations with long-term conditions. Health Expect 2021; 24:2065-2077. [PMID: 34492734 PMCID: PMC8628594 DOI: 10.1111/hex.13351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 06/11/2021] [Accepted: 07/26/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The Living with Chronic Illness (LW-CI) Scale is a comprehensive patient-reported outcome measure that evaluates the complex process of living with long-term conditions. OBJECTIVE This study aimed to analyse the psychometric properties of the LW-CI scale according to the classic test theory and the Rasch model among individuals living with different long-term conditions. DESIGN This was an observational, international and cross-sectional study. METHODS A total of 2753 people from six Spanish-speaking countries living with type 2 diabetes mellitus, chronic obstructive pulmonary disease, chronic heart failure, Parkinson's disease, hypertension and osteoarthritis were included. The acceptability, internal consistency and validity of the LW-CI scale were analysed using the classical test theory, and fit to the model, unidimensionality, person separation index, item local independency and differential item functioning were analysed using the Rasch model. RESULTS Cronbach's α for the LW-CI scale was .91, and correlation values for all domains of the LW-CI scale ranged from .62 to .68, except for Domain 1, which showed correlation coefficients less than .30. The LW-CI domains showed a good fit to the Rasch model, with unidimensionality, item local independency and moderate reliability providing scores in a true interval scale. Except for two items, the LW-CI scale was free from bias by long-term condition type. DISCUSSION After some adjustments, the LW-CI scale is a reliable and valid measure showing a good fit to the Rasch model and is ready for use in research and clinical practice. Future implementation studies are suggested. PATIENT AND PUBLIC CONTRIBUTION Patient and public involvement was conducted before this validation study - in the pilot study phase.
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Affiliation(s)
- Carmen Rodriguez‐Blazquez
- National Epidemiology Centre, Carlos III Institute of HealthMadridSpain
- Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED)MadridSpain
| | - Maria João Forjaz
- National Epidemiology Centre, Carlos III Institute of HealthMadridSpain
- Health Service Research Network on Chronic Diseases (REDISSEC)
| | - Alba Ayala
- Health Service Research Network on Chronic Diseases (REDISSEC)
- University Carlos III of MadridMadridSpain
| | - Mari Carmen Portillo
- School of Health Sciences, NIHR ARC WessexUniversity of SouthamptonSouthamptonUnited Kingdom
| | - Leire Ambrosio
- School of Health Sciences, NIHR ARC WessexUniversity of SouthamptonSouthamptonUnited Kingdom
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Due-Christensen M, Joensen LE, Sarre S, Romanczuk E, Wad JL, Forde R, Robert G, Willaing I, Forbes A. A co-design study to develop supportive interventions to improve psychological and social adaptation among adults with new-onset type 1 diabetes in Denmark and the UK. BMJ Open 2021; 11:e051430. [PMID: 34728449 PMCID: PMC8565545 DOI: 10.1136/bmjopen-2021-051430] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE To develop supportive interventions for adults with new-onset type 1 diabetes (T1D) to facilitate positive adaptive strategies during their transition into a life with diabetes. DESIGN The study used a co-design approach informed by Design Thinking to stimulate participants' reflections on their experiences of current care and generate ideas for new supportive interventions. Visual illustrations were used to depict support needs and challenges. Initial discussions of these needs and challenges were facilitated by researchers and people with diabetes in workshops. Data comprising transcribed audio recordings of the workshop discussions and materials generated during the workshops were analysed thematically. SETTINGS Specialised diabetes centres in Denmark and the United Kingdom. PARTICIPANTS Adults with new-onset T1D (n=24) and healthcare professionals (HCPs) (n=56) participated in six parallel workshops followed by four joint workshops with adults (n=29) and HCPs (n=24) together. RESULTS The common solution prioritised by both adults with new-onset T1D and HCP participants was the development of an integrated model of care addressing the psychological and social elements of the diagnosis, alongside information on diabetes self-management. Participants also indicated a need to develop the organisation, provision and content of care, along with the skills HCPs need to optimally deliver that care. The co-designed interventions included three visual conversation tools that could be used flexibly in the care of adults with new-onset T1D to support physical, psychological and social adaptation to T1D. CONCLUSION This co-design study has identified the care priorities for adults who develop T1D, along with some practical conversational tools that may help guide HCPs in attending to the disruptive experience of the diagnosis and support adults in adjusting into a life with diabetes.
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Affiliation(s)
- Mette Due-Christensen
- Health Promotion Research, Steno Diabetes Center Copenhagen, Gentofte, Denmark
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - Lene Eide Joensen
- Health Promotion Research, Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Sophie Sarre
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - Ewa Romanczuk
- Steno Diabetes Center Odense, Odense Universitetshospital, Odense, Denmark
| | - Julie Lindberg Wad
- Health Promotion Research, Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Rita Forde
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - Glenn Robert
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - Ingrid Willaing
- Health Promotion Research, Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Angus Forbes
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
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Jika BM, Khan HTA, Lawal M. Exploring experiences of family caregivers for older adults with chronic illness: A scoping review. Geriatr Nurs 2021; 42:1525-1532. [PMID: 34735999 DOI: 10.1016/j.gerinurse.2021.10.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 10/05/2021] [Accepted: 10/08/2021] [Indexed: 11/29/2022]
Abstract
A Scoping Review was conducted to explore key issues that underpin the experiences of family caregivers of older adults with chronic illness. The review aims to identify the gap in literature and synthesise evidence on this topic. Globally, family caregivers of older adults with chronic illness experience burden. Evidence suggests that family caregivers' needs are poorly understood and remain largely under recognised by healthcare services. Moreover, little is known about the experience of family caregivers caring for older adults with multiple chronic conditions. Data bases used included: (EBSCOhost, CINAHL, Science Direct, SCOPUS, MEDLINE, PubMed, ISI web of science and grey literature. 3352 records were identified, 58 full-text articles were assessed for eligibility, and 11 papers included in the literature review. Data are narratively synthesized. This review provides findings that suggest further research.
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Affiliation(s)
- Barbara Member Jika
- University of West London, College of Nursing, Midwifery and Healthcare, Paragon House, Boston Manor Road, Brentford TW8 9GB, UK.
| | - Hafiz T A Khan
- University of West London, College of Nursing, Midwifery and Healthcare, Paragon House, Boston Manor Road, Brentford TW8 9GB, UK
| | - Muili Lawal
- University of West London, College of Nursing, Midwifery and Healthcare, Paragon House, Boston Manor Road, Brentford TW8 9GB, UK
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Nick N, Torabizadeh C, Ghahartars M, Janghorban R. Adaptation of patients diagnosed with human papillomavirus: a grounded theory study. Reprod Health 2021; 18:213. [PMID: 34702304 PMCID: PMC8547285 DOI: 10.1186/s12978-021-01264-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 10/12/2021] [Indexed: 11/21/2022] Open
Abstract
Background Human papillomavirus is the most common cause of sexually transmitted diseases. Various studies report that positive human papillomavirus diagnosis results in psychosexual issues for the infected and reduces their quality of life. However, the adaptation of the infected has not been addressed yet. The present study aims to identify the process by which individuals infected with human papillomavirus adapt to their disease. Method This is a qualitative work of research with a grounded theory design. The setting of the study was the skin clinic of Shahid Faghihi Hospital in Shiraz. The participants consisted of 27 individuals: 18 patients, 3 doctors, 2 counselors, and 4 spouses of patients. The subjects were selected via purposeful and theoretical sampling method until data saturation was reached. Data were collected through face-to-face, in-depth, semi-structured interviews from April 2019 to December 2020. The collected data were analyzed using Corbin and Strauss’s method (2015) and MAXQDA 2018. Results The theory which emerged from the data was “trying to maintain resilience in the absence of psychological security.” Analysis of data showed the main concern of participants in adapting to their diagnosis with human papillomavirus was “life stress”. “Stigma and ignorance” was found to be a contextual condition and “paradox in support” was an intervening condition in the patients’ adaptation. The patients’ action/interaction responses to their main concern in the context in question were “emotional confrontation” and “maintaining resilience.” The outcome was “oscillation between tension and tranquility.” Conclusion The present study explains the process by which patients with human papillomavirus adapt to their condition. Identification of the concerns of patients with human papillomavirus and the factors which affect their adaptation can help healthcare policy-makers and providers develop effective support plans in order to increase patients’ quality of life. Early interventions, e.g. counseling care providers to modify their behaviors toward alleviating the psychosexual tension of the infected, can facilitate the adaptation of the infected and decrease the consequences of the infection for them. Graphical Abstract ![]()
Human papillomavirus (HPV) is the most common cause of sexually transmitted diseases. Almost all men and women get the infection at least once throughout their lives. The high-risk types of HPV account for about 5% of cancer cases globally. HPV can cause anogenital cancers and warts in both genders. In this grounded theory study, we conducted 27 in-depth interviews with Iranian patients, their spouses, and health care providers from April 2019 to December 2020. The collected data were analyzed using Corbin and Strauss’s method (2015) and MAXQDA 2018. The participants were concerned about tension in family relationships, being stigmatized, getting cancer, recurrence of warts, transferring their disease to others, and changes in the appearance of their genitalia. They stated that HPV is regarded as a shameful disease in society. Most of the participants said they had never heard anything about HPV. The patients’ action/interaction responses to their concerns were “emotional confrontation” and “maintaining resilience.” These strategies helped the patients recover some of their tranquility. However, some of patients’ concerns were persistent and kept them oscillating between tension and tranquility. An understanding of the patients’ perception of their disease is essential to development of effective educational interventions to change patients’ perspective on their situation and improve their recovery. Furthermore, because of the low level of public awareness about HPV and sexual health and the flow of misinformation to the infected, it is recommended that educational interventions focus on the patients’ concerns.
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Affiliation(s)
- Narjes Nick
- Department of Nursing, School of Nursing and Midwifery, Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Camellia Torabizadeh
- Department of Nursing, School of Nursing and Midwifery, Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehdi Ghahartars
- Molecular Dermatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Roksana Janghorban
- Department of Midwifery, School of Nursing and Midwifery, Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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The Determinants of Living with Long-Term Conditions: An International Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910381. [PMID: 34639681 PMCID: PMC8508439 DOI: 10.3390/ijerph181910381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 09/26/2021] [Accepted: 09/29/2021] [Indexed: 11/17/2022]
Abstract
It is essential that healthcare and social professionals understand the daily lives of people with chronic diseases, and the variables that influence them. The aim of this study was to identify the determinants influencing the process of living with long-term conditions. To investigate this, an observational, international, cross-sectional study was carried out. A consecutive sample of 1788 Spanish-speaking population living with chronic obstructive pulmonary disease, chronic heart failure and type 2 diabetes mellitus were included. Descriptive statistics and multiple linear regression models were performed. The linear regression models identified that social support (β = 0.39, p < 0.001) and the satisfaction with life (β = 0.37, p < 0.001) were the main determinants in the process of living with a long-term condition (49% of the variance). Age (β = -0.08, p = 0.01) and disease duration (β = 0.07, p = 0.01) were determinants only in the chronic heart failure subgroup, and country was significant in the chronic obstructive pulmonary disease subgroup (β = -0.15, p = 0.002). Satisfaction with life and social support were key determinants influencing the process of living with long-term conditions. As such, those aspects should be included in the design of interventions focused on the achievement of a positive living in people with long-term conditions.
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Marín-Maicas P, Corchón S, Ambrosio L, Portillo MC. Living with Long Term Conditions from the Perspective of Family Caregivers. A Scoping Review and Narrative Synthesis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7294. [PMID: 34299745 PMCID: PMC8305191 DOI: 10.3390/ijerph18147294] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/05/2021] [Accepted: 07/06/2021] [Indexed: 12/20/2022]
Abstract
(1) Background: When living with one or more long term conditions (LTCs), both the patient and the family experience the impact of the condition at different levels. The family's needs and perceptions should be considered in the process of caring for people with LTCs. The aim of this review is to understand "the process of living with LTCs" from a family perspective. (2) Methods: A scoping review and narrative synthesis were conducted using a systematic methodology in MEDLINE, CINAHL, Web of Science and PsycINFO, in English and Spanish, including evidence from 2018. (3) Results: A total of 28 articles were included in the review. Acceptance, coping, self-management, integration, and adjustment were key attributes in the process of living with LTCs from the perspective of family caregivers that interrelated in a dynamic way through different mechanisms: being aware of the changing situation, personal networks, information and education, personal conditions, attitude to life and communication. (4) Conclusions: The five attributes that comprise living with LTCs from the perspective of the family caregiver are closely connected of to those of patients living with LTCs; however, self-management and integration have a different meaning and application.
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Affiliation(s)
| | - Silvia Corchón
- Faculty of Nursing and Chiropody, University of Valencia, 46010 Valencia, Spain
| | - Leire Ambrosio
- NIHR ARC Wessex, School of Health Sciences, University of Southampton, Southampton SO17 1BJ, UK; (L.A.); (M.C.P.)
| | - Mari Carmen Portillo
- NIHR ARC Wessex, School of Health Sciences, University of Southampton, Southampton SO17 1BJ, UK; (L.A.); (M.C.P.)
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Ambrosio L, Navarta-Sánchez MV, Portillo MC, Martin-Lanas R, Recio M, Riverol M. Psychosocial Adjustment to Illness Scale in family caregivers of patients with Parkinson's Disease: Spanish validation study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:1030-1040. [PMID: 32783306 DOI: 10.1111/hsc.13137] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 07/17/2020] [Accepted: 07/21/2020] [Indexed: 06/11/2023]
Abstract
Psychosocial adjustment to a complex and disabling long-term condition like Parkinson´s disease is a complex, dynamic, cyclical and interactive process. Family caregivers, face multiple challenges that require a significant effort in terms of psychosocial adjustment, which must be considered by healthcare professionals in order to provide a holistic care. The patients' self-report version of the Psychosocial Adjustment to Illness Scale (PAIS-SR), which has been validated in Spain for use in Parkinson's disease, is designed to evaluate the psychosocial adjustment of patients. Our purpose was to validate the Spanish PAIS-SR version for caregivers of patients with Parkinson's disease. An open, national cross-sectional study with one point-in-time evaluation and retest was carried out in 450 family caregivers of patients with Parkinson's disease. Data were collected in Spain from April 2016 to September 2017. The psychometric analysis performed showed that the Spanish version of the PAIS-SR for caregivers presents adequate indicators of reliability, internal and external validity, and is structured according to the seven-domain model proposed by the author of the instrument.
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Affiliation(s)
- Leire Ambrosio
- Faculty of Nursing, University of Navarra, Pamplona, Spain
| | | | | | - Raquel Martin-Lanas
- Department of Psychiatry and Clinical Psychology, Clínica Universidad de Navarra, Pamplona, Spain
| | - Miriam Recio
- Department of Neurology, Clínica Universidad de Navarra, Pamplona, Spain
| | - Mario Riverol
- Department of Neurology, Clínica Universidad de Navarra, Pamplona, Spain
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Sematlane NP, Knight L, Masquillier C, Wouters E. Adapting to, integrating and self-managing HIV as a chronic illness: a scoping review protocol. BMJ Open 2021; 11:e047870. [PMID: 34162650 PMCID: PMC8231044 DOI: 10.1136/bmjopen-2020-047870] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 05/27/2021] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION The process of adapting to a life with a chronic illness, is a well-researched phenomenon for a number of common chronic illnesses. The construct, adaptation, embeds the notions of integration of the chronic illness into identity and self-management. Integration precedes self-management and is key to living positively with a chronic illness. Adaptation is an important concept in understanding trajectory and outcomes of living with a chronic illness. Applicability of these concepts to HIV as a chronic illness; when suppressive adherence has been achieved, however, is unknown. Specifically, the adaptation process to living with HIV as a chronic illness, the integration of HIV into identity and the resulting self-management behaviours by adults living with HIV are relatively unexplored. We describe a protocol for a scoping review of adaptation to living with HIV, we structure the enquiry around integration of HIV into identity and self-management and interrogate theories, models and frameworks that have been proposed and studied and we evaluate them for relevance and usefulness in the care and management of HIV. METHODS AND ANALYSIS Methods proposed by the Johanna Briggs Institute will be followed. The protocol was drafted using the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for Scoping Reviews and was registered with the Open Science Framework. MEDLINE, SCOPUS, Cochrane Library, CINHAL and SocINDEX databases will be searched. A search in Social Science Research Network eLibrary and Open Access Theses and Dissertations will gather grey literature and reference lists of included sources will be screened. Study selection process will involve a title and abstract review and full text review, guided by clearly defined inclusion and exclusion criteria. ETHICS AND DISSEMINATION Ethical approval is not required because this is a proposed review and collection of data on publicly available materials. The results will be published in a topic relevant journal and presented at related scientific events.
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Affiliation(s)
- Neo Phyllis Sematlane
- School of Public Health, University of the Western Cape Faculty of Community and Health Sciences, Bellville, South Africa
| | - Lucia Knight
- School of Public Health, University of the Western Cape Faculty of Community and Health Sciences, Bellville, South Africa
- Division of Social and Bahavioural Sciences, School of Public Health and Family Medicine, University of Cape Town, Rondebosch, South Africa
| | - Caroline Masquillier
- Centre for Population, Family & Health, Department of Sociology, Faculty of Social Sciences, University of Antwerp, Antwerp, Belgium
| | - Edwin Wouters
- Centre for Population, Family & Health, Department of Sociology, Faculty of Social Sciences, University of Antwerp, Antwerp, Belgium
- Centre for Health Systems Research & Development, University of the Free State, Bloemfontein, South Africa
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Lopes GSG, Rolim ILTP, Alves RDS, Pessoa TRRF, Maia ER, Lopes MDSV, Morais APP, Queiroz RCDS. Social representations on diabetic foot: contributions to PHC in the Brazilian Northeast. CIENCIA & SAUDE COLETIVA 2021; 26:1793-1803. [PMID: 34076120 DOI: 10.1590/1413-81232021265.04702021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 02/28/2021] [Indexed: 01/13/2023] Open
Abstract
This study aimed to identify the structuring elements guiding the establishment of the social representations of diabetic foot among people with diabetes mellitus. This qualitative study is based on the Social Representations Theory and was conducted in a capital of the Brazilian Northeast. The free word association test and a roadmap were used to characterize the sociodemographic and clinical profile to collect data. The analysis was performed using openEVOC software. The constituent elements of the diabetic foot's social representation "cure" and "really bad", revealing that living with a diabetic foot is challenging, but there is hope for a cure, which is a driving force in the daily search for care. The "prevention" element emerged in the representational field, denoting a more critical view and a capacity to transform the identified core elements. We found that the representational structure is based on subjective, valuating, and attitudinal contents. This knowledge can contribute to the design of interventions in the provision of care and diabetic foot screening in PHC services.
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Affiliation(s)
- Geysa Santos Góis Lopes
- Rede Sarah de Hospitais do Aparelho Locomotor. Avenida Governador Luiz Rocha s/n, Liberdade 65035-270 São Luís MA Brasil.
| | | | - Renata de Sousa Alves
- Departamento de Análises Clínicas e Toxicológicas, Universidade Federal do Ceará. Fortaleza CE Brasil
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Meneses Monroy A, Rodríguez-Blázquez C, Ursúa ME, Caparrós N, Ruiz de Ocenda MI, López L, Caro J, Elizondo N, Ambrosio L. [Validation of the living with osteoarthritis in Spanish population]. Aten Primaria 2021; 53:102044. [PMID: 33836404 PMCID: PMC8056235 DOI: 10.1016/j.aprim.2021.102044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 10/27/2020] [Accepted: 01/07/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Present the psychometric results of the Living with Osteoarthritis (LW-OA) in Spanish population. DESIGN Observational, cross-sectional and multicenter study, with retest on a fraction of the sample. LOCATION Public and private centres of primary and secondary healthcare, as well as patient associations from Navarra, La Rioja, Madrid, Valencia and Malaga. PARTICIPANTS The sample was composed by 291 patients with OA with a medical diagnosis in every stage of the disease from primary or secondary healthcare, Spanish nationality and not hospitalized. INTERVENTIONS In addition to LW-OA, a sociodemographic questionnaire was included, as well as scales to evaluate social support perceived from the patient (DUFSS), quality of life (WHOQOL-BREF) and satisfaction with life. MAIN MEASUREMENTS Psychometric properties of the LW-OA were measured, as viability and acceptability, reliability (internal consistency and reproducibility), precision and construct validity (convergent, internal and known-groups). RESULTS 100% of the data were computable. Excellent data quality was obtained. Cronbach's alpha for the scale total was 0.87 and the homogeneity index 0.22. ICC for the scale total was 0.88. As for precision, the SEM was 5.18 (<½DE=7.47). CONCLUSIONS The LW-OA is a valid and feasible measure to evaluate the process of living with OA in Spain.
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Affiliation(s)
- Alfonso Meneses Monroy
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, España
| | | | - María Eugenia Ursúa
- Centro de Salud San Juan, Servicio Navarro de Salud, Pamplona, Navarra, España
| | - Neus Caparrós
- Departamento de Derecho, Universidad de La Rioja, La Rioja, Logroño, España
| | | | | | - Jorge Caro
- Servicio Andaluz de Salud, Distrito Sanitario Málaga-Valle del Guadalhorce, Málaga, España
| | - Nerea Elizondo
- Complejo Hospitalario de Navarra, Servicio Navarro de Salud, Pamplona, Navarra, España
| | - Leire Ambrosio
- NIHR Applied Research Collaboration Wessex, School of Health Sciences, University of Southampton, Southampton, Reino Unido.
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Caro-Bautista J, Rodríguez-Blázquez C, Perez-Manchon D, Timonet-Andreu E, Carvajal-Carrascal G, Fuentes-Ramírez A, Corchon S, Aranda-Gallardo M, Ambrosio L. Validation of living with chronic illness scale in a type 2 diabetes mellitus population. Health Qual Life Outcomes 2021; 19:93. [PMID: 33731142 PMCID: PMC7972215 DOI: 10.1186/s12955-021-01715-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 02/23/2021] [Indexed: 12/14/2022] Open
Abstract
Background Worldwide, type 2 diabetes mellitus (T2DM) is one of the most prevalent chronic diseases and one of those producing greatest impact on patients’ day-to-day quality of life. Our study aim is to validate the “Living with Chronic Illness Scale” for a Spanish-speaking T2DM population. Methods In this observational, international, cross-sectional study, 582 persons with T2DM were recruited in primary care and outpatient hospital consultations, in Spain and Colombia, during the period from May 2018 to June 2019. The properties analysed were feasibility/acceptability, internal consistency, reliability, precision and (structural) content-construct validity including confirmatory factor analysis. The COSMIN checklist was used to assess the methodological/psychometric quality of the instrument. Results The scale had an adequate internal consistency and test retest reliability (Cronbach’s alpha = 0.90; intraclass correlation coefficient = 0.96, respectively). In addition, the instrument is precise (standard error of measurement = 3.34, with values < ½SD = 8.52) and correlates positively with social support (DUFSS) (rs = 0.56), quality of life (WHOQOL-BREF) (rs = 0.51–0.30) and ssatisfaction with life (SLS-6) (rs = 0.50–0.38). The original 26-items version of the scale did not support totally the confirmatory factor analysis. The COSMIN checklist is favourable for all the properties analysed, although weaknesses are detected for structural validity. Conclusions The LW-CI-T2DM is a valid, reliable and accurate instrument for use in clinical practice to determine how a person’s life is affected by the presence of diabetes. This instrument correlates well with the associated constructs of social support, quality of life and satisfaction. Additional research is needed to determine how well the questionnaire structure performs when robust factor analysis methods are applied. Supplementary Information The online version contains supplementary material available at 10.1186/s12955-021-01715-x.
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Affiliation(s)
- Jorge Caro-Bautista
- Andalusian Public Health System, District of Primary Health Care of Málaga-Valle del Guadalhorce and Instituto de Investigación Biomédica de Málaga-IBIMA, Málaga, Spain
| | | | | | - Eva Timonet-Andreu
- Department of Cardiology, Costa del Sol Hospital and Instituto de Investigación Biomédica de Málaga-IBIMA, Málaga, Spain
| | | | | | - Silvia Corchon
- Faculty of Nursing and Chiropody, University of Valencia, Valencia, Spain
| | | | - Leire Ambrosio
- School of Health Sciences, NIHR ARC Wessex, University of Southampton, Building 67, University Road, SO171BJ, Southampton, United Kingdom.
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Ambrosio L, Hislop‐Lennie K, Barker H, Culliford D, Portillo MC. Living with Long term condition Scale: A pilot validation study of a new person centred tool in the UK. Nurs Open 2021; 8:1909-1919. [PMID: 33723922 PMCID: PMC8186700 DOI: 10.1002/nop2.859] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 02/07/2021] [Accepted: 03/01/2021] [Indexed: 11/07/2022] Open
Abstract
AIM To cross-culturally adapt and determine the preliminary psychometric properties of the English version of the LwLTC Scale in people living with long-term conditions in the UK. DESIGN Cross-cultural adaptation and cross-sectional study. METHODS Forty-nine patients with five long-term conditions were included in the pilot study. Patients completed the English version of the LwLTC Scale and a bespoke questionnaire related to the scale. Feasibility/acceptability, internal consistency and construct validity were analysed. RESULTS 59.2% of participants were female, with an average age of 65.9 (SD = 12.30). Cronbach's alpha coefficient ranged between 0.50 and 0.84. Content validity showed that the English version of the LwLTC Scale was useful even negative items were identified. CONCLUSION These preliminary psychometric properties are satisfactory and promising. Further psychometric analyses are needed to verify them in a larger and more representative sample size during the main validation study, which is now in process.
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Affiliation(s)
- Leire Ambrosio
- School of Health SciencesUniversity of SouthamptonHampshireUK
- NIHR Applied Research CollaborationWessex University of SouthamptonHampshireUK
| | | | - Hannah Barker
- NIHR Applied Research CollaborationWessex University of SouthamptonHampshireUK
| | - David Culliford
- School of Health SciencesUniversity of SouthamptonHampshireUK
- NIHR Applied Research CollaborationWessex University of SouthamptonHampshireUK
| | - Mari Carmen Portillo
- School of Health SciencesUniversity of SouthamptonHampshireUK
- NIHR Applied Research CollaborationWessex University of SouthamptonHampshireUK
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Corchon S, Rodriguez-Blazquez C, Carvajal-Carrascal G, Fuentes-Ramirez A, Ruiz de Ocenda MI, Caparros N, Timonet-Andreu E, Navarta-Sanchez MV, Ambrosio L. International psychometric validation of the Living with Chronic Illness Scale in Spanish-speaking patients with chronic obstructive pulmonary disease. BMJ Open 2021; 11:e039973. [PMID: 33712522 PMCID: PMC7959234 DOI: 10.1136/bmjopen-2020-039973] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 07/30/2020] [Accepted: 10/07/2020] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES To validate the Living with Chronic Illness (LW-CI) Scale in patients with chronic obstructive pulmonary disease (COPD). DESIGN Observational, cross-sectional validation study with retest. Acceptability, reliability, precision and construct validity were tested. SETTING The study took place in primary and secondary specialised units of public and private hospitals of Spain and Colombia. PARTICIPANTS The study included 612 patients with COPD assessed from May 2018 to May 2019. A consecutive cases sampling was done. Inclusion criteria included: (A) patients with a diagnosis of COPD; (B) native Spanish speaking; (C) able to read and understand questionnaires; and (D) able to provide informed consent. Exclusion criteria included: (A) cognitive deterioration and (B) pharmacological effect or disorder that could disrupt the assessment. RESULTS The LW-CI-COPD presented satisfactory data quality, with no missing data or floor/ceiling effects, showing high internal consistency for all the domains (Cronbach's alpha for the total score 0.92). Test-retest reliability was satisfactory (intraclass correlation coefficient=0.92). The LW-CI-COPD correlated 0.52-0.64 with quality of life and social support measures. The scale demonstrated satisfactory known-groups validity, yielding significantly different scores in patients grouped according to COPD severity levels. CONCLUSIONS This has been the first validation study of the LW-CI-COPD. It is a feasible, reliable, valid and precise self-reported scale to measure living with COPD in the Spanish-speaking population. Therefore, it could be recommended for research and clinical practice to measure this concept and evaluate the impact of centred-care interdisciplinary interventions based on the patients' perspective, focused on providing holistic and comprehensive care to patients with COPD.
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Affiliation(s)
- Silvia Corchon
- Faculty of Nursing and Chiropody, University of Valencia, Valencia, Spain
| | - Carmen Rodriguez-Blazquez
- National Centre of Epidemiology and Consortium for Biomedical Research in Neurodegenerative Diseases (Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas/CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | | | | | | | - Neus Caparros
- Faculty of Legal and Social Science, University of La Rioja, La Rioja, Spain
| | | | | | - Leire Ambrosio
- School of Health Sciences, NIHR ARC Wessex, University of Southampton, Southampton, UK
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