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Tanimura C, Oba K, Noguchi Y, Itamochi T. A Concept Analysis of Self-Management of Physical Frailty. Yonago Acta Med 2024; 67:80-92. [PMID: 38803587 PMCID: PMC11128080 DOI: 10.33160/yam.2024.05.007] [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: 02/29/2024] [Accepted: 04/09/2024] [Indexed: 05/29/2024]
Abstract
This review aimed to clarify the concept of self-management in the context of physical frailty and to provide insights that support the development of interventions to prevent physical frailty. A concept analysis using thirty-three studies was performed, six attributes of the concept "self-management of physical frailty" were identified: {Cooperating with healthcare professionals or familiar persons}, {Investing and managing in resources}, {Acquisition and maintenance of individualized self-management strategies}, {Self-directed process}, {Goal setting and personalized action planning} and {Living with one's own health condition with a positive attitude}. Self-management of physical frailty can be defined as a process in which an individual independently sets goals and action plans, engages in strategies such as exercise and nutritional management, and lives with one's own health condition with a positive attitude by collaborating with healthcare professionals and others, in addition to utilizing resources. To support the process in which an individual independently sets goals and action plans, engages in strategies, self-management support based on learning theories that lead to cognitive, emotional, and behavioral changes is necessary.
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Affiliation(s)
- Chika Tanimura
- School of Health Science, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
| | - Keiko Oba
- School of Health Science, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
| | - Yoshimi Noguchi
- School of Health Science, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
| | - Tomoyuki Itamochi
- Department of Nursing Science, Faculty of Nursing and Nutrition, The University of Shimane, Izumo 693-8550, Japan
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Yang MC, Clayton C, Harris D, Pelletier C, Schmidt J, Zwicker JG, Sakakibara BM. A Qualitative Investigation on Chronic Disease Management and Prevention Among Older Adults During the COVID-19 Pandemic. Am J Health Promot 2024; 38:384-393. [PMID: 38000140 PMCID: PMC10903114 DOI: 10.1177/08901171231218681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2023]
Abstract
PURPOSE To qualitatively describe experiences of chronic disease management and prevention in older adults (age ≥65 years) during COVID-19. APPROACH Qualitative descriptive approach. SETTING Data collected online via telephone and video-conferencing technologies to participants located in various cities in British Columbia, Canada. Data analyzed by researchers in the cities of Vancouver and Kelowna in British Columbia. PARTICIPANTS Twenty-four community-living older adults (n = 24) age ≥65 years. METHODS Each participant was invited to complete a 30-to-45-minute virtual, semi-structured, one-on-one interview with a trained interviewer. Interview questions focused on experiences managing health prior to COVID-19 and transitioning experiences of practicing health management and prevention strategies during COVID-19. Audio recordings of interviews were transcribed verbatim and analyzed thematically. RESULTS The sample's mean age was 73.4 years (58% female) with 75% reporting two or more chronic conditions (12.5% none, 12.5% one). Three themes described participants' strategies for chronic disease management and prevention: (1) having a purpose to optimize health (i.e., managing health challenges and maintaining independence); (2) internal self-control strategies (i.e., self-accountability and adaptability); and (3) external support strategies (i.e., informational support, motivational support, and emotional support). CONCLUSION Helping older adults identify purposes for their own health management, developing internal control strategies, and optimizing social support opportunities may be important person-centred strategies for chronic disease management and prevention during unprecedented times like COVID-19.
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Affiliation(s)
- Michelle C. Yang
- Graduate Programs in Rehabilitation Sciences, University of British Columbia, Vancouver, BC, Canada
- Centre for Chronic Disease Prevention and Management, University of British Columbia, Kelowna, Canada
| | - Cam Clayton
- Vancouver Fraser Medical Program, University of British Columbia, Vancouver, BC, Canada
| | - Devin Harris
- Department of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada
- Interior Health Authority, Kelowna, BC, Canada
| | - Chelsea Pelletier
- School of Health Sciences, University of Northern British Columbia, Prince George, BC, Canada
| | - Julia Schmidt
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Jill G. Zwicker
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
- BC Children’s Hospital Research Institute, Vancouver, BC, Canada
| | - Brodie M. Sakakibara
- Centre for Chronic Disease Prevention and Management, University of British Columbia, Kelowna, Canada
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
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Dinh TTH, Bonner A. Exploring the relationships between health literacy, social support, self-efficacy and self-management in adults with multiple chronic diseases. BMC Health Serv Res 2023; 23:923. [PMID: 37649013 PMCID: PMC10466814 DOI: 10.1186/s12913-023-09907-5] [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: 04/03/2023] [Accepted: 08/12/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Self-management in chronic diseases is essential to slowing disease progression and preventing complications. However, empirical research on the associations of critical factors, such as health literacy, social support, and self-efficacy with self-management in the context of multiple chronic diseases is scarce. This study aimed to investigate these associations and provides insights for healthcare providers to develop effective educational strategies for people with multiple chronic diseases. METHODS Using a cross-sectional survey design, adults (n = 600) diagnosed with at least two chronic diseases were conveniently recruited. To measure health literacy, social support, self-efficacy, and chronic disease self-management behaviours, the Health Literacy Questionnaire (HLQ), Medical Outcome Study - Social Support Survey, Self-efficacy in Managing Chronic Disease, and Self-management in Chronic Diseases instruments were utilized respectively. Comorbidity status was assessed using Age-adjusted Charlson Comorbidity Index (ACCI). A generalised linear regression model was used with a backward technique to identify variables associated with self-management. RESULTS Participants' mean age was 61 years (SD = 15.3), 46% were female, and most had up to 12 years of education (82.3%). Mean scores for HLQ domains 1-5 varied from 2.61 to 3.24 (possible score 1-4); domains 6-9 from 3.29 to 3.65 (possible score 1-5). The mean scores were 52.7 (SD = 10.4, possible score 0-95), 5.46 (SD = 1.9, possible score 0-10) and 82.1 (SD = 12.4, possible score 30-120) for social support, self-efficacy, and self-management, respectively. Mean ACCI was 6.7 (SD = 2.1). Eight factors (age > 65 years, being female, 4 health literacy domains, greater social support, and higher self-efficacy levels) were significantly associated with greater self-management behaviours while comorbidity status was not. The factors that showed the strongest associations with self-management were critical health literacy domains: appraisal of health information, social support for health, and healthcare provider support. CONCLUSIONS Developing critical health literacy abilities is a more effective way to enhance self-management behaviours than relying solely on self-confidence or social support, especially for people with multiple chronic diseases. By facilitating communication and patient education, healthcare providers can help patients improve their critical health literacy, which in turn can enhance their self-management behaviours.
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Affiliation(s)
- Thi Thuy Ha Dinh
- School of Nursing, University of Tasmania, Launceston, TAS, Australia.
- School of Nursing and Midwifery, Griffith University, Brisbane, QLD, Australia.
| | - Ann Bonner
- School of Nursing and Midwifery, Griffith University, Brisbane, QLD, Australia
- Kidney Health Service, Metro North Hospital and Health Service, Brisbane, QLD, Australia
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Lawless MT, Tieu M, Chan RJ, Hendriks JM, Kitson A. Instruments Measuring Self-Care and Self-Management of Chronic Conditions by Community-Dwelling Older Adults: A Scoping Review. J Appl Gerontol 2023:7334648231161929. [PMID: 36880688 DOI: 10.1177/07334648231161929] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
Given the high prevalence of chronic conditions and multimorbidity in older adults, there is a need to better conceptualize and measure self-care and self-management to promote a person-centered approach. This scoping review aimed to identify and map instruments measuring self-care and self-management of chronic conditions by older adults. We searched six electronic databases, charted data from the studies and tools and reported the results in accordance with the PRISMA-ScR guidelines. A total of 107 articles (103 studies) containing 40 tools were included in the review. There was substantial variation in the tools in terms of their aims and scope, structure, theoretical foundations, how they were developed, and the settings in which they have been used. The quantity of tools demonstrates the importance of assessing self-care and self-management. Consideration of the purpose, scope, and theoretical foundation should guide decisions about tools suitable for use in research and clinical practice.
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Affiliation(s)
- Michael T Lawless
- Caring Futures Institute, College of Nursing and Health Sciences, 1065Flinders University, Adelaide, SA, Australia
| | - Matthew Tieu
- Caring Futures Institute, College of Nursing and Health Sciences, 1065Flinders University, Adelaide, SA, Australia.,College of Humanities, Arts and Social Sciences, 1065Flinders University, Adelaide, SA, Australia
| | - Raymond J Chan
- Caring Futures Institute, College of Nursing and Health Sciences, 1065Flinders University, Adelaide, SA, Australia
| | - Jeroen M Hendriks
- Caring Futures Institute, College of Nursing and Health Sciences, 1065Flinders University, Adelaide, SA, Australia
| | - Alison Kitson
- Caring Futures Institute, College of Nursing and Health Sciences, 1065Flinders University, Adelaide, SA, Australia
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Klinedinst TC, Ciro CA, Kendzor DE. A pilot, randomized, feasibility study to improve health self-management behaviors in older adults with multiple chronic conditions and functional limitations: Protocol for the Behavioral Activation and Occupational Therapy Trial (BA+OT). JOURNAL OF MULTIMORBIDITY AND COMORBIDITY 2023; 13:26335565231163037. [PMID: 36911183 PMCID: PMC9998403 DOI: 10.1177/26335565231163037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 02/14/2023] [Indexed: 03/14/2023]
Abstract
Background Approximately 45% of older adults in the U.S. have 2 or more chronic health conditions (e.g., arthritis, hypertension, diabetes) in addition to functional limitations that prevent performance of health self-management activities. Self-management continues to be the gold standard for managing MCC, but functional limitations create difficulty with these activities (e.g., physical activity, symptom monitoring). Restricted self-management accelerates the downward spiral of disability and accumulating chronic conditions which, in turn, increases rates of institutionalization and death by 5-fold. Currently, there are no tested interventions designed to improve independence in health self-management activities in older adults with MCC and functional limitations. Research suggests that older adults are more likely to change behavior with interventions that assist with planning health-promoting daily activities, especially when contending with complex medical regimens and functional limitations. Our team asserts that combining occupational therapy (OT) and behavioral activation (BA) shows promise to improve health self-management in populations with chronic conditions and/or functional limitations. This innovative combination uses the goal setting, scheduling/monitoring activities, and problem-solving components of the BA approach as well as the environmental modification, activity adaptation, and focus on daily routines from OT practice. Objectives We will test the effect of this combined approach in a Stage I, randomized controlled pilot feasibility study compared to enhanced usual care. We will recruit 40 older adults with MCC and functional limitation and randomize 20 to the PI- delivered BA-OT protocol. This research will inform modification and larger-scale testing of this novel intervention.
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Affiliation(s)
- Tara C Klinedinst
- Department of Rehabilitation Sciences, College of Allied Health, University of Oklahoma Health Sciences Center- Schusterman Campus, Tulsa, OK, USA.,Department of Internal Medicine, OU-TU School of Community Medicine, Tulsa, OK, USA
| | - Carrie A Ciro
- Department of Rehabilitation Sciences, College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Darla E Kendzor
- TSET Heath Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.,Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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King L, Harrington A, Nicholls S, Thornton K, Tanner E. Towards reduction of preventable hospital readmission: Older people and family members' views on planned self-management of care at home. J Clin Nurs 2022. [PMID: 35974684 DOI: 10.1111/jocn.16492] [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: 02/18/2022] [Revised: 07/15/2022] [Accepted: 07/22/2022] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To reduce the likelihood of preventable readmissions, the aim was to investigate how older people (with their family members) managed their chronic health conditions at home following hospital discharge. The objectives explored older people and their family members' perspectives on how discharge plans assisted self-management of their chronic conditions, their recognition of deterioration and when to seek treatment/re-attend hospital. BACKGROUND Chronic conditions have challenged older adults' self-management, particularly after hospital discharge and can impact on preventable readmission. Few studies have examined patients' and their family members' perspectives on the management of their conditions at home after hospitalisation. DESIGN A qualitative exploratory design known as Interpretive Description was utilised. METHODS Purposeful sampling involved 27 community-dwelling older adults; nineteen were discharged patients with one or more chronic health conditions. Eight nominated family members were also recruited to enhance understanding of the older persons' self-management at home. Interviews were undertaken and thematic data analysis followed the COREQ guidelines. RESULTS Five themes emerged: (1) Post-Discharge Advice; (2) Managing at Home; (3) Recognition and Response to Deterioration; (4) Community Care and Support; and (5) The "Burden" on Others of Post-Discharge Care. CONCLUSION Older people sought a clear plan for self-management at home prior to discharge. This plan should contain potential signs of deterioration and guidance on future action. We found that support given to older people from family and friends was critical to prevent readmission. In addition, their local General Practitioner and Pharmacist played an essential part in the support of their care. For some, social support services were also important. Nurse telephone follow-up in the week following discharge was mostly absent. However, this strategy would be strongly recommended. RELEVANCE TO CLINICAL PRACTICE To mitigate against preventable readmission, we recommend the above strategies to assist the older person at home with self-management of their chronic conditions.
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Affiliation(s)
- Lindy King
- College of Nursing & Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Ann Harrington
- College of Nursing & Health Sciences, Flinders University, Adelaide, South Australia, Australia.,Adjunct Research Professor, Australian Centre for Christianity and Culture, Charles Sturt University, Barton, Australian Capital Territory, Australia
| | - Seth Nicholls
- College of Nursing & Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Karleen Thornton
- Nursing and Midwifery Education, Research and Practice Development, Northern Adelaide Local Health Network, Adelaide, South Australia, Australia
| | - Elizabeth Tanner
- Gerontology and Interprofessional Education and Practice, School of Nursing and School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
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Mitchell E, Ziegler E. Sexual Dysfunction in Gay and Bisexual Prostate Cancer Survivors: A Concept Analysis. JOURNAL OF HOMOSEXUALITY 2022; 69:1119-1139. [PMID: 33818298 DOI: 10.1080/00918369.2021.1905384] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Sexual dysfunction is a common side effect of prostate cancer (PCa) treatment, yet it remains poorly defined in the literature. Current definitions are based on heteronormative assumptions which do not consider the unique experiences of gay and bisexual (GBM) PCa survivors. The purpose of this paper is to use Walker and Avant's method to conduct a concept analysis of sexual dysfunction among GBM in the context of PCa survivorship. The review included 46 articles published between 2002-2019. The following attributes were identified: (1) erectile dysfunction, (2) ejaculatory change (anhedonia/anejaculation), (3) urinary incontinence/climacturia, and (4) anodyspareunia. For GBM PCa survivors, sexual dysfunction involves reduced or abnormal functioning of four core elements of a sexual encounter, which inhibit GBM from engaging in and being satisfied with sexual activity.
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Affiliation(s)
- Evan Mitchell
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, Ontario, Canada
| | - Erin Ziegler
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, Ontario, Canada
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Gordon K, Dainty KN, Steele Gray C, DeLacy J, Shah A, Seto E. Normalizing Telemonitoring in Nurse-Led Care Models for Complex Chronic Patient Populations: Case Study. JMIR Nurs 2022; 5:e36346. [PMID: 35482375 PMCID: PMC9100369 DOI: 10.2196/36346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 03/12/2022] [Accepted: 03/13/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The implementation of telemonitoring (TM) has been successful in terms of the overall feasibility and adoption in single disease care models. However, a lack of available research focused on nurse-led implementations of TM that targets patients with multiple and complex chronic conditions (CCC) hinders the scale and spread to these patient populations. In particular, little is known about the clinical perspective on the implementation of TM for patients with CCC in outpatient care. OBJECTIVE This study aims to better understand the perspective of the clinical team (both frontline clinicians and those in administrative positions) on the implementation and normalization of TM for complex patients in a nurse-led clinic model. METHODS A pragmatic, 6-month implementation study was conducted to embed multicondition TM, including heart failure, hypertension, and diabetes, into an integrated nurse-led model of care. Throughout the study, clinical team members were observed, and a chart review was conducted of the care provided during this time. At the end of the study, clinical team members participated in qualitative interviews and completed the adapted Normalization Measure Development questionnaires. The Normalization Process Theory guided the deductive data analysis. RESULTS Overall, 9 team members participated in the study as part of a larger feasibility study of the TM program, of which 26 patients were enrolled. Team members had a shared understanding of the purpose and value of TM as an intervention embedded within their practice to meet the diverse needs of their patients with CCC. TM aligned well with existing chronic care practices in several ways, yet it changed the process of care delivery (ie, interactional workability subconstruct). Effective TM normalization in nurse-led care requires rethinking of clinical workflows to incorporate TM, relationship development between the clinicians and their patients, communication with the interdisciplinary team, and frequent clinical care oversight. This was captured well through the subconstructs of skill set workability, relational integration, and contextual integration of the Normalization Process Theory. CONCLUSIONS Clinicians successfully adopted TM into their everyday practice such that some providers felt their role would be significantly and negatively affected without TM. This study demonstrated that smartphone-based TM systems complemented the routine and challenging clinical work caring for patients with CCC in an integrated nurse-led care model.
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Affiliation(s)
- Kayleigh Gordon
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Centre for Global eHealth Innovation, Techna Institute, University Health Network, Toronto, ON, Canada
| | - Katie N Dainty
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- North York General Hospital, North York, ON, Canada
| | - Carolyn Steele Gray
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada
| | - Jane DeLacy
- William Osler Health System, Brampton, ON, Canada
| | - Amika Shah
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Centre for Global eHealth Innovation, Techna Institute, University Health Network, Toronto, ON, Canada
| | - Emily Seto
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Centre for Global eHealth Innovation, Techna Institute, University Health Network, Toronto, ON, Canada
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Byrne G, Keogh B, Daly L. Self-management support for older adults with chronic illness: implications for nursing practice. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2022; 31:86-94. [PMID: 35094539 DOI: 10.12968/bjon.2022.31.2.86] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Self-management is a key skill that older adults with multiple comorbidities require. Self-management interventions include medication management, self-monitoring and self-awareness and self-management often requires the older adult to manage the emotional consequences of having multiple comorbidities. The benefits of self-management for older adults include reduced reliance on the health system, enhanced quality of life, empowerment of the individual and reduction in the burden associated with chronic illness. Many factors can influence an older adult's ability to self-manage, including health literacy, mental health difficulties and socio-economic factors. Self-management support is the provision of structures, services and programmes to support and enhance the skills of older adults in managing their own conditions. Nurses are in a pivotal position across the continuum of care, using both person-centred care and the 'Making Every Contact Count' approach, to support older adults to self-manage their conditions.
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Affiliation(s)
- Gobnait Byrne
- Assistant Professor, School of Nursing and Midwifery, Trinity College Dublin, Ireland
| | - Brian Keogh
- Assistant Professor, School of Nursing and Midwifery, Trinity College Dublin, Ireland
| | - Louise Daly
- Assistant Professor, School of Nursing and Midwifery, Trinity College Dublin, Ireland
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Gan DRY, Wister AV, Best JR. Environmental Influences on Life Satisfaction and Depressive Symptoms Among Older Adults With Multimorbidity: Path Analysis Through Loneliness in the Canadian Longitudinal Study on Aging. THE GERONTOLOGIST 2022; 62:855-864. [PMID: 35034124 PMCID: PMC9290896 DOI: 10.1093/geront/gnac004] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND AND OBJECTIVES More older adults with multimorbidity are aging in place than ever before. Knowing how the environment affects their mental well-being could enhance the efficacy of age-friendly interventions for multimorbidity resilience. With reference to the Transdisciplinary Neighborhood Health Framework, we construct and examine a priori models of environmental influences on life satisfaction and depressive symptoms. RESEARCH DESIGN AND METHODS Baseline and follow-up data (after 3 years) were drawn from the Canadian Longitudinal Study on Aging to identify a subsample (n = 14,301) of participants aged at least 65 years with at least 2 chronic diseases. Path analysis examined sociobehavioral attributes (i.e., social support, social participation, walking) and loneliness as primary and secondary mediators, controlling for age, sex, education, and outcomes during baseline. RESULTS Good model fit was found (TFI = 1.00; CFI = 1.00; RMSEA < 0.001; SRMR < 0.001). The total effects of housing quality (rtotal = 0.08, -0.07) and neighborhood cohesion (rtotal = 0.03, -0.06) were weak but statistically significant in the expected direction. The mediators explained 21%-31% of the total effects of housing quality and 67%-100% of the total effects of neighborhood cohesion. Loneliness mediated 27%-29% of these environmental influences on mental well-being, whereas walking mediated a mere 0.4%-0.9% of the total effects. Walking did not explain the relationship between housing quality and mental well-being. DISCUSSION AND IMPLICATIONS Data supported a priori pathways from environment to mental well-being through sociobehavioral attributes and loneliness. If these pathways from neighborhood cohesion to life satisfaction reflect causal effects, community-based age-friendly interventions should focus on enhancing neighborhood cohesion to mitigate loneliness among multimorbid older adults for their mental well-being.
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Affiliation(s)
- Daniel R Y Gan
- Address correspondence to: Daniel R. Y. Gan, PhD, Gerontology Research Centre, Simon Fraser University, #2800-515 West Hastings Street, Vancouver, BC V6B 5K3, Canada. E-mail:
| | - Andrew V Wister
- Gerontology Research Centre, Simon Fraser University, Vancouver, British Columbia, Canada
| | - John R Best
- Gerontology Research Centre, Simon Fraser University, Vancouver, British Columbia, Canada,Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
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Schulman-Green D, Feder SL, Montano AR, Batten J, Tan H, Hoang K, Grey M. Use of the self- and family management framework and implications for further development. Nurs Outlook 2021; 69:991-1020. [PMID: 34183187 DOI: 10.1016/j.outlook.2021.05.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 04/20/2021] [Accepted: 05/02/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND The Self- and Family Management Framework (SFMF) was created in 2006 and revised in 2015 to guide research on self- and family management of chronic conditions. There has been no review of use of the SFMF. PURPOSE We reviewed articles citing the SFMF to identify the frequency and nature of use. METHOD We conducted a citation analysis, searching Web of Science, Scopus, and Google Scholar databases and extracted key data from identified articles. FINDINGS Of 126 articles, 84(66%) cited the 2006 SFMF, 37(29%) cited the 2015 SFMF, and 6(5%) cited both. The SFMF was used most to inform study design. Users noted strengths (e.g., considers family context) and limitations (e.g., non-specification of patient- family caregiver synergies) of the framework. DISCUSSION The SFMF has been used broadly to guide research on self- and family management of chronic conditions. Findings will inform development of a third version of the SFMF.
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Affiliation(s)
| | | | | | | | - Hui Tan
- Yale New Haven Health Bridgeport Hospital, Bridgeport, CT
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12
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Educational Processes for Health and Disease Self-Management in Public Health: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126448. [PMID: 34203594 PMCID: PMC8296271 DOI: 10.3390/ijerph18126448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 06/10/2021] [Accepted: 06/11/2021] [Indexed: 11/16/2022]
Abstract
This study systematically reviewed processes and educational programs for self-management of health and diseases that are the subject of public health attention. This systematic review of the literature (SRL) is relevant to recognizing the characteristics of the educational processes in self-managing chronic diseases in contexts where technology did not play a significant role. Following the PRISMA protocol, the authors independently reviewed full-text articles from several databases using the following criteria: (1) intervention studies evaluating the effects of self-management health programs; (2) educational process of disease self-management; (3) studies that included at least one control group, and (4) peer-reviewed studies. In addition, the Scottish Intercollegiate Guideline Network measurement tool was used to assess the risk of bias in each trial. In the final sample, 38 articles were included. The findings regarding health education methods of self-care, using community-based care and technological tools, are considered fundamental. Among the conclusions, the relevance of the pedagogy that health education processes demand improvement in post-pandemic program effectiveness stands out.
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13
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Montano AR. A concept analysis of interprofessional collaborative practice for community-dwelling older adults. Nurs Forum 2021; 56:413-420. [PMID: 33533058 DOI: 10.1111/nuf.12553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 01/22/2021] [Indexed: 06/12/2023]
Abstract
Models of interprofessional collaborative practice have demonstrated improved outcomes for community-dwelling older adults. However, the concept of interprofessional collaborative practice for community-dwelling older adults needs clarification and a clear definition. A concept analysis based on the method posited by Walker and Avant was conducted to formulate an operational definition of this concept. Defining attributes, antecedents, consequences and empirical referents were identified from a review of the literature. A model case and contrary case were selected to further clarify the concept of interprofessional collaborative practice for community-dwelling older adults. Nurses are ideal leaders of interprofessional teams caring for older adults and can utilize this concept in practice, education and research.
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Affiliation(s)
- Anna-Rae Montano
- Center for Gerontology and Health Care Research, Brown University School of Public Health, Providence, Rhode Island, USA
- The Center of Innovation in Long Term Services and Supports, Providence VA Medical Center, Providence, Rhode Island, USA
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De León-Ramírez M, Peñarrieta-de Córdova M, León-Hernández R, Gutiérrez-Gómez T, Piñones-Martínez M, Quintero-Valle L. Relación entre automanejo y síntomas depresivos en personas con diabetes e hipertensión. ENFERMERÍA UNIVERSITARIA 2020. [DOI: 10.22201/eneo.23958421e.2020.1.681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introducción: Las personas con diabetes e hipertensión experimentan con mayor frecuencia sintomatología depresiva, lo cual contribuye a un inadecuado automanejo de la enfermedad, que implica tareas como: la toma de la medicación, asistir a las consultas médicas, el conocimiento de signos y síntomas, además de la toma de decisiones.
Objetivo: Por lo anterior, el objetivo de este trabajo es identificar la relación entre automanejo en general y sus dimensiones con síntomas depresivos en personas con diabetes e hipertensión.
Método: Estudio transversal-correlacional con n=205 pacientes con diagnóstico de diabetes (100) e hipertensión (105). Muestreo no probabilístico por conveniencia. Se utilizó la estadística descriptiva y r de Pearson. Se aplicaron los instrumentos Partners in Health (PIH) y The Patient Health Questionnaire (PHQ-8).
Resultados: Se encontró correlación estadísticamente significativa entre la sintomatología depresiva y el automanejo (r=-0.308 ρ<0.001).
Discusión y Conclusiones: Se concluye que la sintomatología depresiva se relaciona con el automanejo de la enfermedad de la siguiente manera: a mayor automanejo menor sintomatología de depresión, o a mayor sintomatología depresiva menor automanejo; dicha relación confirma que ambas variables se afectan mutuamente y/o mantienen una relación estrecha.
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Leong SM, Lei WI, Chan UW. The Six-Month and One-Year Outcome of a Chronic Disease Self-Management Program Among Older Adults in Macao: A Quasi-Experimental Study. SAGE Open Nurs 2020; 6:2377960820958231. [PMID: 35155758 PMCID: PMC8832321 DOI: 10.1177/2377960820958231] [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: 04/15/2020] [Accepted: 08/21/2020] [Indexed: 11/16/2022] Open
Abstract
Introduction Promoting older adults to self-manage their chronic conditions is a major
focus of the Macao government and healthcare professionals since more than
80% of older adults have suffered chronic conditions. Objectives This study evaluated the effect of the Chronic Disease Self-management
Program (CDSMP) on self-management behaviors, self-efficacy, health status,
and healthcare services utilization among Macao older adults with chronic
disease over six months, and assessed whether the intervention effect
persisted for one year. Methods A longitudinal and quasi-experimental design was used in this study. A total
number of 158 older adults with at least one chronic disease were recruited
from three Macao community centers. Participants in the study group engaged
in a six-session CDSMP in the community centers and participants in the
control group received usual care. The Chronic Disease Self-management
Questionnaire was used to assess the outcome measures for baseline,
six-month and one-year assessment. Results The age of subjects ranged from 60 to 88, 64.6% had three or more chronic
diseases. The results showed that the subjects in the study group had
significant improvement in self-management behaviors, self-efficacy, and
some health-related indicators at the point of six months, and these
improvements were still observable at the point of one year when comparing
to the control group. The results also showed that the study group had a
decrease in healthcare services utilization, but there was no significant
difference between the two groups. Conclusion This study confirmed that the community-dwelling older adults in Macao can
acquire positive outcomes in self-management and health-related indicators
from the CDSMP. Hence, it is worth promoting this program as a health
promotion activity in community.
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Affiliation(s)
- Sok Man Leong
- Education Department, Kiang Wu Nursing College of Macau, Macau SAR, China
| | - Wai In Lei
- Education Department, Kiang Wu Nursing College of Macau, Macau SAR, China
| | - Un Wa Chan
- Public Health Laboratory of Macau, Macau SAR, China (Former staff of Kiang Wu Nursing College of Macau)
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Pereira F, Roux P, Rosselet Amoussou J, Martins MM, von Gunten A, Verloo H. Medication Management Models for Polymedicated Home-Dwelling Older Adults With Multiple Chronic Conditions: Protocol of a Systematic Review. JMIR Res Protoc 2019; 8:e13582. [PMID: 31140441 PMCID: PMC6658322 DOI: 10.2196/13582] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 03/26/2019] [Accepted: 03/29/2019] [Indexed: 02/06/2023] Open
Abstract
Background Older adults with multiple chronic diseases commonly require complex medication regimes. When combined with frailty, cognitive impairment, and changing pharmacological prescriptions, older adults’ polymedication regimes increase the risk of medication-related problems (MRPs) and hospitalization. Effective, well-organized medication management could avoid MRPs and their clinical outcomes. Objective Identify medication management models and analyze their impact on managing and preventing MRPs for polymedicated, home-dwelling older adults. Methods We will conduct a systematic review of published articles in relevant professional scientific journals from inception until March 31, 2019, in the following electronic databases,: Embase; Medline OvidSP; PubMed (NOT Medline[sb]); Cumulative Index to Nursing and Allied Health Literature (CINAHL) EBSCO; PsycINFO OvidSP; Cochrane Library, Wiley; and Web of Science. We will also hand search the bibliographies of all the relevant articles found and search for unpublished studies. We will consider publications in English, French, German, Spanish, Italian, and Portuguese. Retrieved articles will be screened for eligibility. Statistical analyses will be conducted following the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and Meta-analysis Of Observational Studies in Epidemiology (MOOSE) statements. Data will be analyzed using SPSS Statistics for Windows, version 25.0 (IBM Corp), and Review Manager, version 5.5 (The Nordic Cochrane Centre, The Cochrane Collaboration). Results A preliminary search in Embase delivered 3272 references. This preliminary search allows us to complete our research strategy with equation development and to search the other databases. Relevant articles identified will allow for searching the reference lists for unpublished studies. The inclusion and exclusion criteria will be rigorously respected in the study selection. The entire study is expected to be completed by January 2020. Conclusions This review will provide an exhaustive view of medication management models that could be effective for polymedicated, home-dwelling older adults and will allow us to analyze their impact on managing and preventing MRPs. Trial Registration PROSPERO CRD42018117287; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=117287 (Archived by WebCite at http://www.webcitation.org/77fCfbCjT) International Registered Report Identifier (IRRID) DERR1-10.2196/13582
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Affiliation(s)
- Filipa Pereira
- School of Health Sciences, HES-SO Valais-Wallis, Sion, Switzerland.,Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
| | - Pauline Roux
- Research Center for Psychology of Health, Aging and Sport Examination, University of Lausanne, Lausanne, Switzerland
| | - Joëlle Rosselet Amoussou
- Psychiatry Library, Education and Research Department, Hospital and University of Lausanne, Lausanne, Switzerland
| | - Maria Manuela Martins
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal.,Higher School of Nursing of Porto, Porto, Portugal
| | - Armin von Gunten
- Service of Old Age Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Henk Verloo
- School of Health Sciences, HES-SO Valais-Wallis, Sion, Switzerland.,Service of Old Age Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
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Senteio CR. Investigating the Enduring Impact of a Community-Based Health Education Program to Promote African American Elders' Use of Technology Designed to Support Chronic Disease Self-Management. Geriatrics (Basel) 2018; 3:E70. [PMID: 31011105 PMCID: PMC6371165 DOI: 10.3390/geriatrics3040070] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 10/09/2018] [Accepted: 10/12/2018] [Indexed: 01/07/2023] Open
Abstract
Elders experience chronic disease disparities and barriers to access technology designed to support recommended self-management behaviors. Elders from racial minority groups are among those who experience particular disparities in chronic disease incidence, outcomes, and barriers to technology use. In order to investigate strategies to address barriers, the study team recruited elder African Americans with diabetes and young adults connected to the elders through naturally occurring familial or social networks. Participants attended a community-based health education session focused on enhancing self-efficacy for recommended self-management and using consumer-oriented technology accessible on their smartphones for self-management support. To assess enduring impact, the study team conducted a pilot study to investigate perceptions and use one month following the health education session. Both elders and young adults offered perspectives on what was effective in teaching elders how to use technology. Both age groups stressed that having patience was crucial, as is providing encouragement for the elders to try tasks on their own. Both elders and young adults also showed a statistically significant increase in aspirations to work together for additional intergenerational health and technology knowledge exchange. Several elder participants continued using technology that they first used during the session. This novel, pilot study describes how to promote self-management and technology use for individuals plagued by persistent chronic disease and technology use disparities.
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Affiliation(s)
- Charles R Senteio
- School of Communication and Information, Rutgers University, New Brunswick, NJ 08901, USA.
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18
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Hamler TC, Miller VJ, Petrakovitz S. Chronic Kidney Disease and Older African American Adults: How Embodiment Influences Self-Management. Geriatrics (Basel) 2018; 3:E52. [PMID: 31011089 PMCID: PMC6319230 DOI: 10.3390/geriatrics3030052] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 08/02/2018] [Accepted: 08/15/2018] [Indexed: 12/22/2022] Open
Abstract
Patients living with chronic kidney disease (CKD) must balance the medical management of their kidney disease and other chronic conditions with their daily lives, including managing the emotional and psychosocial consequences of living with a chronic disease. Self-management is critical to managing chronic kidney disease, as treatment consists of a complex regimen of medications, dosages, and treatments. This is a particularly important issue for older African American adults who will comprise a significant portion of the older adult population in the coming years. Yet current conceptualizations of self-management behaviors cannot adequately address the needs of this population. Embodiment theory provides a novel perspective that considers how social factors and experiences are embodied within decision-making processes regarding self-management care among older African Americans. This paper will explore how embodiment theory can aid in shifting the conceptualization of self-management from a model of individual choice, to a framework that cannot separate lived experiences of social, political, and racial factors from clinical understandings of self-management behaviors. This shift in the conceptualization of self-management is particularly important to consider for CKD management because the profound illness burdens require significant self-management and care coordination skills.
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Affiliation(s)
- Tyrone C Hamler
- Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH 44106, USA.
| | - Vivian J Miller
- School of Social Work, University of Texas at Arlington, Arlington, TX 76109, USA.
| | - Sonya Petrakovitz
- Department of Anthropology, Case Western Reserve University, Cleveland, OH 44106, USA.
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