1
|
Kamei T, Kawada A, Minami K, Takahashi Z, Ishigaki Y, Yamanaka T, Yamamoto N, Yamamoto Y, Suzuki Y, Watanabe T, Iijima K. Effectiveness of an interdisciplinary home care approach for older adults with chronic conditions: A systematic review and meta-analysis. Geriatr Gerontol Int 2024. [PMID: 39021240 DOI: 10.1111/ggi.14931] [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: 01/30/2024] [Revised: 06/15/2024] [Accepted: 06/18/2024] [Indexed: 07/20/2024]
Abstract
The effectiveness of interdisciplinary home healthcare service consisting of at least two or more healthcare providers, such as a nurse, physician and physiotherapist, for community-dwelling older adults remains unclear. This systematic review assesses the effects of interdisciplinary home care on quality of life (QOL) and health outcomes in older adults with chronic conditions using validated tools. Databases were searched using CINAHL Plus with Full Text, PubMed, EMBASE, CENTRAL, PsycINFO, and OpenGrey from inception to January 25, 2021. Eligibility criteria included (i) an interdisciplinary home care approach, (ii) participants aged 65 years and older with chronic conditions, (iii) randomized controlled trials (RCTs), and (iv) original literature in English. The study reviewer's dyad independently screened the literature and assessed the study quality using the Cochrane's Risk of Bias 2 tool. The analysis employed qualitative and quantitative integration and Grading of Recommendations Assessment, Development, and Evaluation. This study included 13 RCTs with 4709 participants. Four RCTs indicated that interdisciplinary home healthcare services reduced hospital admissions during the initial 6 months after the start of home care interventions (risk ratio [RR] = 0.73; 95% confidence interval [CI] = 0.61-0.88; p < 0.001; I2 = 0%). However, evidence certainty was moderate; QOL and mortality showed low certainty; and institutionalization and adherence showed moderate certainty of evidence. This study suggests that the interdisciplinary home care approach reduces hospital admissions but lacks effects on other outcomes. More robust studies are required to evaluate this evidence. Geriatr Gerontol Int 2024; ••: ••-••.
Collapse
Affiliation(s)
- Tomoko Kamei
- Graduate School of Nursing Science, St Luke's International University, Tokyo, Japan
| | - Aki Kawada
- Graduate School of Nursing Science, St Luke's International University, Tokyo, Japan
| | - Kotoko Minami
- Graduate School of Nursing Science, St Luke's International University, Tokyo, Japan
| | - Zaiya Takahashi
- Department of Medical Education, Graduate School of Medicine, Chiba University, Chiba, Japan
| | | | - Takashi Yamanaka
- Department of Home Care Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Noriko Yamamoto
- Department of Gerontological Homecare and Long-term Care Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yuko Yamamoto
- Chiba Faculty of Nursing, Tokyo Healthcare University, Chiba, Japan
| | - Yusuke Suzuki
- Centre for Community Liaison and Patient Consultations, Nagoya University Hospital, Aichi, Japan
| | - Takamasa Watanabe
- Centre for Family Medicine Development, Japanese Health and Welfare Co-operative Federation, Tokyo, Japan
| | - Katsuya Iijima
- Institute for Future Initiatives, Institute of Gerontology, The University of Tokyo, Tokyo, Japan
| |
Collapse
|
2
|
Whittaker SL, Brusco NK, Hill KD, Taylor NF. Self-management Programs Within Rehabilitation Yield Positive Health Outcomes at a Small Increased Cost Compared With Usual Care: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil 2024:S0003-9993(24)00995-X. [PMID: 38729404 DOI: 10.1016/j.apmr.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: 04/30/2023] [Revised: 04/09/2024] [Accepted: 05/02/2024] [Indexed: 05/12/2024]
Abstract
OBJECTIVE To determine if self-management programs, supported by a health professional, in rehabilitation are cost effective. DATA SOURCES Six databases were searched until December 2023. STUDY SELECTION Randomized controlled trials with adults completing a supported self-management program while participating in rehabilitation or receiving health professional input in the hospital or community settings were included. Self-management programs were completed outside the structured, supervised therapy and health professional sessions. Included trials had a cost measure and an effectiveness outcome reported, such as health-related quality of life or function. Grading of Recommendations, Assessment, Development, and Evaluations was used to determine the certainty of evidence across trials included in each meta-analysis. Incremental cost-effectiveness ratios were calculated based on the mean difference from the meta-analyses of contributing health care costs and quality of life. DATA EXTRACTION After application of the search strategy, two independent reviewers determined eligibility of identified literature, initially by reviewing the title and/or abstract before full-text review. Using a customized form, data were extracted by one reviewer and checked by a second reviewer. DATA SYNTHESIS Forty-three trials were included, and 27 had data included in meta-analyses. Where self-management was a primary intervention, there was moderate certainty of a meaningful positive difference in quality-of-life utility index of 0.03 units (95% confidence interval, 0.01-0.06). The cost difference between self-management as the primary intervention and usual care (comprising usual intervention/therapy, minimal intervention [including education only], or no intervention) potentially favored the comparison group (mean difference=Australian dollar [AUD]90; 95% confidence interval, -AUD130 to AUD310). The cost per quality-adjusted life year (QALY) gained for self-management programs as a stand-alone intervention was AUD3000, which was below the acceptable willingness-to-pay threshold in Australia per QALY gained (AUD50,000/QALY gained). CONCLUSIONS Self-management as an intervention is low cost and could improve health-related quality of life.
Collapse
Affiliation(s)
- Sara L Whittaker
- Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, School of Primary and Allied Health Care, Monash University, Melbourne, Victoria.
| | - Natasha K Brusco
- Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, School of Primary and Allied Health Care, Monash University, Melbourne, Victoria
| | - Keith D Hill
- Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, School of Primary and Allied Health Care, Monash University, Melbourne, Victoria
| | - Nicholas F Taylor
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria; Eastern Health, Allied Health Clinical Research Office, Box Hill, Victoria, Australia
| |
Collapse
|
3
|
Mosteiro Miguéns DG, Rodríguez Fernández A, Zapata Cachafeiro M, Vieito Pérez N, Represas Carrera FJ, Novío Mallón S. Community Activities in Primary Care: A Literature Review. J Prim Care Community Health 2024; 15:21501319231223362. [PMID: 38197384 PMCID: PMC10785739 DOI: 10.1177/21501319231223362] [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: 10/29/2023] [Revised: 11/30/2023] [Accepted: 12/01/2023] [Indexed: 01/11/2024] Open
Abstract
Community health promotion activities are a useful tool for a proactive approach to healthy lifestyles. However, the implementation of these types of activities at health centers is not standardized. The aim of this review was to analyse the characteristics of community activities undertaken in the primary care setting and substantiate available evidence on their health impact. We conducted a bibliographic review until November 15th, 2023 in the TRIPDATABASE, MEDLINE, EMBASE, and DIALNET databases. We included original papers on interventions, community activities, and actions and/or social prescriptions which had been implemented in a Primary Care setting, included a group approach in at least one session, and described some type of evaluation of the intervention applied. Studies targeted at professionals and those without involvement of the primary care team were excluded. The search identified 1912 potential studies. We included a total of 30 studies, comprising 11 randomized clinical trials, 14 quasi-experimental studies, 1 cohort study, and 4 qualitative studies. The issues most frequently addressed in community activities were healthy habits, physical activity, cardiovascular diseases and diabetes. Community activities can improve the physical and psychological environment of their participants, as well as their level of knowledge about the issues addressed. That said, however, implementation of these types of interventions is not uniform. The existence of a professional community-activity liaison officer at health centers, who would help integrate the health system with the community sector, could serve to standardize implementation and maximize the health impact of these types of interventions.
Collapse
Affiliation(s)
| | - Almudena Rodríguez Fernández
- University of Santiago de Compostela, Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER of Epidemiology and Public Health, CIBERESP) Instituto de Salud Carlos III, Madrid, Spain
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Maruxa Zapata Cachafeiro
- University of Santiago de Compostela, Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER of Epidemiology and Public Health, CIBERESP) Instituto de Salud Carlos III, Madrid, Spain
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Natalia Vieito Pérez
- University Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
| | | | | |
Collapse
|
4
|
Khunti K, Chudasama YV, Gregg EW, Kamkuemah M, Misra S, Suls J, Venkateshmurthy NS, Valabhji J. Diabetes and Multiple Long-term Conditions: A Review of Our Current Global Health Challenge. Diabetes Care 2023; 46:2092-2101. [PMID: 38011523 DOI: 10.2337/dci23-0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 07/26/2023] [Indexed: 11/29/2023]
Abstract
Use of effective treatments and management programs is leading to longer survival of people with diabetes. This, in combination with obesity, is thus contributing to a rise in people living with more than one condition, known as multiple long-term conditions (MLTC or multimorbidity). MLTC is defined as the presence of two or more long-term conditions, with possible combinations of physical, infectious, or mental health conditions, where no one condition is considered as the index. These include a range of conditions such as cardiovascular diseases, cancer, chronic kidney disease, arthritis, depression, dementia, and severe mental health illnesses. MLTC has major implications for the individual such as poor quality of life, worse health outcomes, fragmented care, polypharmacy, poor treatment adherence, mortality, and a significant impact on health care services. MLTC is a challenge, where interventions for prevention and management are lacking a robust evidence base. The key research directions for diabetes and MLTC from a global perspective include system delivery and care coordination, lifestyle interventions and therapeutic interventions.
Collapse
Affiliation(s)
- Kamlesh Khunti
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, U.K
| | - Yogini V Chudasama
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, U.K
| | - Edward W Gregg
- School of Population Health, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
| | - Monika Kamkuemah
- Innovation Africa and Department of Architecture, Faculty of Engineering, Built Environment and Information Technology, University of Pretoria, Pretoria, South Africa
| | - Shivani Misra
- Division of Metabolism, Digestion and Reproduction, Imperial College London, London, U.K
- Department of Diabetes and Endocrinology, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, U.K
| | - Jerry Suls
- Institute for Health System Science, Feinstein Institutes for Medical Research Northwell Health, New York, NY
| | - Nikhil S Venkateshmurthy
- Public Health Foundation of India, New Delhi, India
- Centre for Chronic Disease Control, New Delhi, India
| | - Jonathan Valabhji
- Division of Metabolism, Digestion and Reproduction, Imperial College London, London, U.K
- Department of Diabetes and Endocrinology, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, U.K
| |
Collapse
|
5
|
Camargo-Plazas P, Robertson M, Alvarado B, Paré GC, Costa IG, Duhn L. Diabetes self-management education (DSME) for older persons in Western countries: A scoping review. PLoS One 2023; 18:e0288797. [PMID: 37556399 PMCID: PMC10411808 DOI: 10.1371/journal.pone.0288797] [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: 04/10/2023] [Accepted: 07/04/2023] [Indexed: 08/11/2023] Open
Abstract
Diabetes mellitus is a chronic metabolic health condition affecting millions globally. Diabetes is a growing concern among aging societies, with its prevalence increasing among those aged 65 and above. Enabling disease self-management via relevant education is part of high-quality care to improve health outcomes and minimize complications for individuals living with diabetes. Successful diabetes self-management education (DSME) programs usually require tailoring for the intended audience; however, there is limited literature about the preferences of older persons in Western countries concerning DSME. As such, a broad overview of DSME for older persons was an identified need. To map the available evidence on DSME for persons aged 65 years and older in Western countries, the JBI methodology for conducting and reporting scoping reviews was used. In this scoping review, we considered all studies about DSME for older persons with T1D and T2D in Western countries where lifestyles, risks, prevention, treatment of diabetes, and approaches to self-management and DSME are similar (e.g., North America, Western and Northern Europe and Australasia). Systematic keyword and subject heading searches were conducted in 10 databases (e.g., MEDLINE, JBI EBP) to identify relevant English language papers published from 2000 to 2022. Titles and abstracts were screened to select eligible papers for full-text reading. Full-text screening was done by four independent reviewers to select studies for the final analysis. The review identified 2,397 studies, of which 1,250 full texts were screened for eligibility. Of the final 44 papers included in the review, only one included participants' understanding of DSME. The education programs differed in their context, design, delivery mode, theoretical underpinnings, and duration. Type of research designs, outcome measures used to determine the effectiveness of DSME, and knowledge gaps were also detailed. Overall, most interventions were effective and improved clinical and behavioural outcomes. Many of the programs led to improvements in clinical outcomes and participants' quality of life; however, the content needs to be adapted to older persons according to their culture, different degrees of health literacy, preference of education (e.g., individualized or group), preference of setting, degree of frailty and independence, and comorbidities. Few studies included the voices of older persons in the design, implementation, and evaluation of DSME programs. Such experiential knowledge is vital in developing educational programs to ensure alignment with this population's preferred learning styles, literacy levels, culture, and needs-such an approach could manifest more substantive, sustained results.
Collapse
Affiliation(s)
| | | | - Beatriz Alvarado
- Department of Public Health Sciences, School of Medicine, Queen’s University, Kingston, ON, Canada
| | | | | | - Lenora Duhn
- School of Nursing, Queen’s University, Kingston, ON, Canada
| |
Collapse
|
6
|
Mirzaei T, Ravari A, Hosseini F, Hassanshahi E. Comparison of the Effect of Education Using Team-based Learning Method and Lecture Method on Controlling Diabetes in the Elderly: A Quasi-Experimental Study. INTERNATIONAL JOURNAL OF COMMUNITY BASED NURSING AND MIDWIFERY 2023; 11:201-209. [PMID: 37489223 PMCID: PMC10363271 DOI: 10.30476/ijcbnm.2023.97837.2210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 06/03/2023] [Accepted: 06/26/2023] [Indexed: 07/26/2023]
Abstract
Background Patient education is considered as an essential part of diabetes control. This research is conducted to compare the effect of education using team-based learning (TBL) method and lecture method on blood pressure (BP), serum levels of fasting blood sugar (FBS), glycosylated hemoglobin (HbA1c), and Body mass index (BMI) in the elderly with diabetes. Methods This quasi-experimental study was conducted on 61 elderly patients with type 2 diabetes in diabetes clinics in Rafsanjan, during October 2018 to January 2019. Patients were selected using simple random sampling. They were divided into two groups of TBL and lecture-based learning. For each group, educational content was presented through 2-hour sessions held once a week for 1 months. FBS, HbA1c, BMI, and BP were measured at baseline and 3 months after the intervention. Data were analyzed through SPSS 21, using Chi-square test, independent t-test, and paired t-test; A P-value<0.05 was considered as significant. Results After the intervention, the TBL group had a significant decrease in systolic and diastolic BP compared to the lecture group (P<0.001). Before and 3 months after the intervention in the TBL group, there was a significant decrease between the means of FBS (P=0.01), HbA1c (P<0.001), and systolic and diastolic BP (P<0.001), but in the lecture group, only the systolic BP showed a significant decrease (P<0.001). Conclusion TBL method had more effects on controlling diabetes type 2 in the elderly than the lecture method. It is suggested that health providers should consider TBL for the education of the elderly with diabetes.
Collapse
Affiliation(s)
- Tayebeh Mirzaei
- Geriatric Care Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Ali Ravari
- Geriatric Care Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Fatemeh Hosseini
- Geriatric Care Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Department of Community Health Nursing, School of Nursing and Midwifery, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Elham Hassanshahi
- Geriatric Care Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| |
Collapse
|
7
|
Yous ML, Ganann R, Ploeg J, Markle-Reid M, Northwood M, Fisher K, Valaitis R, Chambers T, Montelpare W, Légaré F, Beleno R, Gaudet G, Giacometti L, Levely D, Lindsay C, Morrison A, Tang F. Older adults' experiences and perceived impacts of the Aging, Community and Health Research Unit-Community Partnership Program (ACHRU-CPP) for diabetes self-management in Canada: a qualitative descriptive study. BMJ Open 2023; 13:e068694. [PMID: 37019487 PMCID: PMC10083734 DOI: 10.1136/bmjopen-2022-068694] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/07/2023] Open
Abstract
OBJECTIVES To assess the experiences and perceived impacts of the Aging, Community and Health Research Unit-Community Partnership Program (ACHRU-CPP) from the perspectives of older adults with diabetes and other chronic conditions. The ACHRU-CPP is a complex 6-month self-management evidence-based intervention for community-living older adults aged 65 years or older with type 1 or type 2 diabetes and at least one other chronic condition. It includes home and phone visits, care coordination, system navigation support, caregiver support and group wellness sessions delivered by a nurse, dietitian or nutritionist, and community programme coordinator. DESIGN Qualitative descriptive design embedded within a randomised controlled trial was used. SETTING Six trial sites offering primary care services from three Canadian provinces (ie, Ontario, Quebec and Prince Edward Island) were included. PARTICIPANTS The sample was 45 community-living older adults aged 65 years or older with diabetes and at least one other chronic condition. METHODS Participants completed semistructured postintervention interviews by phone in English or French. The analytical process followed Braun and Clarke's experiential thematic analysis framework. Patient partners informed study design and interpretation. RESULTS The mean age of older adults was 71.7 years, and the mean length of time living with diabetes was 18.8 years. Older adults reported positive experiences with the ACHRU-CPP that supported diabetes self-management, such as improved knowledge in managing diabetes and other chronic conditions, enhanced physical activity and function, improved eating habits, and opportunities for socialisation. They reported being connected to community resources by the intervention team to address social determinants of health and support self-management. CONCLUSIONS Older adults perceived that a 6-month person-centred intervention collaboratively delivered by a team of health and social care providers helped support chronic disease self-management. There is a need for providers to help older adults connect with available health and social services in the community. TRIAL REGISTRATION NUMBER ClinicalTrials.gov ID: NCT03664583; Results.
Collapse
Affiliation(s)
- Marie-Lee Yous
- School of Nursing, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Rebecca Ganann
- School of Nursing, Aging, Community and Health Research Unit, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Jenny Ploeg
- School of Nursing, Aging, Community and Health Research Unit, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Maureen Markle-Reid
- School of Nursing, Aging, Community and Health Research Unit, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Melissa Northwood
- School of Nursing, Aging, Community and Health Research Unit, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Kathryn Fisher
- School of Nursing, Aging, Community and Health Research Unit, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Ruta Valaitis
- School of Nursing, Aging, Community and Health Research Unit, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Tracey Chambers
- School of Nursing, Aging, Community and Health Research Unit, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - William Montelpare
- Department of Applied Human Sciences, Faculty of Science, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - France Légaré
- VITAM Centre de recherche en santé durable, Université Laval, Quebec, Quebec, Canada
- Department of Family and Emergency Medicine, Faculty of Medicine, Université Laval, Quebec, Quebec, Canada
| | - Ron Beleno
- School of Nursing, Aging, Community and Health Research Unit, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Gary Gaudet
- Department of Applied Human Sciences, Faculty of Science, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - Luisa Giacometti
- School of Nursing, Aging, Community and Health Research Unit, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Deborah Levely
- School of Nursing, Aging, Community and Health Research Unit, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Craig Lindsay
- School of Nursing, Aging, Community and Health Research Unit, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Allan Morrison
- Department of Applied Human Sciences, Faculty of Science, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - Frank Tang
- School of Nursing, Aging, Community and Health Research Unit, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| |
Collapse
|
8
|
de Oliveira JL, Dal Sasso Mendes K, de Almeida LY, de Almeida JCP, Souza Gonçalves J, Strobbe S, de Souza J. Mental Health Care in Primary Health Care: An Integrative Review. Issues Ment Health Nurs 2023; 44:329-337. [PMID: 37015019 DOI: 10.1080/01612840.2023.2189954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
In this study, we analyzed recent studies on mental health approaches developed in primary health care to identify the emphasis of such interventions, their technical feasibility for the setting in question, and their levels of evidence. An integrative review was conducted of primary studies from the LILACS, PubMed, Embase, CINAHL, and Web of Science databases using the PRISMA search strategy. Nineteen studies were identified with a high level of evidence that contribute to the advancement of knowledge in the area. However, academic, cultural, and linguistic barriers still need to be overcome to facilitate sharing of such interventions' findings and protocols.
Collapse
Affiliation(s)
- Jaqueline Lemos de Oliveira
- Department of Psychiatric Nursing and Human Sciences, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto, Brazil
| | - Karina Dal Sasso Mendes
- Department of General and Specialized Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto, Brazil
| | - Leticia Yamawaka de Almeida
- Center for Studies, Research and Practice in Primary Health Care, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | | | - Jamila Souza Gonçalves
- Department of Psychiatric Nursing and Human Sciences, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto, Brazil
| | - Stephen Strobbe
- Department of Systems, Populations, and Leadership, University of Michigan School of Nursing, Ann Arbor, Michigan, USA
| | - Jacqueline de Souza
- Department of Psychiatric Nursing and Human Sciences, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto, Brazil
| |
Collapse
|
9
|
Robertson M, Parè G, Costa I, Alvarado B, Duhn L, Plazas PC. “I Could Have Stood a Little More Education Rather than Just: ‘Hey, you’re Diabetic Man, Make the Best out of It’”: Revisioning Diabetes Self-Management Education for Older Adults. Res Aging 2022:1640275221138968. [DOI: 10.1177/01640275221138968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Objectives: Providing diabetes self-management education (DSME) in an evidence-based format that is accessible and tailored to the population needs is crucial for individuals living with diabetes mellitus. Our qualitative study explores the experiences of older adults living with diabetes while residing in a rural setting. Methods: Adults aged 65 or older and residing in a rural area of Ontario completed a photovoice activity and semi-structured interviews to illustrate their experience of living with diabetes and accessing DSME. Results: Fourteen participants (11 males; mean age = 74 years) completed the photovoice activity and interview. Four main themes were identified pertaining to learning about diabetes education, the depth and breadth of learning, applying knowledge to daily life, and engaging older adults in DSME. Discussion: Diabetes self-management education should account for older adults’ preferences in learning about diabetes and self-management to promote access to evidence-based information, bolster knowledge and self-management efficacy, and improve disease control.
Collapse
Affiliation(s)
| | - Geneviéve Parè
- School of Nursing, Queen’s University, Kingston, ON, Canada
| | - Idevania Costa
- School of Nursing, Lakehead University, Thunder Bay, ON, Canada
| | - Beatriz Alvarado
- Department of Public Health Sciences, Queen’s University,Kingston, ON, Canada
| | - Lenora Duhn
- School of Nursing, Queen’s University, Kingston, ON, Canada
| | | |
Collapse
|
10
|
Influence of health-system change on treatment burden: a systematic review. Br J Gen Pract 2022; 73:e59-e66. [PMID: 36253115 PMCID: PMC9591018 DOI: 10.3399/bjgp.2022.0066] [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: 02/03/2022] [Accepted: 07/13/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Treatment burden is a patient-centred concept describing the effort required of people to look after their health and the impact this has on their functioning and wellbeing. High treatment burden is more likely for people with multiple long-term conditions (LTCs). Validated treatment burden measures exist, but have not been widely used in practice or as research outcomes. AIM To establish whether changes in organisation and delivery of health systems and services improve aspects contributing to treatment burden for people with multiple LTCs. DESIGN AND SETTING Systematic review of randomised controlled trials (RCTs) investigating the impact of system-level interventions on at least one outcome relevant to previously defined treatment burden domains among adults with ≥2 LTCs. METHOD The Embase, Ovid MEDLINE, and Web of Science electronic databases were searched for terms related to multimorbidity, system-level change, and treatment burden published between January 2010 and July 2021. Treatment burden domains were derived from validated measures and qualitative literature. Synthesis without meta-analysis (SWiM) methodology was used to synthesise results and study quality was assessed using the Cochrane risk-of-bias (version 2) tool. RESULTS The searches identified 1881 articles, 18 of which met the review inclusion criteria. Outcomes were grouped into seven domains. There was some evidence for the effect of system-level interventions on some domains, but the studies exhibited substantial heterogeneity, limiting the synthesis of results. Some concern over bias gave low confidence in study results. CONCLUSION System-level interventions may affect some treatment burden domains. However, adoption of a standardised outcome set, incorporating validated treatment burden measures, and the development of standard definitions for care processes in future research would aid study comparability.
Collapse
|
11
|
Izquierdo V, Pazos-Couselo M, González-Rodríguez M, Rodríguez-González R. Educational programs in type 2 diabetes designed for community-dwelling older adults: A systematic review. Geriatr Nurs 2022; 46:157-165. [PMID: 35700683 DOI: 10.1016/j.gerinurse.2022.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 05/17/2022] [Accepted: 05/19/2022] [Indexed: 12/14/2022]
Abstract
AIMS This systematic review aimed to assess the effectiveness of educational interventions in type 2 diabetes specifically designed for community-dwelling older adults. METHODS In accordance with PRISMA guidelines, a systematic search of studies published between 2010 and 2021 was conducted across five electronic databases and manual sources. The study protocol was previously registered in PROSPERO (CRD42021288236). RESULTS Twelve papers matched the inclusion criteria and were appraised using MERSQI. The features of the educational programs were heterogeneous, and none complied with the ten suggested standards for diabetes self-management education and support. Comprehensive gerontological assessment was not considered. Outcomes included biomedical, psychosocial, behavioral, and knowledge measures. HbA1c and knowledge showed improvements with a high certainty level according to GRADE. CONCLUSIONS Structured DSME programs aimed at older adults have great potential, however there is still room to improve. Applying the principles of a comprehensive gerontological approach and the standards for DSME as continuous monitoring and support could increase their benefits.
Collapse
Affiliation(s)
- Veronica Izquierdo
- Faculty of Nursing, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Marcos Pazos-Couselo
- Faculty of Nursing, University of Santiago de Compostela, Santiago de Compostela, Spain; Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain; Research Methods (RESMET), Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.
| | | | - Raquel Rodríguez-González
- Faculty of Nursing, University of Santiago de Compostela, Santiago de Compostela, Spain; Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain; Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| |
Collapse
|
12
|
Interprofessional Collaboration and Diabetes Management in Primary Care: A Systematic Review and Meta-Analysis of Patient-Reported Outcomes. J Pers Med 2022; 12:jpm12040643. [PMID: 35455759 PMCID: PMC9029958 DOI: 10.3390/jpm12040643] [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: 03/16/2022] [Revised: 04/11/2022] [Accepted: 04/13/2022] [Indexed: 02/05/2023] Open
Abstract
The global spread of diabetes poses serious threats to public health requiring a patient-centered approach based both on interprofessional collaboration (IPC) given by the cooperation of several different health professionals, and patients’ perspective through the assessment of Patient-Reported Outcomes (PROs). The aim of the present study is to evaluate the impact of interprofessional collaboration interventions, for the management of type 2 diabetes in primary care settings, through PROs. A systematic review and meta-analysis was conducted querying the PubMed, Scopus and Embase databases. Out of the 1961 papers initially retrieved, 19 met the inclusion criteria. Interprofessional collaboration is significantly associated with an increase in both patient’s satisfaction (SMD 0.32 95% CI 0.05–0.59) and in the mental well-being component of the HRQoL (SMD 0.18; 95% CI 0.06–0.30), and there was also promising evidence supporting the association between an interprofessional approach and an increase in self-care and in generic and specific quality-of-life. No statistical differences were found, supporting the positive impact on IPC interventions on the physical component of the HRQoL, depression, emotional distress, and self-efficacy. In conclusion, the effect of IPC impacts positively on the few areas assessed by PROMs. Policymakers should promote the widespread adoption of a collaborative approach as well as to endorse an active engagement of patients across the whole process of care.
Collapse
|
13
|
Ploeg J, Markle-Reid M, Valaitis R, Fisher K, Ganann R, Blais J, Chambers T, Connors R, Gruneir A, Légaré F, MacIntyre J, Montelpare W, Paquette JS, Poitras ME, Riveroll A, Yous ML. The Aging, Community and Health Research Unit Community Partnership Program (ACHRU-CPP) for older adults with diabetes and multiple chronic conditions: study protocol for a randomized controlled trial. BMC Geriatr 2022; 22:99. [PMID: 35120457 PMCID: PMC8814798 DOI: 10.1186/s12877-021-02651-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 11/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Older adults (≥65 years) with diabetes and multiple chronic conditions (MCC) (> 2 chronic conditions) experience reduced function and quality of life, increased health service use, and high mortality. Many community-based self-management interventions have been developed for this group, however the evidence for their effectiveness is limited. This paper presents the protocol for a randomized controlled trial (RCT) comparing the effectiveness and implementation of the Aging, Community and Health Research Unit-Community Partnership Program (ACHRU-CPP) to usual care in older adults with diabetes and MCC and their caregivers. METHODS We will conduct a cross-jurisdictional, multi-site implementation-effectiveness type II hybrid RCT. Eligibility criteria are: ≥65 years, diabetes diagnosis (Type 1 or 2) and at least one other chronic condition, and enrolled in a primary care or diabetes education program. Participants will be randomly assigned to the intervention (ACHRU-CPP) or control arm (1:1 ratio). The intervention arm consists of home/telephone visits, monthly group wellness sessions, multidisciplinary case conferences, and system navigation support. It will be delivered by registered nurses and registered dietitians/nutritionists from participating primary care or diabetes education programs and program coordinators from community-based organizations. The control arm consists of usual care provided by the primary care setting or diabetes education program. The primary outcome is the change from baseline to 6 months in mental functioning. Secondary outcomes will include, for example, the change from baseline to 6 months in physical functioning, diabetes self-management, depressive symptoms, and cost of use of healthcare services. Analysis of covariance (ANCOVA) models will be used to analyze all outcomes, with intention-to-treat analysis using multiple imputation to address missing data. Descriptive and qualitative data from older adults, caregivers and intervention teams will be used to examine intervention implementation, site-specific adaptations, and scalability potential. DISCUSSION An interprofessional intervention supporting self-management may be effective in improving health outcomes and client/caregiver experience and reducing service use and costs in this complex population. This pragmatic trial includes a scalability assessment which considers a range of effectiveness and implementation criteria to inform the future scale-up of the ACHRU-CPP. TRIAL REGISTRATION Clinical Trials.gov Identifier NCT03664583 . Registration date: September 10, 2018.
Collapse
Affiliation(s)
- Jenny Ploeg
- School of Nursing, Aging, Community and Health Research Unit, Faculty of Health Sciences, McMaster University, 1280 Main Street West, Room HSc3N25, Hamilton, Ontario, L8S 4K1, Canada.
| | - Maureen Markle-Reid
- School of Nursing, Aging, Community and Health Research Unit, Faculty of Health Sciences, McMaster University, 1280 Main Street West, Room HSc3N25, Hamilton, Ontario, L8S 4K1, Canada
| | - Ruta Valaitis
- School of Nursing, Aging, Community and Health Research Unit, Faculty of Health Sciences, McMaster University, 1280 Main Street West, Room HSc3N25, Hamilton, Ontario, L8S 4K1, Canada
| | - Kathryn Fisher
- School of Nursing, Aging, Community and Health Research Unit, Faculty of Health Sciences, McMaster University, 1280 Main Street West, Room HSc3N25, Hamilton, Ontario, L8S 4K1, Canada
| | - Rebecca Ganann
- School of Nursing, Aging, Community and Health Research Unit, Faculty of Health Sciences, McMaster University, 1280 Main Street West, Room HSc3N25, Hamilton, Ontario, L8S 4K1, Canada
| | - Johanne Blais
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Pavillon Ferdinand-Vandry, 1050, avenue de la Médecine, Local 4617, Québec, G1V 0A6, Canada
| | - Tracey Chambers
- School of Nursing, Aging, Community and Health Research Unit, Faculty of Health Sciences, McMaster University, 1280 Main Street West, Room HSc3N25, Hamilton, Ontario, L8S 4K1, Canada
| | - Robyn Connors
- Department of Applied Human Sciences, Faculty of Science, University of Prince Edward Island, Room 111, Steel Building, 550 University Avenue, Charlottetown, Prince Edward Island, C1A 4P3, Canada
| | - Andrea Gruneir
- Department of Family Medicine Research Program, University of Alberta, 6-40 University Terrace, Edmonton, Alberta, T6G 2T4, Canada
| | - France Légaré
- VITAM-Centre de recherche en santé durable, Université Laval, Pavillon Landry-Poulin, 2525, Chemin de la Canardière, Quebec City, QC, G1J 0A4, Canada and Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Québec, G1K 7P4, Canada
| | - Janet MacIntyre
- Faculty of Nursing, Room 116, Health Sciences Building, University of Prince Edward Island, 550 University Avenue, Charlottetown, Prince Edward Island, C1A 4P3, Canada
| | - William Montelpare
- Margaret and Wallace McCain Chair in Human Development and Health, Department of Applied Human Sciences, Faculty of Science, Room 122, Health Sciences Building, University of Prince Edward Island, 550 University Avenue, Charlottetown, Prince Edward Island, C1A 4P3, Canada
| | - Jean-Sébastien Paquette
- Groupe de Médecine de Famile Universitaire (GMF-U) du Nord de Lanaudière and Department of Family Medicine and Emergency Medicine, Faculty of Medicine Université Laval, Pavillon Ferdinand-Vandry, 1050, Avenue de la Médecine, Local 4617, Québec, G1V 0A6, Canada
| | - Marie-Eve Poitras
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke - Campus Saguenay, 305 Rue Saint Vallier, Chicoutimi, QC, G7H 5H6, Canada
| | - Angela Riveroll
- Department of Applied Human Sciences, Faculty of Science, University of Prince Edward Island, Room 115, Steel Building, 550 University Avenue, Charlottetown, Prince Edward Island, C1A 4P3, Canada
| | - Marie-Lee Yous
- School of Nursing, Aging, Community and Health Research Unit, Faculty of Health Sciences, McMaster University, 1280 Main Street West, Room HSc3N25, Hamilton, Ontario, L8S 4K1, Canada
| | | |
Collapse
|
14
|
Dobrow L, Estrada I, Burkholder-Cooley N, Miklavcic J. Potential Effectiveness of Registered Dietitian Nutritionists in Healthy Behavior Interventions for Managing Type 2 Diabetes in Older Adults: A Systematic Review. Front Nutr 2022; 8:737410. [PMID: 35141261 PMCID: PMC8819057 DOI: 10.3389/fnut.2021.737410] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 12/03/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose A systematic review was conducted to assess how the involvement of a registered dietitian nutritionist (RDN) in healthy behavior interventions (HBIs) potentially affects outcomes in older adults with type 2 diabetes (T2D). Methods Literature was searched for primary research published between 2016 and 2020 on HBI involving a RDN affecting outcomes in older adults with T2D. Evaluations of hemoglobin A1c (HbA1c), blood glucose, blood pressure, cholesterol, anthropometry, body composition, medication usage, healthcare cost, and self-efficacy and/or adherence to healthy behaviors outcomes were selected for inclusion. All the literature included were summarized, evaluated for certainty of evidence criteria, and assessed for bias. Results A total of 12 studies were included for assessment. Involvement of a RDN in HBI was shown to reduce HbA1c, fasting blood glucose, low-density lipoprotein (LDL) cholesterol, and blood pressure and improve lean body mass, body mass index (BMI), and self-efficacy in populations of older adults with T2D. Compared to older adults with T2D receiving HBI involving RDNs, patients receiving usual care may incur higher healthcare costs or longer hospital stays. There was a high certainty of evidence for a RDN involvement in HBI with regard to reduction in HbA1c. There was a moderate certainty of evidence for a RDN involvement in HBI with regard to favorable changes in weight or body composition and cardiometabolic health outcomes. Statistically significant improvements in outcomes were usually sustained in follow-up after conclusion of HBI. Conclusion RDNs may play an integral role in HBIs resulting in improved glycemic control, weight management, cardiovascular outcomes, and presumably comorbidity management. RDNs are important facilitators of diet education and nutrition assessment, which are essential in T2D management and should, therefore, be considered for routine inclusion in interprofessional teams for improved outcomes in older adults with T2D.
Collapse
Affiliation(s)
- Laurel Dobrow
- Schmid College of Science and Technology, Chapman University, Orange, CA, United States
| | - Isabella Estrada
- Schmid College of Science and Technology, Chapman University, Orange, CA, United States
| | | | - John Miklavcic
- Schmid College of Science and Technology, Chapman University, Orange, CA, United States
- School of Pharmacy, Chapman University, Irvine, CA, United States
- *Correspondence: John Miklavcic
| |
Collapse
|
15
|
Eriksen CU, Kamstrup–Larsen N, Birke H, Helding SAL, Ghith N, Andersen JS, Frølich A. Models of care for improving health-related quality of life, mental health, or mortality in persons with multimorbidity: A systematic review of randomized controlled trials. JOURNAL OF MULTIMORBIDITY AND COMORBIDITY 2022; 12:26335565221134017. [PMID: 36325259 PMCID: PMC9618762 DOI: 10.1177/26335565221134017] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVES To categorize and examine the effectiveness regarding health-related quality of life (HRQoL), mental health, and mortality of care models for persons with multimorbidity in primary care, community care, and hospitals through a systematic review. METHODS We searched PubMed, Embase, and Cochrane Central Register of Controlled Trials up to May 2020. One author screened titles and abstracts, and to validate, a second author screened 5% of the studies. Two authors independently extracted data and assessed risk of bias using the tool by the Cochrane Effective Practice and Organisation of Care group. Study inclusion criteria were (1) participants aged ≥ 18 years with multimorbidity; (2) referred to multimorbidity or two or more specific chronic conditions in the title or abstract; (3) randomized controlled design; and (4) HRQoL, mental health, or mortality as primary outcome measures. We used the Foundation Framework to categorize the models and the PRISMA-guideline for reporting. RESULTS In this study, the first to report effectiveness of care models in patients with multimorbidity in hospital settings, we included 30 studies and 9,777 participants with multimorbidity. 12 studies were located in primary care, 9 in community care, and 9 in hospitals. HRQoL was reported as the primary outcome in 12 studies, mental health in 17 studies, and mortality in three studies-with significant improvements in 5, 14, and 2, respectively. The studies are presented according to settings. CONCLUSIONS Although 20 of the care models reported positive effects, the variations in populations, settings, model elements, and outcome measures made it difficult to conclude on which models and model elements were effective.
Collapse
Affiliation(s)
- Christian U Eriksen
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region of Denmark, Denmark
| | - Nina Kamstrup–Larsen
- The Research Unit for General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; AND Innovation and Research Center for Multimorbidity, Slagelse Hospital, Region Zealand, Denmark
| | - Hanne Birke
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region of Denmark, Denmark
| | - Sofie A L Helding
- Rigshospitalet and DanTrials ApS, Juliane Marie Centre, Kobenhavn, Denmark; Zero Phase 1 Unit, Bispebjerg and Frederiksberg Hospital, The Capital Region of Denmark, Denmark
| | - Nermin Ghith
- Research Group for Genomic Epidemiology, National Food Institute, Technical University of Denmark, Denmark
| | - John S Andersen
- The Research Unit for General Practice, Department of Public Health, University of Copenhagen, Denmark
| | - Anne Frølich
- The Research Unit for General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; AND Innovation and Research Center for Multimorbidity, Slagelse Hospital, Region Zealand, Denmark
| |
Collapse
|
16
|
Xu L, Cui J, Li M, Wu Q, Liu M, Xu M, Shi G, Yin J, Yang J. Association Between Serum Asprosin and Diabetic Nephropathy in Patients with Type 2 Diabetes Mellitus in the Community: A Cross-Sectional Study. Diabetes Metab Syndr Obes 2022; 15:1877-1884. [PMID: 35757196 PMCID: PMC9215350 DOI: 10.2147/dmso.s361808] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 06/09/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To explore the association between serum asprosin and diabetic nephropathy (DN) in patients with type 2 diabetes mellitus (T2DM) in the community. METHODS In this cross-sectional study, we retrospectively collected the clinical data of T2DM patients from a community health service center in southeastern Shanxi Province between November 2019 and July 2021. Logistic regression analysis was used to calculate the odds ratio (OR) and the 95% confidence interval (95% CI) of asprosin levels on the risk of DN. RESULTS Among 498 T2DM patients included in this study, 221 had microalbuminuria, 105 had massive albuminuria, and 172 did not have any signs of nephropathy. Serum asprosin level was positively correlated with diastolic blood pressure, body mass index, triglycerides, aspartate aminotransferase, alanine aminotransferase, creatinine, ACR and albumin-to-creatinine ratio (all P < 0.05) and negatively correlated with low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, fasting plasma glucose, HbA1c and estimated glomerular filtration rate (all P < 0.05). After adjusting for covariates, increased asprosin was associated with diabetic nephropathy (all OR = 2.560, 95% CI: 1.1592-4.116; P < 0.001). CONCLUSION The risk of DN significantly increases with serum asprosin levels, especially among female patients.
Collapse
Affiliation(s)
- Linxin Xu
- First Clinical Medical College, Shanxi Medical University, Taiyuan, People’s Republic of China
- Department of Endocrinology, First Hospital of Shanxi Medical University, Shanxi Medical University, Taiyuan, Shanxi, 030001, People’s Republic of China
| | - Junfang Cui
- Department of Geratology, First Hospital of Shanxi Medical University, Shanxi Medical University, Taiyuan, 030001, People’s Republic of China
| | - Mina Li
- Department of Endocrinology, First Hospital of Shanxi Medical University, Shanxi Medical University, Taiyuan, Shanxi, 030001, People’s Republic of China
| | - Qianqian Wu
- Department of Endocrinology, First Hospital of Shanxi Medical University, Shanxi Medical University, Taiyuan, Shanxi, 030001, People’s Republic of China
| | - Ming Liu
- Department of Endocrinology, First Hospital of Shanxi Medical University, Shanxi Medical University, Taiyuan, Shanxi, 030001, People’s Republic of China
| | - Minggang Xu
- Department of Endocrinology, Changzhi Second People’s Hospital, Changzhi, 046000, People’s Republic of China
| | - Guoliang Shi
- Department of Endocrinology, Changzhi Second People’s Hospital, Changzhi, 046000, People’s Republic of China
| | - Jianhong Yin
- Department of Endocrinology, First Hospital of Shanxi Medical University, Shanxi Medical University, Taiyuan, Shanxi, 030001, People’s Republic of China
| | - Jing Yang
- First Clinical Medical College, Shanxi Medical University, Taiyuan, People’s Republic of China
- Department of Endocrinology, First Hospital of Shanxi Medical University, Shanxi Medical University, Taiyuan, Shanxi, 030001, People’s Republic of China
- Correspondence: Jing Yang; Jianhong Yin, Tel +86-351-4639756, Email ;
| |
Collapse
|
17
|
Jiwani R, Dennis B, Bess C, Monk S, Meyer K, Wang J, Espinoza S. Assessing acceptability and patient experience of a behavioral lifestyle intervention using fitbit technology in older adults to manage type 2 diabetes amid COVID-19 pandemic: A focus group study. Geriatr Nurs 2021; 42:57-64. [PMID: 33248357 PMCID: PMC7933081 DOI: 10.1016/j.gerinurse.2020.11.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/11/2020] [Accepted: 11/13/2020] [Indexed: 01/01/2023]
Abstract
Type 2 diabetes (T2D) contributes to reduced quality of life in older adults, especially in those with comorbidities such as being overweight or obese. Personal fitness technology (Fitbit ®) has the potential to improve the management of T2D. Using a semi-structured interview guide, focus groups were conducted to explore participants' acceptability and experiences following a behavioral lifestyle intervention that integrated Fitbit in overweight/obese older adults with T2D amid the COVID-19 pandemic which began during the time of this study. Focus group transcripts were transcribed and analyzed using thematic analysis. Eighteen (18) of the 20 participants completed the program and focus group interviews. Overall, we observed high acceptability of the program, and participants reported favorable experiences such as increased knowledge of health behaviors, improved diabetes management, and improved quality of life following the behavioral lifestyle intervention, even under stressful life circumstances from COVID-19.
Collapse
Affiliation(s)
- Rozmin Jiwani
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA; Geriatric Research, Education & Clinical Center (GRECC), South Texas Veterans Health Care System, San Antonio, Texas, USA.
| | - Brittany Dennis
- Graduate School of Biomedical Sciences, University of Texas Health Science Center at San Antonio, San Antonio,Texas, USA; Center on Smart and Connected Health Technologies at University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Chandler Bess
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Siler Monk
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Kylie Meyer
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Jing Wang
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA; Center on Smart and Connected Health Technologies at University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Sara Espinoza
- Geriatric Research, Education & Clinical Center (GRECC), South Texas Veterans Health Care System, San Antonio, Texas, USA; Department of Medicine, Division of Geriatrics, Gerontology & Palliative Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA; Sam & Ann Barshop Institute for Longevity and Aging Studies, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| |
Collapse
|