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Been-Dahmen JMJ, van der Stege H, Oldenmenger WH, Braat C, van der Lans MCM, Scheper M, van Staa A, Ista E. What factors contribute to cancer survivors' self-management skills? A cross-sectional observational study. Eur J Oncol Nurs 2024; 69:102539. [PMID: 38460391 DOI: 10.1016/j.ejon.2024.102539] [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: 09/26/2023] [Revised: 02/13/2024] [Accepted: 02/17/2024] [Indexed: 03/11/2024]
Abstract
PURPOSE Many cancer survivors, facing the consequences of their disease and its treatment, have medical and supportive aftercare needs. However, limited knowledge exists regarding the relationship between support needs and survivors' self-management skills. The study aim is to explore factors contributing to cancer survivors' self-management skills. METHODS A cross-sectional study was conducted among cancer survivors (n = 277) of two outpatient oncology clinics at a university hospital in the Netherlands. Patients with head and neck cancer (n = 55) who had received radiotherapy and cisplatin or cetuximab were included, as well as patients who had undergone hematopoietic stem cell transplantation (n = 222). The primary outcome was self-management skills, assessed using the Partners in Health Scale (PIH), which comprises two subscales: knowledge and coping (PIH-KC), and recognition and management of symptoms, and adherence to treatment (PIH-MSA). Secondary outcomes were quality of life (EORTC QLQ-C30), self-efficacy (SECD6), patient-centered care (CAPHS), and social support (HEIQ). Machine learning-based Random Forest models were employed to construct associative models. Feature Importance (FI) was used to express the contribution to the model. RESULTS High emotional quality of life (FI = 33.1%), increased self-efficacy (FI = 22.2%), and greater social support (FI = 18.2%) were identified as key factors contributing to cancer survivors' self-management knowledge (PIH-KC). Furthermore, greater support from professionals (FI = 36.1%) and higher self-efficacy (FI = 18.2%) were found to benefit participants' recognition and management, and therapy adherence (PIH-MSA). CONCLUSIONS A patient-centered relationship between nurses and cancer survivors is essential for therapy adherence and the management of aftercare needs. Training to provide this holistic self-management support is required.
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Affiliation(s)
- Janet M J Been-Dahmen
- Rotterdam University of Applied Sciences, Research Center Innovations in Care, Rotterdam, P.O. Box 25035, 3001 HA, Rotterdam, the Netherlands.
| | - Heleen van der Stege
- Rotterdam University of Applied Sciences, Research Center Innovations in Care, Rotterdam, P.O. Box 25035, 3001 HA, Rotterdam, the Netherlands.
| | - Wendy H Oldenmenger
- Erasmus MC Cancer Institute, University Medical Center Rotterdam, Department of Medical Oncology, Rotterdam, the Netherlands.
| | - Cora Braat
- Erasmus MC Cancer Institute, University Medical Center Rotterdam, Department of Radiotherapy, Rotterdam, the Netherlands.
| | - Mariska C M van der Lans
- Erasmus MC Cancer Institute, University Medical Center Rotterdam, Department of Hematology, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands.
| | - Mark Scheper
- Rotterdam University of Applied Sciences, Research Center Innovations in Care, Rotterdam, P.O. Box 25035, 3001 HA, Rotterdam, the Netherlands; Macquarie University, Faculty of Medicine and Science, Allied Health Professions, Sydney, Australia.
| | - AnneLoes van Staa
- Rotterdam University of Applied Sciences, Research Center Innovations in Care, Rotterdam, P.O. Box 25035, 3001 HA, Rotterdam, the Netherlands.
| | - Erwin Ista
- Erasmus MC, University Medical Center Rotterdam, Department of Internal Medicine - Section Nursing Science, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands; Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, Department of Neonatal and Pediatric Intensive Care, Division of Pediatric Intensive Care, Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands.
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2
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Mann C, Staubach P, Grabbe S, Wegner J, Hennig K, Nikolakis G, Szepietowski JC, Matusiak L, von Stebut E, Kirschner U, Podda M, Garcovich S, Schultheis M. Self-management-competency as a new target in Hidradenitis suppurativa care. J DERMATOL TREAT 2023; 34:2245082. [PMID: 37577779 DOI: 10.1080/09546634.2023.2245082] [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: 07/19/2023] [Accepted: 07/31/2023] [Indexed: 08/15/2023]
Abstract
Background: Hidradenitis suppurativa affects approximately 1% of the population.Objective: Highlighting the relevance of self-management-competency as a new therapeutic target.Method: 258 patients from the 'Epidemiology and Care in Acne inversa (EpiCAi)' project were included in the study. Disease burden was measured by patient-rated questionnaires in terms of disease activity, pain, quality of life, depression and insomnia and correlated with the domains of the health education impact questionnaire (heiQ) measuring self-management-competency.Results: 66 male (25.6%) and 192 female (74.4%) patients, with a mean age of 40.3 ± 10.24 years were included. Mean scores of pain on the numeric rating scale (NRS), Dermatology Life Quality Index (DLQI) and Hospital Anxiety and Depression Scale (HADS) were 5.11 ± 2.68, 11.35 ± 7.79 and 13.71 ± 7.57, respectively. The Insomnia severity index (ISI) showed a mean of 9.58 ± 5.76. The HADS has the highest increased total risk across all heiQ domains. With respect to the heiQ domains, the highest exposure can be attributed to improving constructive attitudes and approaches as well as decreasing emotional distress.Conclusion: There is a clear association of self-management-competency with overall disease burden, which underlines the need for psychoeducational support. This study provides ideas to develop new possible strategies of care.
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Affiliation(s)
- C Mann
- Department of Dermatology, University Medical Center, Johannes Gutenberg University, Mainz, Germany
| | - P Staubach
- Department of Dermatology, University Medical Center, Johannes Gutenberg University, Mainz, Germany
| | - S Grabbe
- Department of Dermatology, University Medical Center, Johannes Gutenberg University, Mainz, Germany
| | - J Wegner
- Department of Dermatology, University Medical Center, Johannes Gutenberg University, Mainz, Germany
| | - K Hennig
- Department of Dermatology, University Medical Center, Johannes Gutenberg University, Mainz, Germany
| | - G Nikolakis
- Department of Dermatology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane, Dessau, Germany
| | - J C Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - L Matusiak
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - E von Stebut
- Department of Dermatology, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - U Kirschner
- Dermatology Outpatient Office Dr. Uwe Kirschner, Mainz, Germany
| | - M Podda
- Hautklinik, Klinikum Darmstadt GmbH, Darmstadt, Germany
| | - S Garcovich
- Dermatology Outpatient Office Dr, Simone Garcovich, Rome, Italy
| | - M Schultheis
- Department of Dermatology, University Medical Center, Johannes Gutenberg University, Mainz, Germany
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van Zanten R, van Dijk M, Van Hecke A, Duprez V, Annema C, van Staa A, Been-Dahmen JMJ, de Weerd AE, Maasdam L, van Buren M, Ista E, Massey EK. The self-regulation skills instrument in transplantation (SSIt): Development and measurement properties of a self-report self-management instrument. PATIENT EDUCATION AND COUNSELING 2023; 115:107924. [PMID: 37516027 DOI: 10.1016/j.pec.2023.107924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 06/30/2023] [Accepted: 07/21/2023] [Indexed: 07/31/2023]
Abstract
OBJECTIVE To develop a self-management instrument for organ transplant recipients that incorporates self-regulations skills and to determine its measurement properties. METHODS The instrument includes concepts from social cognitive models: problem awareness, attitude, self-efficacy, motivation, social support, goal setting, goal pursuit, skills and goal affect. The measurement properties were evaluated based on the COSMIN guidelines. Face and content validity were determined through patient assessment, Three-Step Test-Interview and expert assessment using the Content Validity Index. Structural validity and reliability were tested using exploratory factor analysis and Cronbach's alpha. Construct validity was tested by comparing subscales with the Health Education Impact Questionnaire (heiQ). RESULTS After face and content validity assessment 47 items were entered into the exploratory factor analysis. The analysis showed two meaningful factors, with internal consistency of 0.90 and 0.89. Spearman correlations between the subscales and heiQ were moderate (0.55; 0.46). The final version consists of 21 items, divided into two scales: 'Setbacks' and 'Successes'. CONCLUSIONS The Self-regulation skills instrument in transplantation (SSIt) is a valid and reliable instrument to asses necessary skills for self-management after transplantation and may be useful for other patients as well. PRACTICE IMPLICATIONS Insight into self-regulation competencies can help healthcare professionals to tailor self-management support.
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Affiliation(s)
- Regina van Zanten
- Department of Internal Medicine, Erasmus MC Transplant Institute, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Monique van Dijk
- Department of Internal Medicine, Nursing studies, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Ann Van Hecke
- Department of Public Health and Primary Care, University Centre of Nursing and Midwifery, Ghent University, Ghent, Belgium; Ghent University Hospital, Staff nursing director, Ghent, Belgium
| | - Veerle Duprez
- Ghent University Hospital, nursing department, Ghent, Belgium
| | - Coby Annema
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, section of Nursing Science, Groningen, the Netherlands
| | - AnneLoes van Staa
- Rotterdam University of Applied Sciences, Research Center Innovation in Care, Rotterdam, the Netherlands
| | - Janet M J Been-Dahmen
- Rotterdam University of Applied Sciences, Research Center Innovation in Care, Rotterdam, the Netherlands
| | - Annelies E de Weerd
- Department of Internal Medicine, Erasmus MC Transplant Institute, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Louise Maasdam
- Department of Internal Medicine, Erasmus MC Transplant Institute, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Marleen van Buren
- Department of Internal Medicine, Erasmus MC Transplant Institute, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Erwin Ista
- Department of Internal Medicine, Nursing studies, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Emma K Massey
- Department of Internal Medicine, Erasmus MC Transplant Institute, University Medical Center Rotterdam, Rotterdam, the Netherlands.
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Meng X, Chan AHS. Cross-Regional Research in Demographic Impact on Safety Consciousness and Safety Citizenship Behavior of Construction Workers: A Comparative Study between Mainland China and Hong Kong. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12799. [PMID: 36232095 PMCID: PMC9566649 DOI: 10.3390/ijerph191912799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/01/2022] [Accepted: 10/02/2022] [Indexed: 06/16/2023]
Abstract
The construction industry has rapidly developed with continuous prosperity in Hong Kong and Mainland China, although accidents still occur with unacceptable frequency and severity. For promoting the safety issue of workers in construction industry, safety citizenship behavior (SCB) and safety consciousness (SC) were considered two influential constructs and further studied with integration of sociodemographic theories by scholars. However, no study has compared the SC and SCB of construction workers in terms of the demographic influence between Mainland China and Hong Kong. To fill this research gap, this study investigated the territorial difference between these two regions by conducting a cross-sectional questionnaire survey with recruitment of 253 Mainland construction workers and 256 Hong Kong construction workers. Significant similarities and differences of SC and SCB performance were revealed in terms of the workers with different genders, education levels, weekly working hours, and ages. This study provides insights into the comparison of demographic influence on SC and SCB of construction workers between Hong Kong and Mainland China, which is unique as it can yield useful managerial knowledge relevant to the personal safety of targeted groups of construction workers with particular demographic characteristics in both regions and contribute the implementation of safety interventions in line with the specific distinction in the territorial aspect.
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Affiliation(s)
- Xiangcheng Meng
- Sub-Institute of Public Security, China National Institute of Standardization, Beijing 100191, China
| | - Alan H. S. Chan
- Department of Advanced Design and Systems Engineering, City University of Hong Kong, Hong Kong 999077, China
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5
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van Zanten R, van Dijk M, van Rosmalen J, Beck D, Zietse R, Van Hecke A, van Staa A, Massey EK. Nurse-led self-management support after organ transplantation-protocol of a multicentre, stepped-wedge randomized controlled trial. Trials 2022; 23:14. [PMID: 34991680 PMCID: PMC8733435 DOI: 10.1186/s13063-021-05896-0] [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: 01/19/2021] [Accepted: 11/30/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Recipients of an organ transplantation face a number of challenges and often need to change their health behaviour. Good self-management skills are essential for optimal clinical outcomes. However, few interventions are available to support post-transplant self-management. To fill this gap, we developed a self-management support intervention offered by nurse practitioners. The primary aim of the study is to implement and test the effectiveness of the ZENN intervention in promoting self-management skills among heart, kidney liver and lung transplant recipients in comparison to standard care. The secondary aim is to assess the self-management support skills of nurse practitioners who will deliver the intervention. METHODS This multi-centre stepped-wedge randomized controlled trial will take place from September 2020 until May 2023. All departments will commence with inclusion of patients in the control period. Each department will be randomly assigned to a start date (step in the wedge) to commence the experimental period. Patients in the control period will receive standard care and will be asked to complete questionnaires at baseline (T0), 6 months (T1) and 12 months (T2), to assess self-management, self-regulation, quality of life and adherence. During the experimental period, patients will receive standard care plus the ZENN intervention and receive the same set of questionnaires as participants in the control period. Nurse practitioners will complete a baseline and follow-up questionnaire to assess differences in self-management support skills. Video recordings of outpatient clinic consultations during the control and experimental periods will determine the differences in nurses' needs-thwarting and needs-supporting skills between the control and experimental period. DISCUSSION The ZENN intervention could be a useful approach to support patients' self-management skills after organ transplantation and thus promote clinical outcomes as well as avoid adverse events. TRIAL REGISTRATION Dutch Trial Register NL8469 . Registered on March 19, 2020.
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Affiliation(s)
- Regina van Zanten
- Department of Internal Medicine, Erasmus MC Transplant Institute, University Medical Center, Dr. Molewaterplein 40, Rotterdam, 3015 GD, The Netherlands.
| | - Monique van Dijk
- Department of Internal Medicine, Nursing Studies, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Joost van Rosmalen
- Department of Biostatistics, Erasmus Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Denise Beck
- Department of Internal Medicine, Erasmus MC Transplant Institute, University Medical Center, Dr. Molewaterplein 40, Rotterdam, 3015 GD, The Netherlands
| | - Robert Zietse
- Department of Internal Medicine, Erasmus MC Transplant Institute, University Medical Center, Dr. Molewaterplein 40, Rotterdam, 3015 GD, The Netherlands
| | - Ann Van Hecke
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University Hospital, Ghent, Belgium.,Department of Nursing Director, Ghent University Hospital, Ghent, Belgium
| | | | - Emma K Massey
- Department of Internal Medicine, Erasmus MC Transplant Institute, University Medical Center, Dr. Molewaterplein 40, Rotterdam, 3015 GD, The Netherlands
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Skorstad M, de Rooij BH, Jeppesen MM, Bergholdt SH, Ezendam NPM, Bohlin T, Jensen PT, Lindemann K, van de Poll L, Vistad I. Self-management and adherence to recommended follow-up after gynaecological cancer: results from the international InCHARGE study. Int J Gynecol Cancer 2021; 31:1106-1115. [PMID: 33858949 DOI: 10.1136/ijgc-2020-002377] [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: 12/30/2020] [Revised: 03/24/2021] [Accepted: 03/24/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To assess the relationship between self-management skills and adherence to follow-up guidelines among gynecological cancer survivors in the Netherlands, Norway, and Denmark, and to assess the relationship between adherence to follow-up programs and use of additional healthcare services. METHODS For this international, multicenter, cross-sectional study, we recruited gynecological cancer survivors 1-5 years after completion of treatment. Information on follow-up visits, use of healthcare resources, self-management (measured by the Health Education Impact Questionnaire), clinical characteristics, and demographics were obtained by validated questionnaires. Participants were categorized as adherent if they attended the number of follow-up visits recommended by national guidelines, non-adherent if they had fewer visits than recommended, or over-users if they had more visits than recommended. RESULTS Of 4455 invited survivors, 2428 (55%) returned the questionnaires, and 911 survivors were included in the analyses. Survivors with high self-management most frequently adhered to recommended follow-up. Non-adherent survivors showed lower self-management in the health-directed activity domain (OR 1.54, 95% CI 1.03 to 2.32) than adherent survivors. No other associations between self-management and follow-up adherence were revealed. Non-adherent survivors tended to have endometrial cancer, surgical treatment only, be older, and be Danish residents. Over-users reported more follow-up visits and also used additional healthcare services more frequently than adherent survivors. CONCLUSION Low self-management appears to reduce the likelihood of adherence to national guidelines for gynecological cancer follow-up. Focusing on patient education for survivors at risk of low self-management to ensure adherence to recommended follow-up may improve personalization of follow-up.
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Affiliation(s)
- Mette Skorstad
- Department of Gynaecology and Obstetrics, Sorlandet Hospital Kristiansand, Kristiansand, Norway
| | - Belle H de Rooij
- Department of Medical and Clinical Psychology, IKNL, Utrecht, Utrecht, Netherlands.,Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands
| | - Mette Moustgaard Jeppesen
- Department of Gynaecology and Obstetrics, Hospital Lillebaelt Middelfart Hospital, Middelfart, Denmark.,OPEN, Odense Patient data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Stinne Holm Bergholdt
- Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark
| | - Nicole Paulina Maria Ezendam
- Department of Medical and Clinical Psychology, IKNL, Utrecht, Utrecht, Netherlands.,Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands
| | - Tonje Bohlin
- Department of Gynaecology and Obstetrics, Vestfold Hospital Trust, Tonsberg, Norway
| | - Pernille Tine Jensen
- Faculty of Health Science, Aarhus University, Aarhus, Denmark.,Department of Gynecology and Obstetrics, Aarhus Universitetshospital, Aarhus, Denmark
| | - Kristina Lindemann
- Department of Gynecological Oncology, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Lonneke van de Poll
- Department of Medical and Clinical Psychology, IKNL, Utrecht, Utrecht, Netherlands.,Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands.,Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Ingvild Vistad
- Department of Gynaecology and Obstetrics, Sorlandet Hospital Kristiansand, Kristiansand, Norway.,Department of Clinical Science, University of Bergen Faculty of Medicine and Dentistry, Bergen, Norway
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Assessing health empowerment - Brazilian cross-cultural adaptation and validity testing of the health education impact questionnaire (heiQ) among people with chronic low back pain. Braz J Phys Ther 2021; 25:460-470. [PMID: 33583719 DOI: 10.1016/j.bjpt.2021.01.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 12/01/2020] [Accepted: 01/21/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND There is no patient reported outcome measure available in Brazilian Portuguese to comprehensively assess outcomes following administration of patient education programs for people with chronic conditions. OBJECTIVE To describe the cross-cultural adaptation and measurement properties of the Brazilian Portuguese version of the Health Education Impact Questionnaire (heiQ), a multidimensional questionnaire designed for the evaluation of patient education programs, which was tested in people with chronic low back pain (LBP). METHODS One hundred thirty-seven individuals with non-specific chronic LBP (age: 38.7 ± 13.2) were enrolled in the study. The translation was performed according to international standards. Intraclass correlation coefficient (ICC) was used to assess test-retest reliability, Cronbach's α to assess internal consistency, Pearson rank correlation to compare the heiQ scales with comparator scales, and confirmatory factor analysis (CFA) for structural validity. RESULTS The test-retest analysis yielded ICC values ranging from 0.75 to 0.91. Cronbach's alphas for the seven scales ranged from 0.70 to 0.89. Significant correlations between affective and general health constructs and the heiQ scales (72%) were observed. For the majority of the scales, the CFA fit statistics showed to be good to excellent. CONCLUSION Overall, the Brazilian Portuguese version of the heiQ showed acceptable reliability, internal consistency, construct validity, and structural validity in individuals with chronic LBP. The heiQ scales may serve as direct outcomes to assess education and self-management programs for the Brazilian Portuguese speaker population.
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Beerthuizen T, Rijssenbeek-Nouwens LH, van Koppen SM, Khusial RJ, Snoeck-Stroband JB, Sont JK. Internet-Based Self-Management Support After High-Altitude Climate Treatment for Severe Asthma: Randomized Controlled Trial. J Med Internet Res 2020; 22:e13145. [PMID: 32706692 PMCID: PMC7407281 DOI: 10.2196/13145] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 10/29/2019] [Accepted: 03/29/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In patients with severe asthma, high-altitude climate treatment has been shown to improve asthma control. However, asthma symptoms and limitations may increase after finishing inpatient rehabilitation programs and returning to sea level. OBJECTIVE We assessed the effectiveness of a patient-tailored, internet-based, self-management strategy in addition to usual care after finishing high-altitude climate treatment. METHODS We performed a randomized controlled trial with a 1-year follow-up in patients from a high-altitude asthma center in Davos, Switzerland. At the end of a 12-week multidisciplinary rehabilitation program, 62 adults with asthma were randomized to receive either internet-based self-management support in addition to usual care (n=33) or usual care only after discharge (n=29). The endpoints were changes in asthma-related quality of life according to the Asthma Quality of Life Questionnaire (AQLQ) (a higher score is better) and asthma control according to the Asthma Control Questionnaire (ACQ) (a lower score is better), with a minimally important difference of 0.5 points for both. RESULTS Asthma-related quality of life and asthma control declined over time in the usual care strategy group, whereas there was a slower decline in the internet-based strategy group. For both endpoints, mixed-model analysis showed a significant positive effect in favor of internet-based self-management during follow-up (mean AQLQ score difference 0.39, 95% CI 0.092-0.69; P=.01 and ACQ score difference -0.50, 95% CI -0.86 to -0.15; P=.006), which was prominent among patients with uncontrolled asthma at discharge (AQLQ score difference 0.59, 95% CI 0.19-0.99; P=.003 and ACQ score difference -0.73, 95% CI -1.18 to -0.28; P=.002). CONCLUSIONS Internet-based self-management support was associated with a smaller decline in quality of life and asthma control as compared with usual care, especially in patients with lower asthma control, after completion of high-altitude climate treatment. Internet-based self-management support in adults with severe asthma seems feasible and effective to maintain quality of life and asthma control. TRIAL REGISTRATION The trial is registered in the Netherlands Trial Register (NTR1995).
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Affiliation(s)
- Thijs Beerthuizen
- Department of Biomedical Data Sciences, Section Medical Decision Making, Leiden University Medical Center, Leiden, Netherlands
| | | | - Sophia M van Koppen
- Department of Biomedical Data Sciences, Section Medical Decision Making, Leiden University Medical Center, Leiden, Netherlands
| | - Rishi J Khusial
- Department of Biomedical Data Sciences, Section Medical Decision Making, Leiden University Medical Center, Leiden, Netherlands
| | - Jiska B Snoeck-Stroband
- Department of Biomedical Data Sciences, Section Medical Decision Making, Leiden University Medical Center, Leiden, Netherlands
| | - Jacob K Sont
- Department of Biomedical Data Sciences, Section Medical Decision Making, Leiden University Medical Center, Leiden, Netherlands
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Pozza A, Osborne RH, Elsworth GR, Gualtieri G, Ferretti F, Coluccia A. Evaluation of the Health Education Impact Questionnaire (heiQ), a Self-Management Skill Assessment Tool, in Italian Chronic Patients. Psychol Res Behav Manag 2020; 13:459-471. [PMID: 32547268 PMCID: PMC7246315 DOI: 10.2147/prbm.s245063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 02/27/2020] [Indexed: 11/23/2022] Open
Abstract
Background The Health Education Impact Questionnaire (heiQ) aims to evaluate eight self-management skills in people with chronic conditions. Knowledge about the relations between these self-management skills and different quality of life (QoL) outcomes has received little attention. It is also important to provide further evidence on its properties in non-English healthcare contexts, as the questionnaire is being used in cross-cultural research. Furthermore, in the Italian healthcare context, the relationship between the medical staff and the patients remains asymmetrical, with the latter having the role of passive recipients of medical prescriptions and services. The current study provided further evidence about the psychometric properties of the heiQ among Italian people with chronic conditions, specifically by assessing the factor structure, reliability, convergent/divergent and criterion validity (ie, the specific contribution of each of the self-management skills to QoL outcomes). Methods Two hundred ninety-nine individuals with a chronic condition (mean age = 61.4 years, 50% females) completed the heiQ and the Medical Outcomes Study-Short Form (MOS SF-36). Confirmatory factor analyses, Composite Reliability Indices (CRI), bivariate correlations and linear regression analyses were computed. Results A model with 8 correlated factors showed good fit, in a similar way to previous studies. CRI values were acceptable to good for all the subscales. Associations between some of the heiQ subscales and some of the MOS SF-36 subscales supported criterion validity. In particular, it was confirmed by the moderate associations between the constructive attitudes and approaches subscale and the MOS SF-36 vitality and perceived mental health and by the moderate correlations between the health directed activities subscale and the MOS SF-36 Vitality. In linear regressions, higher emotional distress predicted higher physical and mental QoL, while higher mental QoL was also associated with stronger constructive attitudes and approaches. Conclusion The heiQ has robust properties across translations and it can also be used routinely in Italian healthcare contexts. The evidence that all the other self-management skills did not predict either physical or mental QoL could suggest that the self-management model of chronic diseases is still not sufficiently developed in the Italian context, where patients are passive recipients of medical instructions.
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Affiliation(s)
- Andrea Pozza
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Richard H Osborne
- Centre for Global Health and Equity, Swinburne University of Technology, Melbourne, Australia.,Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Gerald R Elsworth
- Centre for Global Health and Equity, Swinburne University of Technology, Melbourne, Australia
| | - Giacomo Gualtieri
- Legal Medicine Unit, Santa Maria alle Scotte University Hospital, Siena, Siena, Italy
| | - Fabio Ferretti
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Anna Coluccia
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
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Pozza A, Osborne RH, Elsworth GR, Ferretti F, Coluccia A. Italian validation of the health education impact questionnaire (heiQ) in people with chronic conditions. Health Qual Life Outcomes 2020; 18:89. [PMID: 32228608 PMCID: PMC7106648 DOI: 10.1186/s12955-020-01329-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 03/16/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The health education impact Questionnaire (heiQ) measures eight self-management skills in people with chronic conditions. It seems to be important to provide cross-cultural evidence on its properties in non-English healthcare contexts. The present study assessed the psychometric properties of the heiQ in Italian adults with chronic conditions. METHODS Two hundred ninety-nine individuals with a chronic condition (mean age = 61.4 years, 50.16% females) completed the heiQ and the Medical Outcomes Study-Short Form (SF-36). Confirmatory factor analyses, Composite Reliability Indices, and bivariate correlations were performed. RESULTS Structural validity based on 8 correlated factors with good fit was in line with previous research. Concurrent validity was confirmed, as shown by moderate associations between the scores on the Constructive attitudes and approaches, Self-monitoring and insight, Health directed activities, Social integration and support, and Emotional distress subscales and the scores on SF-36 Physical functioning, General health perceptions, Vitality, Social functioning, Perceived mental health and Role limitations due to physical and emotional problems subscales. CONCLUSIONS The Italian heiQ has strong properties and it can be used routinely also in the Italian healthcare services.
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Affiliation(s)
- Andrea Pozza
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Viale Bracci, 16 53100, Siena, Italy
| | - Richard H Osborne
- Centre for Global Health and Equity, Swinburne University of Technology, Melbourne, Australia.,University of Copenhagen, Copenhagen, Denmark
| | | | - Fabio Ferretti
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Viale Bracci, 16 53100, Siena, Italy.
| | - Anna Coluccia
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Viale Bracci, 16 53100, Siena, Italy
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Beems MEC, Toonders SAJ, van Westrienen PE, Veenhof C, Pisters MF. Identifying subgroups based on self-management skills in primary care patients with moderate medically unexplained physical symptoms. J Psychosom Res 2019; 125:109785. [PMID: 31421323 DOI: 10.1016/j.jpsychores.2019.109785] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 07/15/2019] [Accepted: 07/20/2019] [Indexed: 01/20/2023]
Abstract
OBJECTIVE Medically Unexplained Physical Symptoms (MUPS) are a major burden on both patients and society and frequently develop into chronic MUPS. Self-management interventions may prevent moderate MUPS from becoming chronic. Tailoring interventions to the patient population is strongly recommended. This can be facilitated by identifying subgroups based on self-management skills. This study aimed to identify these subgroups and their clinical profiles in primary care patients with moderate MUPS. METHODS A cross-sectional study was performed on baseline measurements from a randomized clinical trial (PARASOL-study). To identify subgroups based on self-management skills, a hierarchical cluster analysis was conducted for adults with moderate MUPS from primary health care centers. Self-management skills were measured with the Health education impact Questionnaire. Cluster variables were seven constructs of this questionnaire. Additionally, specific patient profiles were determined by comparing the identified clusters on the clinical variables pain, fatigue and physical functioning. RESULTS Four subgroups were identified: High-Self-Management Skills (SMS) (n = 29), Medium-SMS (n = 55), Low-SMS (n = 49) and Active & Low Distress-SMS (n = 20). The latter showed a distinctly different pattern on cluster variables, while the other subgroups differed significantly on means of the cluster variables (p < .001). On clinical variables, significant differences between subgroups were mainly found on fatigue and physical functioning. CONCLUSION This study found four specific subgroups based on self-management skills in moderate MUPS-patients. One subgroup demonstrated a distinctly different pattern on self-management skills. In other subgroups, more similar patterns on self-management skills were found that negatively correlated with pain and fatigue and positively correlated with physical functioning.
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Affiliation(s)
- M E C Beems
- Physical Therapy Sciences, Program in Clinical Health Sciences, University Medical Center Utrecht, Utrecht, the Netherlands; Center for Physical Therapy Research and Innovation in Primary Care, Leidsche Rijn Julius Health Care Centers, Utrecht, the Netherlands; Fysio Center Den Haag, The Hague, the Netherlands.
| | - S A J Toonders
- Center for Physical Therapy Research and Innovation in Primary Care, Leidsche Rijn Julius Health Care Centers, Utrecht, the Netherlands; Physical Therapy Research, Department of Rehabilitation, Physical Therapy Science and Sport, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands; Department of Health Innovation and Technology, Fontys University of Applied Sciences, Eindhoven, the Netherlands.
| | - P E van Westrienen
- Center for Physical Therapy Research and Innovation in Primary Care, Leidsche Rijn Julius Health Care Centers, Utrecht, the Netherlands; Physical Therapy Research, Department of Rehabilitation, Physical Therapy Science and Sport, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands; Department of Health Innovation and Technology, Fontys University of Applied Sciences, Eindhoven, the Netherlands.
| | - C Veenhof
- Center for Physical Therapy Research and Innovation in Primary Care, Leidsche Rijn Julius Health Care Centers, Utrecht, the Netherlands; Physical Therapy Research, Department of Rehabilitation, Physical Therapy Science and Sport, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands; Expertise Center Innovation of Care, Research Group Innovation of Mobility Care, Utrecht University of Applied Sciences, Utrecht, the Netherlands.
| | - M F Pisters
- Physical Therapy Sciences, Program in Clinical Health Sciences, University Medical Center Utrecht, Utrecht, the Netherlands; Center for Physical Therapy Research and Innovation in Primary Care, Leidsche Rijn Julius Health Care Centers, Utrecht, the Netherlands; Physical Therapy Research, Department of Rehabilitation, Physical Therapy Science and Sport, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands; Department of Health Innovation and Technology, Fontys University of Applied Sciences, Eindhoven, the Netherlands.
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12
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Self-management and health related quality of life in persons with chronic obstructive pulmonary disease. Qual Life Res 2019; 28:2889-2899. [DOI: 10.1007/s11136-019-02231-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2019] [Indexed: 12/20/2022]
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13
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Joo LC, Hamid SAA, Yaacob NM, Hairon SM, Cheng KY, Bujang MA. Validation of Malay Version of Body Self- Image Questionnaire-Short Form among Malaysian Young Adults. Malays J Med Sci 2019; 25:131-141. [PMID: 30914855 PMCID: PMC6422542 DOI: 10.21315/mjms2018.25.4.13] [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: 04/11/2018] [Accepted: 07/26/2018] [Indexed: 12/01/2022] Open
Abstract
Background Body self-image questionnaire-short form (BSIQ-SF) is developed to measure body image perceptions. Due to the cultural, language and environmental differences between western and eastern population, the validity and reliability need to be established. The aim of this study was to determine validity and reliability of Malay version BSIQ-SF. Methods A cross-sectional study involved web-based survey was employed. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) was performed using SPSS version 22 and Mplus 7.3. Results There were 688 young adults in Malaysia with mean age of 23.67 (SD = 0.188) and mean body mass index (BMI) of 23.34 (SD = 0.27) participated in the study. Exploratory factor analysis performed and the number domains reduced from nine to four, namely ‘Negative Affect’, ‘Attractiveness Evaluation’, ‘Physical Functionality Awareness’ and ‘Height Dissatisfaction’. CFA further confirmed the structure of the model with adequate goodness-of-fit values [CFI = 0.927, TLI = 0.913, SRMR = 0.075, RMSEA = 0.053 (95% CI: 0.047, 0.060)]. Conclusion The revised 21-item of the Malay version BSIQ-SF was a valid and reliable instrument to measure body image perceptions among Malaysian young adults.
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Affiliation(s)
- Lim Chien Joo
- Unit of Biostatistics and Research Methodology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.,Clinical Research Centre, Sarawak General Hospital, Ministry of Health, Malaysia
| | - Siti-Azrin Ab Hamid
- Unit of Biostatistics and Research Methodology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Najib Majdi Yaacob
- Unit of Biostatistics and Research Methodology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Suhaily Mohd Hairon
- Department of Community Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Kueh Yee Cheng
- Unit of Biostatistics and Research Methodology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Mohamad Adam Bujang
- Clinical Research Centre, Sarawak General Hospital, Ministry of Health, Malaysia
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Ammerlaan J, van Os-Medendorp H, de Boer-Nijhof N, Scholtus L, Kruize AA, van Pelt P, Prakken B, Bijlsma H. Short term effectiveness and experiences of a peer guided web-based self-management intervention for young adults with juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2017; 15:75. [PMID: 29029616 PMCID: PMC5640921 DOI: 10.1186/s12969-017-0201-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 10/05/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A web-based self-management intervention guided by peer-trainers was developed to support young adults' self-management in coping with Juvenile Idiopathic Arthritis (JIA). To investigate its effectiveness, a randomized controlled trial (RCT) was conducted. In addition, the content of the chat and participants' goals were studied to identify underlying processes. METHODS An RCT with a six-month follow up period was conducted among 72 young adults with JIA, aged between 16 and 25 years old, randomly assigned to the intervention or to the usual care control group. After 24 weeks, in both groups 24 participants completed all measurements. Intentions to treat analyses were carried out by means of linear mixed models for longitudinal measurements. With self-efficacy as primary outcome, self-management, disease activity, quality of life, absenteeism of school/work, health care medication use and adherence to the intervention were studied. The participants' goals, personal achievements, interactions on the chat, and their appreciation of the intervention were analyzed using thematic analyses. RESULTS No significant differences were found on self-efficacy, quality of life, and self-management between the participants of the control group and the intervention group. In the intervention group, modeling and sharing experiences were the most recognized themes. Fifty-five goals were formulated and divided into the following categories: improvement and maintaining balance, setting and recognizing boundaries, communicating and coping with incomprehension. Adherence, appreciation of the own learning experience, and personal achievements were rated positively. CONCLUSION The web-based intervention did not lead to an improvement of self-efficacy. However, additional qualitative analyses showed that the intervention was appreciated and valuable for the participants. More research is needed on how to measure the added value of this intervention compared to the usual care. TRIAL REGISTRATION Trial registration number NTR4679 .
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Affiliation(s)
- Judy Ammerlaan
- Department Rheumatology & Clinical Immunology HPN D02.244, University Medical Center Utrecht, PO Box 85090, 3508 GA, Utrecht, the Netherlands. .,Department Rheumatology & Clinical Immunology, HPN D02.244, University Medical Center Utrecht, PO Box 85500, 3500 GA, Utrecht, the Netherlands.
| | - Harmieke van Os-Medendorp
- 0000000090126352grid.7692.aDepartment Dermatology and Allergology HPN D02.244, University Medical Center Utrecht, PO Box 85090, 3508 GA Utrecht, the Netherlands
| | - Nienke de Boer-Nijhof
- 0000000090126352grid.7692.aDepartment Rheumatology & Clinical Immunology HPN D02.244, University Medical Center Utrecht, PO Box 85090, 3508 GA Utrecht, the Netherlands
| | - Lieske Scholtus
- 0000000090126352grid.7692.aDepartment Rheumatology & Clinical Immunology HPN D02.244, University Medical Center Utrecht, PO Box 85090, 3508 GA Utrecht, the Netherlands
| | - Aike A. Kruize
- 0000000090126352grid.7692.aDepartment of Rheumatology & Clinical Immunology HPN F02.127, University Medical Center Utrecht, PO Box 85090, 3508 GA Utrecht, the Netherlands
| | - Philomine van Pelt
- 0000000090126352grid.7692.aDepartment of Pediatric Immunology, Erasmus MC, Department of Rheumatology, University Medical Center Utrecht, PO Box 2040, Room Nb 852, 3000 GA Rotterdam, Netherlands ,0000000090126352grid.7692.aDepartment of Pediatric Immunology, University Medical Center Utrecht, PO Box 85090, 3508 AB Utrecht, Netherlands
| | - Berent Prakken
- 0000000090126352grid.7692.aDepartment of Pediatric Immunology, University Medical Center Utrecht, PO Box 85090, 3508 AB Utrecht, Netherlands
| | - Hans Bijlsma
- 0000000090126352grid.7692.aDepartment of Rheumatology & Clinical Immunology HPN F02.127, University Medical Center Utrecht, PO Box 85090, 3508 GA Utrecht, the Netherlands
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