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Nielsen MT, Nielsen MH, Sørensen S, Skovdal M. The social and organisational factors shaping acceptability of a self-management education and exercise intervention for people with hip or knee osteoarthritis in Greenland. Int J Circumpolar Health 2024; 83:2350120. [PMID: 38704858 PMCID: PMC11073430 DOI: 10.1080/22423982.2024.2350120] [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: 09/11/2023] [Accepted: 04/26/2024] [Indexed: 05/07/2024] Open
Abstract
This study aimed to explore the experiences and perspectives of people with osteoarthritis attending the "Osteoarthritis School" (OA School) in Nuuk, Greenland to generate insights and lessons that can inform the development of self-management education and exercise interventions for people with other lifestyle conditions in a Greenland context. We conducted a qualitative interpretive description (ID) study based on ten semi-structured interviews with people with hip or knee osteoarthritis. Interviews were audio-recorded, transcribed, and coded. Using ID, we identified three themes: 1) perceptions and experiences of how the OA School intervention was organised (time and place); 2) perspectives and experiences of the education and exercise components (social factors, motivation, and education); and 3) significant change stories (physical and mental improvements and increased knowledge of OA). Social and organisational factors, such as working out with peers and the time and place of the intervention, influenced the participants' acceptance of the OA School intervention. Knowledge from this study will help us gain insight into what to address when developing future self-management education and exercise interventions in the Greenlandic healthcare system.
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Affiliation(s)
| | - Maja Hykkelbjerg Nielsen
- Steno Diabetes Center Greenland, Queen Ingrid’s Hospital, Nuuk, Greenland
- Greenland Center for Health Research, Institute of Health and Nature, University of Greenland, Nuuk, Greenland
- Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Sonja Sørensen
- Greenland Center for Health Research, Institute of Health and Nature, University of Greenland, Nuuk, Greenland
- Centre for Public Health in Greenland, National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Morten Skovdal
- Section of Health Services Research, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Ashraf T, Aamir KF, Nadeem A, Hassan MU, Raza H, Rauf MA, Din JU, Shah S, Khan F, Akram Z, Ishaque M, Hanif B. Impact of educational intervention on hypertension management by primary care physician: A randomized control trial. PEC INNOVATION 2024; 4:100285. [PMID: 38737890 PMCID: PMC11087987 DOI: 10.1016/j.pecinn.2024.100285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 03/14/2024] [Accepted: 04/26/2024] [Indexed: 05/14/2024]
Abstract
Objective The current study aimed to observe hypertension educational intervention's effect on general physicians (GPs) to improve blood pressure control and patient outcomes indirectly. Methods This randomized control trial includes 42 GPs divided into 2 groups. GPs in group 1 receive face-to-face education with structured educational material on hypertension management strategies by a senior cardiologist. GPs in group 2 receive the print version of education material. The data was collected from six major cities in Pakistan. GPs with at least three years of experience in the broad primary care disciplines, with ages above 18 years, were included in the study. Results A total of 42 physicians (21 from each group) completed questionnaires, while out of 420 hypertension patients, 105 newly diagnosed and already diagnosed patients enrolled under physicians of both groups. The educational material did just as well at informing clinicians as the face-to-face group intervention did and both the interventions had a significant effect on knowledge and BP control. Conclusion After the 3-month follow-up, both interventions, including face-to-face and educational approaches, demonstrated significant effectiveness in improving knowledge and blood pressure control. Innovation The study shows that hypertension educational intervention's effect on general physicians indirectly improves blood pressure control and patient outcomes. And emphasize for developing a hypertension educational program targeted at general physicians.
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Affiliation(s)
- Tariq Ashraf
- Karachi Institute of Heart Disease, Karachi, Pakistan
| | | | - Asif Nadeem
- Armed Forces Institute of Cardiology, Rawalpindi, Pakistan
| | | | - Haseeb Raza
- Mukhtar A. Sheikh Hospital, Multan, Pakistan
| | | | - Jalal Ud Din
- Bolan Medical Complex Hospital, Quetta, Pakistan
| | | | - Fayza Khan
- Health Icon Medical Centre, Karachi, Pakistan
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3
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Felberg TR, Sagli G, Hansen C, Langaas A, Skaaden H. Patient education in multilingual groups of cardiac patients: Mission (im)possible? PEC INNOVATION 2024; 4:100304. [PMID: 38966315 PMCID: PMC11222795 DOI: 10.1016/j.pecinn.2024.100304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 04/26/2024] [Accepted: 06/05/2024] [Indexed: 07/06/2024]
Abstract
Objective In Norway, cardiac rehabilitation with patient education is usually accessible only to patients who understand Norwegian. The Cardiac Care Class (CCC) in focus in this article is a unique healthcare service in that, via interpreting services, it provides patient education to patients with limited Norwegian proficiency (LNP). This article examines the adaptations carried out to make cardiac rehabilitation accessible to LNP patients. Methods The data stem from a qualitative study with participant observation during interpreter-mediated CCCs and from interviews with healthcare professionals, patients, and interpreters conducted by an interdisciplinary team. The collaborative data analysis focused on identifying various forms of adaptations. Results Providing interpreting in CCCs required organizational, logistical, and pedagogical adaptations, including having fewer class participants, engaging qualified interpreters, conducting pre-class meetings with the interpreters, and adjusting the course content and language. Communication was found to be satisfactory, although some critical issues (e.g., interpreters' working conditions) were raised. Conclusion This study showed that interpreter-mediated CCCs can reach multilingual groups provided that the necessary adaptations are made. Innovation This research is the first to show how a cardiac rehabilitation class in Norway is made accessible to multilingual patient groups by providing interpreting.
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Affiliation(s)
- Tatjana R. Felberg
- Oslo Metropolitan University – OsloMet, Department of International Studies and Interpreting, Postboks 4, St. Olavs plass, 0130 Oslo, Norway
| | - Gry Sagli
- Oslo Metropolitan University – OsloMet, Department of International Studies and Interpreting, Postboks 4, St. Olavs plass, 0130 Oslo, Norway
| | - Camilla Hansen
- Oslo Metropolitan University – OsloMet, Department of Nursing and Health Promotion, Postboks 4, St. Olavs plass, 0130 Oslo, Norway
| | - Anne Langaas
- Oslo Metropolitan University – OsloMet, Department of Rehabilitation Science and Health Technology, Postboks 4, St. Olavs plass, 0130 Oslo, Norway
| | - Hanne Skaaden
- Oslo Metropolitan University – OsloMet, Department of International Studies and Interpreting, Postboks 4, St. Olavs plass, 0130 Oslo, Norway
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Sousa H, Ribeiro O, Bártolo A, Costa E, Ribeiro F, Rodrigues M, Paúl C, Figueiredo D. The Connected We St@nd programme: A feasibility pilot study of an online self-management intervention for adults on in-centre haemodialysis and family caregivers. Br J Health Psychol 2024; 29:589-608. [PMID: 38361177 DOI: 10.1111/bjhp.12715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 02/01/2024] [Indexed: 02/17/2024]
Abstract
OBJECTIVE The 'Connected We St@nd' is an online self-management intervention programme for people receiving in-centre haemodialysis and family caregivers that combines an educational and psychosocial support component. This study aimed to evaluate its feasibility and acceptability before proceeding to a large-scale trial. DESIGN This was a pre-post single-arm feasibility pilot study conducted with adults undergoing in-centre haemodialysis and family caregivers. METHODS Feasibility was based on eligibility, consent, retention, completion and intervention adherence rates, while acceptability was assessed in post-intervention focus group interviews. RESULTS Twenty-six people (16 adults on haemodialysis and 10 family caregivers) recruited through social networks completed the intervention. Consent, retention and completion rates were excellent (>90%) and eligibility (77.5%) and intervention adherence were satisfactory (69% for the psychosocial support sessions). Qualitative findings revealed that participants shared positive feelings regarding their participation in the programme. The valuable interactions with group peers and health psychologists during the support sessions, the perception of the adequacy and coherence of the programme's contents and materials and the participants' confidence in using the platform developed to deliver the intervention were some of the aspects highlighted as facilitators of intervention acceptability. Additionally, people on haemodialysis and caregivers reported that participation in the programme brought several educational and emotional benefits (e.g., additional disease-related knowledge, improved communication and coping skills, greater confidence in managing dialysis complications or caregiving demands) that helped increase their self-management skills and psychosocial adjustment to the demands of kidney failure and renal therapies. CONCLUSIONS The results suggested that the 'Connected We St@nd' programme is likely to be feasible and acceptable for adults on haemodialysis and family caregivers, thus representing a promising resource for the future of interdisciplinary renal rehabilitation. Suggestions were made to fine-tune the intervention design to proceed with a large-scale trial.
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Affiliation(s)
- Helena Sousa
- CINTESIS@RISE, Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Oscar Ribeiro
- CINTESIS@RISE, Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Ana Bártolo
- CINTESIS@RISE, CINTESIS.UPT, Portucalense University, Porto, Portugal
| | - Elísio Costa
- REQUIMTE, Faculty of Pharmacy and Competence Centre on Active and Healthy Ageing (Porto4Ageing), University of Porto, Porto, Portugal
| | - Fernando Ribeiro
- iBiMED, School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - Mário Rodrigues
- School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - Constança Paúl
- CINTESIS@RISE, Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
| | - Daniela Figueiredo
- CINTESIS@RISE, School of Health Sciences, University of Aveiro, Aveiro, Portugal
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Carpenter K, Gilman S, French M, Shakur Y, Dunlop-Thomas C, Cullerton L, Drenkard C, Barbour KE, Lim SS. Informing Digital Programs for Lupus Self-Management Education: A Systematic Scoping Review. Arthritis Care Res (Hoboken) 2024; 76:1211-1223. [PMID: 38736154 DOI: 10.1002/acr.25357] [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: 07/26/2023] [Revised: 04/13/2024] [Accepted: 04/19/2024] [Indexed: 05/14/2024]
Abstract
OBJECTIVE We describe the characteristics, content, and effectiveness of digital self-management (SM) education programs for lupus and other chronic conditions to identify gaps and inform the improvement of future programs in lupus. METHODS Three bibliographic databases were searched for articles published between May 2012 and April 2022. The search was cast to capture the breadth of digital SM education programs in the following conditions: lupus, epilepsy, fibromyalgia, multiple sclerosis, sickle cell anemia, Sjögren syndrome, psoriatic arthritis, and rheumatoid arthritis. Title and abstract screening, as well as full-text review, was conducted by two independent reviewers. Data extraction was first completed by one author charting all studies and then, a second time, by four members of the research team charting collaboratively. RESULTS Of the 1,969 articles identified through the search, 14 met inclusion criteria. Two additional articles were included following bibliography review. The 16 articles represented 12 unique digital SM education programs. Programs covered five conditions: epilepsy (n = 3), fibromyalgia (n = 2), multiple sclerosis (n = 4), lupus (n = 1), and rheumatoid arthritis (n = 2). Most programs were asynchronous and internet-based (n = 9) with a prescribed sequence of content (n = 8). Peer, technical, or specialist support was offered in seven programs. Most programs demonstrated statistically significant improvement of symptoms in the intervention group (n = 8). CONCLUSION This scoping review summarizes the current landscape for digital SM education programs in lupus and similar conditions. In lupus, further investigation will fill in the gaps around digital SM education needs, user experience, and evaluation of outcomes.
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Affiliation(s)
| | - Sarah Gilman
- Wayfinder Health Strategies, Falls Church, Virginia
| | | | | | | | | | | | - Kamil E Barbour
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - S S Lim
- Emory University, Atlanta, Georgia
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Mehrotra S, Bhattacharjya S, Shetty RS. Self-management interventions among community-dwelling older adults with type 2 diabetes mellitus: a scoping review protocol. BMJ Open 2024; 14:e084743. [PMID: 39181548 DOI: 10.1136/bmjopen-2024-084743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/27/2024] Open
Abstract
BACKGROUND Globally, the number of older adults is increasing rapidly; simultaneously, there is an epidemiological shift toward chronic diseases. One such chronic disease is type 2 diabetes mellitus (DM) which is caused either by the inability to produce insulin or due to the ineffective use of insulin. In recent years, self-management programmes for chronic conditions have gained importance, especially among occupational therapists. Though there is an increasing focus on 'self-management interventions' among older adults, there is still a lack of such interventions for older adults with type 2 DM in low- or middle-income countries (LMICs). OBJECTIVES Summarise the existing literature on self-management intervention programmes for community-dwelling older adults with type 2 DM; identify the principles, practices and criteria that define a self-management intervention programme for community-dwelling older adults with type 2 DM in LMICs. METHODS This present study will be a scoping review, combining quantitative and qualitative literature with a parallel results convergent synthesis design. The synthesis applies to analysing existing principles and practices that influence the selection and application of 'diabetes self-management intervention' among older adults in community settings with type 2 DM in LMICs. ETHICS AND DISSEMINATION As a secondary analysis, this scoping review does not require ethics approval. The final review results will be submitted for publication in a peer-reviewed journal in the rehabilitation, diabetes, occupational therapy or health promotion-related fields. Other dissemination strategies may be an oral presentation at international conferences or through various social media networks.
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Affiliation(s)
- Shashank Mehrotra
- Department of Occupational Therapy, Manipal College of Health Professions,Manipal Academy of Higher Education, Manipal, Karnataka, India-576104
| | - Sutanuka Bhattacharjya
- Department of Occupational Therapy, Byrdine F. Lewis College of Nursing & Health Professions, Georgia State University, Atlanta, Georgia, USA
| | - Ranjitha S Shetty
- Department of Community Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India -576104
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Gavin JP, Clarkson P, Muckelt PE, Eckford R, Sadler E, McDonough S, Barker M. Healthcare professional and commissioners' perspectives on the factors facilitating and hindering the implementation of digital tools for self-management of long-term conditions within UK healthcare pathways. PLoS One 2024; 19:e0307493. [PMID: 39178238 PMCID: PMC11343405 DOI: 10.1371/journal.pone.0307493] [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: 11/13/2023] [Accepted: 07/05/2024] [Indexed: 08/25/2024] Open
Abstract
Physical activity is important in the self-management of long-term conditions (LTCs). However, implementing physical activity into clinical practice is challenging, due to complex barriers including access to programmes, time pressures, and transport costs, for people with comorbidities, managing multiple responsibilities. Various digital tools exist to overcome these barriers and support wide-scale implementation to help people stay physically active. We explored the experiences, needs and preferences of healthcare professionals and commissioners, regarding the use of digital tools to support people with LTCs to self-manage using physical activity. This included barriers and facilitators to implementing digital tools to support people with LTCs in NHS settings. Semi-structured interviews were conducted (April 2021 to January 2022) in Wessex, southern England, UK. Purposive sampling was used to recruit general practitioners and healthcare professionals, and convenience sampling to recruit commissioners (n = 15). Transcripts were coded to develop conceptual themes allowing comparisons between and among perspectives, with the Normalisation Process Theory (NPT)'s four constructs used to aid interpretation. Results showed that most digital tools supporting physical activity for LTCs, are not well implemented clinically. Current digital tools were seen to lack condition-specificity, usability/acceptability evidence-base, and voluntary sector involvement (i.e., NPT: coherence or 'making sense'). Healthcare professionals and commissioners were unlikely to engage with use of digital tools unless they were integrated into health service IT systems and professional networks (i.e., NPT: cognitive participation), or adaptable to the digital literacy levels of service users and staff (i.e., NPT: collective action-needs for implementation). In practice, this meant being technically, easy to use and culturally accessible (i.e., NPT: collective action-promoting healthcare work). COVID-19 changed professional attitudes towards digital tools, in that they saw them being viable, feasible and critical options in a way they had not done before the pandemic. Implementation was also influenced by endorsement and trustworthiness enhancing the perception of them as secure and evidence-based (i.e., NPT: reflective monitoring). Our findings highlight that consideration must be given to ensuring that digital tools are accessible to both healthcare professionals and patients, have usability/acceptability, and are adaptable to specific LTCs. To promote clinical engagement, digital tools must be evidence-based, endorsed by professional networks, and integrated into existing health systems. Digital literacy of patients and professionals is also crucial for cross-service implementation.
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Affiliation(s)
- James P. Gavin
- School of Health Sciences, University of Southampton, Southampton, Hampshire, United Kingdom
| | - Paul Clarkson
- School of Health Sciences, University of Southampton, Southampton, Hampshire, United Kingdom
- NIHR Applied Research Collaboration Wessex, Southampton, Hampshire, United Kingdom
| | - Paul E. Muckelt
- School of Health Sciences, University of Southampton, Southampton, Hampshire, United Kingdom
| | - Rachael Eckford
- School of Health Sciences, University of Southampton, Southampton, Hampshire, United Kingdom
| | - Euan Sadler
- School of Health Sciences, University of Southampton, Southampton, Hampshire, United Kingdom
| | - Suzanne McDonough
- School of Health Sciences, University of Southampton, Southampton, Hampshire, United Kingdom
- School of Physiotherapy, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Mary Barker
- School of Health Sciences, University of Southampton, Southampton, Hampshire, United Kingdom
- Faculty of Medicine, University of Southampton, Southampton, Hampshire, United Kingdom
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Chien CH, Chuang CK, Wu CT, Pang ST, Liu KL, Yu KJ. Assessment of the psychometric properties of the traditional Chinese version of the cancer survivors' self-efficacy scale. PSICOLOGIA-REFLEXAO E CRITICA 2024; 37:33. [PMID: 39177718 PMCID: PMC11343950 DOI: 10.1186/s41155-024-00317-y] [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: 05/16/2024] [Accepted: 08/12/2024] [Indexed: 08/24/2024] Open
Abstract
BACKGROUND The reliability and validity of the traditional Chinese version of the Cancer Survivors' Self-Efficacy Scale (CS-SES-TC) has not been assessed. OBJECTIVE To assess the psychometric properties of the Traditional Chinese version of the CS-SES-TC. METHODS Participants were recruited from the outpatient departments of a hospital in Taiwan. A single questionnaire was administered to 300 genitourinary cancer survivors. The scales included in the initial questionnaire were the CS-SES-TC, the General Self-Efficacy Scale, the Center for Epidemiologic Studies Depression Scale (CES-D), and the Functional Assessment of Cancer Therapy-General scale (FACT-G). Data obtained from 300 survivors were used to confirm the structure through confirmatory factor analysis (CFA). RESULTS The CFA results indicate that the 11-item CS-SES-TC is consistent with the original scale. Furthermore, it was identified as a unidimensional scale, with the model showing acceptable goodness-of-fit (CFI = 0.99, TLI = 0.97). The factor loading of each item in the CS-SES-TC was above 0.6 and had convergent validity. Based on multiple-group CFA testing, the change (ΔCFI) between the unconstrained and constrained models was ≤ 0.01, indicating that measurement invariance holds for gender. The participants' CS-SES-TC scores were positively correlated with their FACT-G scores and negatively correlated with their CES-D scores. The scales exhibited concurrent validity and discriminant validity. The CS-SES-TC had a Cronbach's α in the range of .97-.98. CONCLUSION The CS-SES-TC had acceptable reliability and validity. Healthcare workers can use this scale for ongoing assessment of the cancer-related self-efficacy of cancer survivors.
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Affiliation(s)
- Ching-Hui Chien
- College of Nursing, Peitou District, National Taipei University of Nursing and Health Sciences, No.365, Ming-Te Road, Taipei City, 112, Taiwan.
| | - Cheng-Keng Chuang
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan City, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chun-Te Wu
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan City, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - See-Tong Pang
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan City, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Kuan-Lin Liu
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Keelung, Keelung City, Taiwan
| | - Kai-Jie Yu
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan City, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Sun V, Guthrie KA, Arnold KB, Antonoff M, Erhunmwunsee L, Borondy-Kitts A, Johnson J, Jones L, Ramirez M, Tong BC, Moremen JR, Yang CFJ, Ng T, Kim SS, Brown LM, Blasberg JD, Lui NS, Kneuertz PJ, Toloza EM, Kim JY, Raz DJ. Comparative effectiveness of perioperative physical activity in older adults with lung cancer and their family caregivers: design of a multicenter pragmatic randomized trial. BMC Cancer 2024; 24:976. [PMID: 39118035 PMCID: PMC11312238 DOI: 10.1186/s12885-024-12660-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Accepted: 07/18/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND With a median age at diagnosis of 70, lung cancer remains a significant public health challenge for older Americans. Surgery is a key component in treating most patients with non-metastatic lung cancer. These patients experience postoperative pain, fatigue, loss of respiratory capacity, and decreased physical function. Data on quality of life (QOL) in older adults undergoing lung cancer surgery is limited, and few interventions are designed to target the needs of older adults and their family caregivers (FCGs). The primary aim of this comparative effectiveness trial is to determine whether telephone-based physical activity coaching before and after surgery will be more beneficial than physical activity self-monitoring alone for older adults and their FCGs. METHODS In this multicenter comparative effectiveness trial, 382 older adults (≥ 65 years) with lung cancer and their FCGs will be recruited before surgery and randomized to either telephone-based physical activity coaching or physical activity self-monitoring alone. Participants allocated to the telephone-based coaching comparator will receive five telephone sessions with coaches (1 pre and 4 post surgery), an intervention resource manual, and a wristband pedometer. Participants in the self-monitoring only arm will receive American Society of Clinical Oncology (ASCO) physical activity information and wristband pedometers. All participants will be assessed at before surgery (baseline), at discharge, and at days 30, 60, and 180 post-discharge. The primary endpoint is the 6-minute walk test (6MWT) at 30 days post-discharge. Geriatric assessment, lower extremity function, self-reported physical function, self-efficacy, and QOL will also be assessed. DISCUSSION The trial will determine whether this telephone-based physical activity coaching approach can enhance postoperative functional capacity and QOL outcomes for older adults with lung cancer and their FCGs. Trial results will provide critical findings to inform models of postoperative care for older adults with cancer and their FCGs. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT06196008.
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Affiliation(s)
- Virginia Sun
- Department of Population Sciences, City of Hope, 1500 East Duarte Road, Duarte, CA, 91010, USA.
| | - Katherine A Guthrie
- SWOG Statistics and Data Management Center, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Kathryn B Arnold
- SWOG Statistics and Data Management Center, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Mara Antonoff
- Department of Thoracic and Cardiovascular Surgery, Division of Surgery, MD Anderson Cancer Center, Houston, TX, USA
| | - Loretta Erhunmwunsee
- Division of Thoracic Surgery, Department of Surgery, City of Hope, Duarte, CA, USA
| | | | - Judy Johnson
- Family Caregiver Research Advocate, St. Louis, MO, USA
| | - Lee Jones
- Patient Research Advocate, Arlington, VA, USA
| | | | - Betty C Tong
- Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University, Durham, NC, USA
| | - Jacob R Moremen
- Division of Thoracic Surgery, University of Mississippi Medical Center, Jackson, MS, USA
| | - Chi-Fu Jeffrey Yang
- Division of Thoracic Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Thomas Ng
- Division of Thoracic Surgery, University of Tennessee Health Sciences Center, Memphis, TN, USA
| | - Samuel S Kim
- Division of Thoracic Surgery, Northwestern University, Chicago, IL, USA
| | - Lisa M Brown
- Division of General Thoracic Surgery, UC Davis Health, Sacramento, CA, USA
| | | | - Natalie S Lui
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Peter J Kneuertz
- Division of Thoracic Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Eric M Toloza
- Department of Thoracic Oncology, Moffitt Cancer Center, Tampa, FL, USA
- Departments of Surgery, Department of Oncologic Sciences, University of South Florida Health Morsani College of Medicine, Tampa, FL, USA
| | - Jae Y Kim
- Division of Thoracic Surgery, Department of Surgery, City of Hope, Duarte, CA, USA
| | - Dan J Raz
- Division of Thoracic Surgery, Department of Surgery, City of Hope, Duarte, CA, USA
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Kashyap N, Sebastian AT, Lynch C, Jansons P, Maddison R, Dingler T, Oldenburg B. Engagement With Conversational Agent-Enabled Interventions in Cardiometabolic Disease Management: Protocol for a Systematic Review. JMIR Res Protoc 2024; 13:e52973. [PMID: 39110504 PMCID: PMC11339562 DOI: 10.2196/52973] [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: 09/20/2023] [Revised: 12/21/2023] [Accepted: 03/04/2024] [Indexed: 08/24/2024] Open
Abstract
BACKGROUND Cardiometabolic diseases (CMDs) are a group of interrelated conditions, including heart failure and diabetes, that increase the risk of cardiovascular and metabolic complications. The rising number of Australians with CMDs has necessitated new strategies for those managing these conditions, such as digital health interventions. The effectiveness of digital health interventions in supporting people with CMDs is dependent on the extent to which users engage with the tools. Augmenting digital health interventions with conversational agents, technologies that interact with people using natural language, may enhance engagement because of their human-like attributes. To date, no systematic review has compiled evidence on how design features influence the engagement of conversational agent-enabled interventions supporting people with CMDs. This review seeks to address this gap, thereby guiding developers in creating more engaging and effective tools for CMD management. OBJECTIVE The aim of this systematic review is to synthesize evidence pertaining to conversational agent-enabled intervention design features and their impacts on the engagement of people managing CMD. METHODS The review is conducted in accordance with the Cochrane Handbook for Systematic Reviews of Interventions and reported in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Searches will be conducted in the Ovid (Medline), Web of Science, and Scopus databases, which will be run again prior to manuscript submission. Inclusion criteria will consist of primary research studies reporting on conversational agent-enabled interventions, including measures of engagement, in adults with CMD. Data extraction will seek to capture the perspectives of people with CMD on the use of conversational agent-enabled interventions. Joanna Briggs Institute critical appraisal tools will be used to evaluate the overall quality of evidence collected. RESULTS This review was initiated in May 2023 and was registered with the International Prospective Register of Systematic Reviews (PROSPERO) in June 2023, prior to title and abstract screening. Full-text screening of articles was completed in July 2023 and data extraction began August 2023. Final searches were conducted in April 2024 prior to finalizing the review and the manuscript was submitted for peer review in July 2024. CONCLUSIONS This review will synthesize diverse observations pertaining to conversational agent-enabled intervention design features and their impacts on engagement among people with CMDs. These observations can be used to guide the development of more engaging conversational agent-enabled interventions, thereby increasing the likelihood of regular intervention use and improved CMD health outcomes. Additionally, this review will identify gaps in the literature in terms of how engagement is reported, thereby highlighting areas for future exploration and supporting researchers in advancing the understanding of conversational agent-enabled interventions. TRIAL REGISTRATION PROSPERO CRD42023431579; https://tinyurl.com/55cxkm26. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/52973.
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Affiliation(s)
- Nick Kashyap
- Baker Department of Cardiovascular Research, Translation and Implementation, La Trobe University, Melbourne, Australia
- Centre for Research Excellence in Digital Technology to Transform Chronic Disease Outcomes, National Health and Medical Research Council, Melbourne, Australia
| | - Ann Tresa Sebastian
- Centre for Research Excellence in Digital Technology to Transform Chronic Disease Outcomes, National Health and Medical Research Council, Melbourne, Australia
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Melbourne, Australia
| | - Chris Lynch
- Baker Department of Cardiovascular Research, Translation and Implementation, La Trobe University, Melbourne, Australia
- Centre for Research Excellence in Digital Technology to Transform Chronic Disease Outcomes, National Health and Medical Research Council, Melbourne, Australia
- Baker Heart and Diabetes Institute, Melbourne, Australia
- School of Psychology & Public Health, La Trobe University, Melbourne, Australia
| | - Paul Jansons
- Centre for Research Excellence in Digital Technology to Transform Chronic Disease Outcomes, National Health and Medical Research Council, Melbourne, Australia
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Melbourne, Australia
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Melbourne, Australia
| | - Ralph Maddison
- Centre for Research Excellence in Digital Technology to Transform Chronic Disease Outcomes, National Health and Medical Research Council, Melbourne, Australia
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Melbourne, Australia
| | - Tilman Dingler
- Centre for Research Excellence in Digital Technology to Transform Chronic Disease Outcomes, National Health and Medical Research Council, Melbourne, Australia
- Delft University of Technology, Delft, Netherlands
| | - Brian Oldenburg
- Baker Department of Cardiovascular Research, Translation and Implementation, La Trobe University, Melbourne, Australia
- Centre for Research Excellence in Digital Technology to Transform Chronic Disease Outcomes, National Health and Medical Research Council, Melbourne, Australia
- Baker Heart and Diabetes Institute, Melbourne, Australia
- School of Psychology & Public Health, La Trobe University, Melbourne, Australia
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Robinson-Dooley V, Sterling E, Collard C, Williams J, Collette T. Introducing Healthy Together: A Monograph of African American Men, Chronic Disease, and Self-Management. SOCIAL WORK IN PUBLIC HEALTH 2024:1-17. [PMID: 39101808 DOI: 10.1080/19371918.2024.2387021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/06/2024]
Abstract
Previous research has outlined evident disparities in the prevalence of chronic conditions among African Americans compared to other groups, with low-income African American men disproportionately affected by almost every disorder. Self-management programs are useful tools for managing chronic disorders beyond the doctor's office. This monograph provides a detailed looking into the current state of the research on low-income African American men with chronic health conditions. An intersectional approach is used to provide a nuanced synthesis of relevant literature. The project outlines the need for programs designed to engage low-income African American men with skills, resources, and tools for managing chronic conditions. Authors argue that improvements to traditional self-management programs can be realized by emphasizing culture, including end-users in the creation of programs, and offering culturally tailored strategies to improve health. Thus, any targeted program must include culturally detailed information about nutrition, exercise, stress, mental health, and leveraging social support.
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Affiliation(s)
| | - Evelina Sterling
- Department of Sociology & Criminal Justice, Kennesaw State University, Kennesaw, Georgia, USA
| | - Carol Collard
- Department of Social Work & Human Services, Kennesaw State University, Kennesaw, Georgia, USA
| | - Jordan Williams
- Department of Social Work & Human Services, Kennesaw State University, Kennesaw, Georgia, USA
| | - Tyler Collette
- Department of Psychological Science, Kennesaw State University, Kennesaw, Georgia, USA
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Skidmore N, Ryan C, Mankelow J, Bradford C, Graham A, Martin D. Exploring the potential of virtual reality for the self-management of chronic pain: A scoping review of its use to address health literacy. Musculoskelet Sci Pract 2024; 72:102962. [PMID: 38703701 DOI: 10.1016/j.msksp.2024.102962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 04/11/2024] [Accepted: 04/19/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND Individuals with low health literacy struggle to manage long-term conditions. Addressing pain-related health competencies is important in the management of chronic pain. Virtual reality may be a useful tool for empowering sustainable health-related stratgies due to its unique ability to engage users in artificial environments. OBJECTIVES The aim of this scoping review was to explore existing research on the use of virtual reality as a tool to promote health literacy in people with chronic pain. DESIGN Scoping Review guided by framework proposed by Arksey & O'Malley. METHOD Articles related to "pain", "virtual reality" and "health literacy" were searched in four electronic databases: CINAHL, PubMed, Embase and PsycINFO using a formal search strategy. Studies were categorised based on intervention content using the Health Literacy Pathway Model which encompasses health knowledge, self-management skills, health communication and information seeking. RESULTS Thirteen studies met the inclusion criteria. Several elements of pain related health literacy were not addressed in the research. Interventions addressed health knowledge, self-management skills, decision making and featured content aiming to address emotional barriers to pain-related health literacy. Other components including active information seeking and use, actively communicating with health professionals and seeking and negotiating treatment options, were not explicitly addressed. CONCLUSION There is heterogeneity in existing research exploring the use of VR to support people with chronic pain. Existing VR tools to address pain-related health literacy do not cover several key components of health literacy. More research is required before a robust assessment of efficacy can be undertaken.
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Affiliation(s)
- N Skidmore
- Centre for Rehabilitation, School of Health and Life Sciences, Teesside University, Middlesbrough, Tees Valley, TS1 3BX, United Kingdom.
| | - C Ryan
- Centre for Rehabilitation, School of Health and Life Sciences, Teesside University, Middlesbrough, Tees Valley, TS1 3BX, United Kingdom.
| | - J Mankelow
- Centre for Rehabilitation, School of Health and Life Sciences, Teesside University, Middlesbrough, Tees Valley, TS1 3BX, United Kingdom.
| | - C Bradford
- Centre for Rehabilitation, School of Health and Life Sciences, Teesside University, Middlesbrough, Tees Valley, TS1 3BX, United Kingdom.
| | - A Graham
- Centre for Rehabilitation, School of Health and Life Sciences, Teesside University, Middlesbrough, Tees Valley, TS1 3BX, United Kingdom.
| | - D Martin
- Centre for Rehabilitation, School of Health and Life Sciences, Teesside University, Middlesbrough, Tees Valley, TS1 3BX, United Kingdom; NIHR Applied Research Collaboration for the North East and Cumbria, United Kingdom.
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Zhou Z, Fang X, Huang Y, Hu J, Zhang K, Jia S. A scoping review of factors associated with self-management in young adults with stroke. PATIENT EDUCATION AND COUNSELING 2024; 125:108308. [PMID: 38705023 DOI: 10.1016/j.pec.2024.108308] [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: 08/09/2023] [Revised: 03/30/2024] [Accepted: 04/25/2024] [Indexed: 05/07/2024]
Abstract
PURPOSE To synthesize the available evidence on factors associated with self-management behavior in young stroke patients. METHODS The methodological guidelines for scoping reviews developed by the Joanna Briggs Institute and the PRISMA-scR-checklist for scoping reviews were used. A total of 5586 studies were identified through bibliographic searches of the scientific databases Medline (OVID), Embase (OVID), CINAHL (EBSCO), and PsycINFO, limited to the period 2000-2023. Studies were independently assessed for inclusion and exclusion criteria by two reviewers. Quantitative observational data and qualitative studies were extracted, mapped, and summarized to provide a descriptive summary of trends and considerations for future research. RESULTS Nine papers were finally selected to answer the research question. Young patients' self-management was mainly influenced by demographic factors (age, gender, income, education, and stroke knowledge), disease-related factors (functionality and independence, duration of stroke diagnosis, cognitive function, and poststroke fatigue), and psychosocial factors (hardiness, spiritual self-care, self-efficacy, and social support). CONCLUSION Further research is needed to determine the trajectory of poststroke self-management over time and its potential predictors, which should lead to the development of specific stroke rehabilitation and stroke self-management support programs for young people (considering factors that influence return to work in young stroke patients' self-management). PRACTICE IMPLICATIONS Healthcare providers can design more efficient interventions to improve the quality of life of young stroke patients after discharge. Gaining an in-depth understanding of the factors that influence self-management can help achieve this.
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Affiliation(s)
- Zifang Zhou
- School of Nursing, Jiangxi Medical College, Nanchang University, Jiangxi, China
| | - Xiaoqun Fang
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Nanchang University, Jiangxi, China
| | - Youhong Huang
- School of Nursing, Jiangxi Medical College, Nanchang University, Jiangxi, China
| | - Jiangyu Hu
- School of Nursing, Jiangxi Medical College, Nanchang University, Jiangxi, China
| | - Kaibing Zhang
- School of Nursing, Jiangxi Medical College, Nanchang University, Jiangxi, China
| | - Shulei Jia
- School of Nursing, Jiangxi Medical College, Nanchang University, Jiangxi, China.
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Adriaans DJM, Rosendaal M, Nieuwenhuijzen GAP, Heesakkers FBM, Notenboom L, Teijink JAW, Laarhoven HWMV, Dierick-van Daele ATM. Expectations and needs of patients with esophageal cancer during curative treatment regarding self-management, self-management support and eHealth: a qualitative study. Eur J Oncol Nurs 2024; 71:102638. [PMID: 38943774 DOI: 10.1016/j.ejon.2024.102638] [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: 11/09/2023] [Revised: 06/03/2024] [Accepted: 06/06/2024] [Indexed: 07/01/2024]
Abstract
PURPOSE Self-management is an essential component of the curative treatment trajectory of esophageal cancer patients. The aims of this study were to explore expectations and needs of esophageal cancer patients during curative treatment regarding self-management, relevant aspects of self-management in which they need additional support, and to explore their willingness to use eHealth. METHODS Semi-structured interviews were conducted with esophageal cancer patients, who had been treated with neoadjuvant chemo(radio)therapy followed by surgery, maximally 1 year after surgery. Based on the general model of self-management, the following themes were discussed: experience-based knowledge, contribution to care, living with the condition, and organization of care and support. A stepwise systematic text condensation guided the data analysis. RESULTS All four domains of the general model of self-management were identified. All participants described a remarkable difference between the pre-operative pathway, when it felt like they were taken by the hand, and the postoperative pathway, when it felt like they were thrown into the deep end. They adjusted to their new life situation by learning new experiences, while dealing with their diminished confidence in their bodies. Patients expressed the need for support from different sources, and were open to the idea of using eHealth in addition to usual care. (digital) Self-management support should be easily accessible, person-centered, confidential, and include personal contact. CONCLUSION Differences were found among esophageal cancer patients regarding self-management, self-management support and eHealth for self-management purposes, indicating there is no one approach that will meet the needs of all patients at all times.
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Affiliation(s)
- Daniëlle J M Adriaans
- Fontys University of Applied Sciences, Ds Th Fliednerstraat 2, Eindhoven, 5631, BN, the Netherlands; Department of Surgery, Catharina Hospital, Eindhoven, Michelangelolaan 2, Eindhoven, 5602, ZA, the Netherlands; CAPHRI School for Public Health and Primary Care, Maastricht University, 6200, MD, Maastricht, the Netherlands.
| | - Mariëlle Rosendaal
- Fontys School of HRM and Psychology, Fontys University of Applied Science, P.O. Box 347, 5600, AH, Eindhoven, the Netherlands
| | - Grard A P Nieuwenhuijzen
- Department of Surgery, Catharina Hospital, Eindhoven, Michelangelolaan 2, Eindhoven, 5602, ZA, the Netherlands
| | - Fanny B M Heesakkers
- Department of Surgery, Catharina Hospital, Eindhoven, Michelangelolaan 2, Eindhoven, 5602, ZA, the Netherlands
| | - Loes Notenboom
- Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands
| | - Joep A W Teijink
- Department of Surgery, Catharina Hospital, Eindhoven, Michelangelolaan 2, Eindhoven, 5602, ZA, the Netherlands; CAPHRI School for Public Health and Primary Care, Maastricht University, 6200, MD, Maastricht, the Netherlands
| | - Hanneke W M van Laarhoven
- Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands; Amsterdam UMC, University of Amsterdam, Department of Medical Oncology, Meibergdreef 9, Amsterdam, the Netherlands
| | - Angelique T M Dierick-van Daele
- Fontys University of Applied Sciences, Ds Th Fliednerstraat 2, Eindhoven, 5631, BN, the Netherlands; Department of Education and Research, Catharina Hospital, Eindhoven, Michelangelolaan 2, Eindhoven, 5602, ZA, the Netherlands; Fontys School of People and Health Studies, Ds Th Fliednerstraat 2, Eindhoven, 5631, BN, the Netherlands
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Alex J, Ferguson C, Ramjan LM, Maneze D, Montayre J, Salamonson Y. Development and psychometric evaluation of an expanded urinary catheter self-management scale: A cross-sectional study. J Adv Nurs 2024; 80:3199-3210. [PMID: 38297914 DOI: 10.1111/jan.16081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 11/24/2023] [Accepted: 01/15/2024] [Indexed: 02/02/2024]
Abstract
AIM To develop and test the psychometric properties of an expanded catheter self-management scale for patients with in-dwelling urinary catheters. DESIGN A cross-sectional validation study. Despite the utility of the original 13-item catheter self-management scale, this instrument did not include bowel management, general hygiene and drainage bag care, which are fundamental skills in urinary catheter self-management to prevent common problems resulting in unnecessary hospital presentations. The expanded catheter self-management scale was developed with 10 additional items to comprehensively assess all five essential aspects of urinary catheter self-management. METHODS A total of 101 adult community-dwelling patients living with indwelling urinary catheters were recruited from Western Sydney, Australia. Using exploratory factor analysis with Varimax rotation, the number of factors to be extracted from the expanded 23-item expanded catheter self-management scale was determined using a scree plot. The reliability of the overall scale and subscales was measured using Cronbach's alpha. Convergent validity was assessed using Spearman's correlations between clinical characteristics, overall scale and subscales. RESULTS The 23-item expanded catheter self-management scale yielded a 5-factor solution, labelled as: (i) self-monitoring of catheter function, (ii) proactive, help-seeking behaviour function, (iii) bowel self-care function, (iv) hygiene-related catheter site function and (v) drainage bag care function. Cronbach's alpha of the expanded catheter self-management scale indicating all 23 items contributed to the overall alpha value. Convergent validity results showed a negative correlation between the overall expanded catheter self-management scale and catheter-related problems. CONCLUSION The 5-factor structure provided a comprehensive assessment of key aspects of urinary catheter self-management essential to reduce the likelihood of catheter-related hospital presentations. IMPLICATIONS The expanded catheter self-management scale can be used to assess and monitor effective patient-centred interventions for optimal self-management to prevent catheter-related problems and improve the quality of life of patients. IMPACT Many patients start their journey of living with a urinary catheter unexpectedly and are not supported with quality information to care for their catheter. The findings of this study show the correlation between catheter self-management skills and catheter-related problems. The expanded catheter self-management scale (E-CSM) assists with analysing the self-management skills of patients living with a catheter and developing tailored interventions to prevent problems and improve their quality of life. In addition, this screening tool can be included in policies, guidelines, and care plans as a standard for improving catheter management and developing educational resources for patients. REPORTING METHOD STROBE checklist was used to report all aspects of this study comprehensively and accurately. PATIENT OR PUBLIC CONTRIBUTION Patients living with indwelling urinary catheter and their carers have participated in surveys, interviews and co-designing interventions. This paper reports the psychometric analysis of the expanded catheter self-management scale (E-CSM) used in the patient survey as part of the main study 'Improving Quality of Life of Patients Living with Indwelling Urinary Catheters: IQ-IDC Study' (Alex et al. in Collegian, 29:405-413, 2021). We greatly value our consumers' contributions and continue to communicate the progress of the study to them. Their contributions will be acknowledged in all publications and presentations. In addition, all participants will be provided the option of receiving the interventions and publications generated from this study.
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Affiliation(s)
- Joby Alex
- Integrated and Community Health, Western Sydney Local Health District, North Parramatta, New South Wales, Australia
- School of Nursing, Western Sydney Local Health District, Wollongong, New South Wales, Australia
- Mt Druitt Community Health Centre, Cnr Buran & Kelly Cl, Mount Druitt, New South Wales, Australia
| | - Caleb Ferguson
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
- Centre for Chronic and Complex Care Research, Blacktown Hospital, Western Sydney Local Health District, North Parramatta, New South Wales, Australia
- Western Sydney University, University of Technology, Queensland University of Technology, Brisbane City, Queensland, Australia
| | - Lucie M Ramjan
- Western Sydney University, School of Nursing and Midwifery, University of Wollongong, Wollongong, New South Wales, Australia
- COHORT, Ingham Institute for Applied Medical Research, Penrith, New South Wales, Australia
| | - Della Maneze
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Jed Montayre
- Centre of Evidence-based Practice for Health Care Policy, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
- University of Wollongong, Wollongong, New South Wales, Australia
| | - Yenna Salamonson
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
- Western Sydney University, Penrith, New South Wales, Australia
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16
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Geßner S, Fuchs M, Pieper LH, Tretbar K. [How to Support People with Hearing Impairment beyond Hearing aid Provision - A Systematic Review on Self-Management Interventions]. Psychother Psychosom Med Psychol 2024; 74:311-322. [PMID: 38996429 DOI: 10.1055/a-2333-7521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2024]
Abstract
OBJECTIVE People with hearing handicap have to use a whole range of strategies to cope with everyday challenges - they have to self-manage their hearing impairment. While the support of self-management is well established in foreign language audiological rehabilitation programs, there are no recommendations in Germany yet. Therefore, the aim of this systematic review is first to give an overview of existing self-management interventions for people with hearing handicap and then to suggest possible applications in the German care system. METHODS A systematic literature search was conducted on PubMed. The articles dealt with self-management interventions for people with hearing impairment. This eligibility criterion was applied to titles, abstracts, and full texts. If eligible, information on the publication, intervention, and evaluation were extracted and qualitatively summarized. The methodological quality of studies was investigated using the NIH assessment tool for interventional studies. RESULTS 23 papers could be included and show a high heterogeneity regarding methodological quality, applied intervention, and design of evaluation. The interventions pursuing various goals include a wide range of content (e. g., communication improvement or psychosocial aspects) and have been implemented on a group-based, individual-based, or self-administered level. Despite a few studies that failed to demonstrate intervention effects, most evaluations found positive ef-fects of the intervention on hearing impairment, psychological well-being, and communication. DISCUSSION The included studies present a high heterogeneity with regard to methodological quality, the intervention conducted, and the evaluation design. Therefore, a summary of the findings was only possible in a qualitative manner. Possibilities of adapting existing intervention programs as well as chances and limits of an implementation in the German health care system are to be discussed in the following. CONCLUSION Overall, interventions including self-management support seem to be a profitable complement to sole technical device supply and should be further fostered in German-speaking countries as well.
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Affiliation(s)
- Sophie Geßner
- Cochlea-Implantat-Zentrum Leipzig, Klinik und Poliklinik für Hals-, Nasen-, Ohrenheilkunde, Universitätsklinikum Leipzig
| | - Michael Fuchs
- Cochlea-Implantat-Zentrum Leipzig, Klinik und Poliklinik für Hals-, Nasen-, Ohrenheilkunde, Universitätsklinikum Leipzig
| | | | - Kathleen Tretbar
- Cochlea-Implantat-Zentrum Leipzig, Klinik und Poliklinik für Hals-, Nasen-, Ohrenheilkunde, Universitätsklinikum Leipzig
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Tidmarsh LV, Harrison R, Finlay KA. Prehabilitation: The underutilised weapon for chronic pain management. Br J Pain 2024; 18:354-364. [PMID: 39092207 PMCID: PMC11289902 DOI: 10.1177/20494637241250239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2024] Open
Abstract
Objective Prehabilitation encompasses preparatory clinical intervention(s) delivered during the period between diagnosis and treatment commencement. Despite widespread successful usage preoperatively, psychological prehabilitation is neglected in outpatient chronic pain management. Although pain management waitlists are associated with treatment attrition and psychological and physical decline, this time window is underutilised in preventing escalation. Waitlists present an under-explored opportunity to 'prehabilitate' patients waiting for treatment. This topical review aimed to: (1) examine the effectiveness of psychological prehabilitation for pain services; (2) evaluate the psychological and physical decline associated with waiting for pain management; (3) highlight key psychological prehabilitative targets for increasing treatment engagement; (4) promote pain management psychological prehabilitation within personalised pain medicine, building recommendations for future interventions. Methods Studies regarding the impact of waitlists and prehabilitation for chronic pain were reviewed. Results Findings demonstrated that the psychological constructs of patient expectations, health locus of control, self-efficacy and pain catastrophizing dynamically influence attrition, treatment engagement and outcomes while waiting. These constructs are amenable to change, emphasising their potential utility within a targeted waitlist intervention. Conclusions Prehabilitating chronic pain patients towards treatment engagement could circumvent cycles of failed treatment seeking, preventing psychological and physical decline, and reducing healthcare utilisation. Utilising the waitlist to identify psychosocial risk factors (external health locus of control, low self-efficacy and high pain catastrophizing) would identify who requires additional support to prevent increased risk of treatment failure, enhancing personalised care before prescribed treatment is accessed. This review cements the urgent need for pain services to engage proactively with prehabilitation innovation.
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Affiliation(s)
- Lydia V. Tidmarsh
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Richard Harrison
- Centre for Integrative Neuroscience and Neurodynamics, University of Reading, Reading, UK
| | - Katherine A. Finlay
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
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Ceyhan Y, Aydin C. Impact of COPD stage on self management with COPD patients: The mediating role of symptoms management. J Clin Nurs 2024; 33:3615-3623. [PMID: 38499992 DOI: 10.1111/jocn.17119] [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: 11/18/2023] [Revised: 03/05/2024] [Accepted: 03/08/2024] [Indexed: 03/20/2024]
Abstract
AIMS It is extremely important to determine the relationship between COPD and self-management (SM) in the disease process. However, the impact of symptom management (SpM) on this relationship is still unclear. The study aimed to examine the mediating role of SpM in the effect of the COPD stage on SM. DESIGN A predictive correlational study was reported following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. METHODS This study was conducted between 15 February 2023 and 15 June 15 2023, with 306 patients. Data were collected using the Symptom Management Scale for Self-Efficacy and the Chronic Disease Self-Management Scale. Descriptive statistics and Process Macro Model 4 in the SPSS program were used for data analysis. RESULTS Most of the patients were in the moderate stage of COPD; their SM scores were at low levels; SpM scores were at moderate levels. The model was significant, and the variables explained 65% of the model. The COPD stage was significantly positively correlated with SpM and negatively correlated with SM. There was a significant positive impact between SpM and SM. The positive and significant standardised indirect effect of SpM on SM evidenced a full mediating effect. CONCLUSIONS Symptom management has a full mediating role in the effect of the COPD stage on SM. It was revealed that the level of SM can be increased by achieving SpM. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Symptoms are vital in COPD. Progression of COPD increases symptom severity. Being successful in SpM greatly contributes to the achievement of self-management. Therefore, nurses should definitely consider symptom control in strengthening self-management in the care of patients with COPD. PATIENT OR PUBLIC CONTRIBUTION Patients' COPD stage was determined by a pulmonologist involved in the study. Voluntary patients with COPD hospitalised in the pulmonology clinic were included in the study.
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Affiliation(s)
- Yasemin Ceyhan
- Department of Internal Medicine Nursing, Kirsehir Ahi Evran University Faculty of Health Sciences, Kırşehir, Turkey
| | - Cihan Aydin
- Department of Chest Diseases, Clinic of Pulmonology, Kirsehir Ahi Evran University Training and Research Hospital, Kırşehir, Turkey
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Johnson ST, Ytterberg C, Peterson E, Johansson S, Kierkegaard M, Gottberg K, Flink M. Development of Fewer Falls in MS-An Online, Theory-Based, Fall Prevention Self-Management Programme for People With Multiple Sclerosis. Health Expect 2024; 27:e14154. [PMID: 39032151 PMCID: PMC11259746 DOI: 10.1111/hex.14154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 07/05/2024] [Accepted: 07/08/2024] [Indexed: 07/22/2024] Open
Abstract
OBJECTIVE The aim of this study was to describe the process used to develop a theory-based, online fall prevention self-management programme for ambulatory and non-ambulatory people with multiple sclerosis (pwMS). METHODS The development process was guided by the Medical Research Council framework of complex interventions and began with a scoping review of the literature on self-management of falls in pwMS. Subsequent phases of development were performed through iterative and concurrent processes and were informed by the perspectives of pwMS and healthcare professionals with MS expertise. RESULTS Through a systematic and iterative process in close collaboration with pwMS and healthcare professionals, a theory-based online fall prevention self-management programme, Fewer Falls in MS, for ambulatory and non-ambulatory pwMS was developed. The programme is grounded in theory and pedagogical models and features utilization of action plans to address diverse influences on fall risks. CONCLUSIONS A carefully operationalized definition of self-management and an iterative co-development process were essential to the creation of the Fewer falls in MS programme. Continuation of the co-development process and collaboration with end users was needed to refine the programme. PATIENT OR PUBLIC CONTRIBUTION PwMS and healthcare professionals were involved throughout the development process of the programme. The patient organization Neuro Sweden was contacted in the initial phase to discuss the relevance of a self-management programme to prevent falls in MS. They supported the research group (all authors) in identification of and contact with pwMS with interest to participate. Three members of the research group (S.T.J., M.F. and C.Y.), that is, the operative group, met neuro Sweden and one pwMS to further discuss the relevance of a self-management programme to prevent falls. To develop the process and content of the fall prevention programme, a co-design process was performed together with pwMS and healthcare professionals. The results of the co-design process are presented in this manuscript. In addition to participating in the co-design process, pwMS and healthcare professionals provided feedback to the research group on programme process and content on several occasions during the subsequent programme development process. In a pretest (Beta version) of the programme, four pwMS acted as test subjects and provided additional feedback on the programme to the research group. TRIAL REGISTRATION NCT04317716.
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Affiliation(s)
- Susanna Tuvemo Johnson
- Department of Neurobiology, Care Science and SocietyKarolinska InstitutetStockholmSweden
- Department of Women's and Children's HealthUppsala UniversityUppsalaSweden
| | - Charlotte Ytterberg
- Department of Neurobiology, Care Science and SocietyKarolinska InstitutetStockholmSweden
- Women's Health and Allied Health Professionals ThemeKarolinska University HospitalStockholmSweden
| | - Elizabeth Peterson
- Department of Occupational Therapy, College of Applied Health SciencesUniversity of Illinois ChicagoChicagoIllinoisUSA
| | - Sverker Johansson
- Department of Neurobiology, Care Science and SocietyKarolinska InstitutetStockholmSweden
- Women's Health and Allied Health Professionals ThemeKarolinska University HospitalStockholmSweden
| | - Marie Kierkegaard
- Department of Neurobiology, Care Science and SocietyKarolinska InstitutetStockholmSweden
- Academic Specialist CenterRegion StockholmStockholmSweden
| | - Kristina Gottberg
- Department of Neurobiology, Care Science and SocietyKarolinska InstitutetStockholmSweden
| | - Maria Flink
- Department of Neurobiology, Care Science and SocietyKarolinska InstitutetStockholmSweden
- Women's Health and Allied Health Professionals ThemeKarolinska University HospitalStockholmSweden
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Svensson NH, Thorlund JB, Olsen PØ, Søndergaard J, Wehberg S, Andersen HS, Caserotti P, Thilsing T. The effect of exercise referral schemes and self-management strategies on use of prescription analgesics among community-dwelling older adults: registry linkage with randomised controlled trials. BMC Geriatr 2024; 24:641. [PMID: 39085817 PMCID: PMC11293001 DOI: 10.1186/s12877-024-05235-3] [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: 07/11/2023] [Accepted: 07/22/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND AND OBJECTIVE Exercise referral schemes and self-management strategies have shown positive effects on patient-reported and objectively measured outcomes, such as increased functional capacity and physical activity level. However, the impact of these interventions on analgesic use remains uncertain. We hypothesised that exercise referral schemes, either utilised alone or in combination with self-management strategies, is more effective in reducing use of prescription analgesics compared with a self-management strategy only. SUBJECTS AND METHODS We utilised data from two completed randomised controlled trials, namely The Welfare Innovation in Primary Prevention (n = 121) and The SITLESS project (n = 338), and information from the national Danish health registries, including the National Prescription Registry. The two trials have investigated the effectiveness of interventions, which include exercise referral schemes and self-management strategies, on various aspects such as physical function and levels of physical activity among community-dwelling older adults. The studies were conducted in the period 2015-2020 and comprised older adults aged 65+ years, living in three different Danish municipalities. Participants were recruited through nationally regulated preventive home-visits. To estimate changes in use of prescription analgesics over time, a linear fixed effects regression model was applied. The outcome measure was the mean total yearly defined daily dose of analgesics. RESULTS All intervention groups showed a within-group increase in overall analgesic use, though not statistically significantly different from zero. There were no differences in estimated changes in mean total yearly defined daily dose when comparing the intervention groups to the group receiving the least extensive intervention (self-management strategies/control). The findings indicated that exercise referral schemes and self-management strategies, whether administrated individually or in combination, did not result in a reduction in analgesic use over time.
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Affiliation(s)
- Nanna Herning Svensson
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Campusvej 55, Odense M, 5230, Denmark.
| | - Jonas Bloch Thorlund
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Campusvej 55, Odense M, 5230, Denmark
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, Odense M, 5230, Denmark
| | - Pia Øllgaard Olsen
- Department of Health, Culture and Development, Municipality of Tønder, Wegners plads 2, Tønder, 6270, Denmark
| | - Jens Søndergaard
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Campusvej 55, Odense M, 5230, Denmark
| | - Sonja Wehberg
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Campusvej 55, Odense M, 5230, Denmark
| | - Helene Støttrup Andersen
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Campusvej 55, Odense M, 5230, Denmark
| | - Paolo Caserotti
- Centre for Active and Healthy Aging, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, Odense M, 5230, Denmark
| | - Trine Thilsing
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Campusvej 55, Odense M, 5230, Denmark
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Skolasky RL, Nolan S, Pierre R, Vinch P, Taylor JL. Nurse-led web-based self-management program to improve patient activation and health outcomes in patients with chronic low back pain: an acceptability and feasibility pilot study. BMC Nurs 2024; 23:524. [PMID: 39085831 PMCID: PMC11293200 DOI: 10.1186/s12912-024-02155-w] [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: 02/09/2024] [Accepted: 07/08/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Patients with chronic low back (cLBP) pain report reduced physical function and ability to participate in social roles and are more likely to use opioid pain medications. While self-management interventions have been shown to support these patients, their effectiveness has been limited due to poor patient engagement. "Patient activation" encompasses the skills, knowledge, and motivation that a person has to manage their health. Supporting patient activation may improve the effectiveness of self-management for cLBP. METHODS In this single-masked pilot study of adults with cLBP, patients were randomized to receive either no intervention (control) or 6 weekly sessions of an evidence-based web-based self-management program (SMP) with or without health behavior change counseling (HBCC) using motivational interviewing. Participants were assessed at baseline and at 12 and 26 weeks using the Patient Activation Measure, Oswestry Disability Index and PROMIS physical function, social role participation, and pain interference. We assessed acceptability and feasibility based on recruitment, session attendance, and follow-up. RESULTS Of 187 individuals screened, 105 were eligible and 34 were randomized to control (n = 12), SMP (n = 4), or SMP + HBCC (n = 18). The population had 19 women, 22 patients married or living with significant other, 13 Black or African American patients, and 4 Hispanic or Latino patients. Participants had a mean (SD) Oswestry Disability Index score of 42 (12), moderate impairments in physical function (40 (6.6)) and social roles (45 (10)), and moderately severe pain interference (61 (6.7)). Of 22 participants receiving SMP sessions, 20 participated in at least 1, 15 participated in at least 3, and 7 participated in all 6 sessions. Loss to follow-up was 6 over the 26-week study. Participants in the SMP and SMP + HBCC groups had at least medium effect size improvements in Patient Activation Measures and small-to-medium effect size improvements in Oswestry Disability Index scores and physical function and large effect size improvement in social roles at 12 weeks. Improvements persisted in the SMP + HBCC group at 26 weeks. CONCLUSIONS A web-based SMP is acceptable and feasible in this population. Participants who received augmentation with HBCC had persistent improvements in health outcomes at 26 weeks. TRIAL REGISTRATION ClinicalTrials.gov Identifier NCT06236529 (2/1/2024 - retrospectively registered). LEVEL OF EVIDENCE: 3
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Affiliation(s)
- Richard L Skolasky
- Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Sarah Nolan
- Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - Raven Pierre
- Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - Paige Vinch
- Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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22
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Timmermans L, Decat P, Foulon V, Van Hecke A, Vermandere M, Schoenmakers B. Transforming healthcare: A pilot study to improve primary healthcare professionals' self-management support behaviour through blended learning. BMC MEDICAL EDUCATION 2024; 24:823. [PMID: 39080650 PMCID: PMC11290224 DOI: 10.1186/s12909-024-05799-z] [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: 12/22/2023] [Accepted: 07/19/2024] [Indexed: 08/02/2024]
Abstract
BACKGROUND Self-management of a chronic condition is a complex but increasingly important issue. However, a supportive attitude and behaviour among healthcare professionals is hampered by a lack of awareness, knowledge and motivation. In addition, the role of professionals in supporting self-management seems unclear. METHODS A blended learning program for primary healthcare professionals was developed to strengthen self-management support in primary care. The program was piloted in community health centres and multidisciplinary medical practices in Flanders. Using the Kirkpatrick model, the impact on healthcare professionals' reaction, learning and behaviour regarding self-management support was evaluated. RESULTS A total of 60 healthcare professionals registered for the educational program. Post-learning questionnaires and verbal feedback showed a positive response, with professionals highly appreciating the innovative blended learning approach. In terms of learning, participants showed a good understanding of self-management support, although nuances were observed in the application of acquired knowledge to practice scenarios. Finally, preliminary insights into behavioural change were explored, revealing a positive impact of the intervention on participants' supportive self-management behaviours in healthcare practice. CONCLUSIONS Our study provides preliminary insights into the outcomes of a blended learning program designed to increase awareness and knowledge of self-management support among professionals. The program needs to be refined for general implementation in primary care.
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Affiliation(s)
- Lotte Timmermans
- Academic Centre of General Practice, Kapucijnenvoer 7, Kapucijnenvoer 7 - , Box 7001, 3000, Louvain, Louvain, KU, Belgium.
| | - Peter Decat
- General Practice and Primary Health Care, Ghent University, Ghent, Belgium
| | - Veerle Foulon
- Clinical Pharmacology and Pharmacotherapy, KU Leuven, Louvain, Belgium
| | - Ann Van Hecke
- University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium
- Department Nursing Director, Ghent University Hospital, Ghent, Belgium
| | - Mieke Vermandere
- Academic Centre of General Practice, Kapucijnenvoer 7, Kapucijnenvoer 7 - , Box 7001, 3000, Louvain, Louvain, KU, Belgium
| | - Birgitte Schoenmakers
- Academic Centre of General Practice, Kapucijnenvoer 7, Kapucijnenvoer 7 - , Box 7001, 3000, Louvain, Louvain, KU, Belgium
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23
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Collette T, Stevens L, Robinson-Dooley V, Sterling E. COVID-19 Related Knowledge, Attitudes, and Behaviors Among Black Men with Chronic Health Conditions: A Latent Profile Analysis. SOCIAL WORK IN PUBLIC HEALTH 2024:1-16. [PMID: 39068542 DOI: 10.1080/19371918.2024.2381621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
Research indicates that Black communities experienced disproportionately higher numbers of confirmed cases and fatalities throughout the COVID-19 pandemic with Black men experiencing marked reductions in life expectancy. Inequities were further magnified by known COVID-19 such as hypertension, diabetes, obesity, and higher prevalence of cardiovascular disease. The current project aimed to assess the knowledge, attitudes, and behaviors related to COVID-19 among Black men with chronic conditions. Specifically, we sought to determine whether COVID-19-related perspectives and behaviors impacted cross-sectional health outcomes. A national sample of Black men (N = 312) who self-reported at least one chronic disease responded to survey questions about their knowledge, attitude, and preventative behaviors (KAP) related to COVID-19. Analyses suggest that unique latent profiles based on COVID-19-related KAP differentially impacted participants' self-reported health and well-being for those low on KAP items. The discussion includes considerations on viral hygiene interventions, misinformation, stigma, and perceptions of discrimination.
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Affiliation(s)
- Tyler Collette
- Department of Psychological Science, Kennesaw State University, Kennesaw, Georgia, USA
| | - Laura Stevens
- School of Social Work, Simmons University, Boston, Massachusetts, USA
| | | | - Evelina Sterling
- Department of Sociology & Criminal Justice, Kennesaw State University, Kennesaw, Georgia, USA
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24
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Gray A, Alemohammad SY, Ramírez-Ortiz D, Trepka MJ. A Systematic Review of Factors Associated with COVID-19 Vaccine Uptake, Hesitancy, and Acceptability Among Adults with HIV: Implications for Integrating COVID-19 Immunization into HIV Care. AIDS Patient Care STDS 2024. [PMID: 39058653 DOI: 10.1089/apc.2024.0097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2024] Open
Abstract
The COVID-19 virus, once a public health emergency, is now endemic. Immunization remains an important measure for mitigating high levels of disease, morbidity, and mortality related to COVID-19 infection. People with HIV (PWH), in particular, benefit from COVID-19 vaccination because of increased risk for severe COVID-19 infection. However, previous data suggest vaccine hesitancy among this population. Given this context and the evolving epidemiology of COVID-19, this review examines factors associated with COVID-19 vaccine hesitancy, acceptability, and uptake among adults with HIV. Through a systematic search of electronic databases, we identified 56 peer-reviewed articles published between the years 2020 and 2023 that matched the objectives of our review out of a total of 797 screened citations. Among our final sample of articles, nearly all global regions were represented, and 61% of studies recruited only PWH. We identified eight categories of factors associated with COVID-19 vaccination outcomes, including HIV-specific factors (e.g., CD4 count), vaccine attitudes (e.g., vaccine confidence), factors related to the COVID-19 virus (e.g., concern about infection), factors specific to the COVID-19 vaccine (e.g., accessibility), social norms and peer factors (e.g., subjective norms), mental health (e.g., anxiety/depression) and other psychological factors (e.g., substance use), demographic characteristics (e.g., age), and health factors (e.g., vaccination history). Reflecting on these factors, we discuss populations in need of vaccine promotion, modifiable targets for intervention, and integrating immunization into HIV care. Public health efforts to promote COVID-19 immunization among PWH must include educational/informational, peer, and structural interventions and must now consider uptake of COVID-19 booster doses.
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Affiliation(s)
- Aaliyah Gray
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Seyedeh Yasaman Alemohammad
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Daisy Ramírez-Ortiz
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Mary Jo Trepka
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
- Research Center in Minority Institutions, Florida International University, Miami, Florida, USA
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25
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Glick AA, Winham DM, Heer MM, Shelley MC, Hutchins AM. Health Belief Model Predicts Likelihood of Eating Nutrient-Rich Foods among U.S. Adults. Nutrients 2024; 16:2335. [PMID: 39064780 PMCID: PMC11279385 DOI: 10.3390/nu16142335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Revised: 07/06/2024] [Accepted: 07/09/2024] [Indexed: 07/28/2024] Open
Abstract
Despite decades of messaging, most Americans still consume excess fats and sugars, but inadequate fiber, potassium, and calcium. Nutrient-rich foods (NRFs) have a high density of favorable nutrients related to calories. Choosing NRFs could lower risk of nutrition-related chronic diseases and aid in their control. We hypothesized that having greater knowledge of NRFs, the presence of a nutrition-related chronic disease or risk factor, and positive Health Belief Model (HBM) views would be predictive of the likelihood of eating NRFs. Through a national online survey panel, 976 adults aged 18-80 completed demographic, health, NRF knowledge, attitudes, and HBM construct questions. Participants were 77% White, 52% women, and 55% had a nutrition-related disease or risk factor. Multivariable HBM scales were generated by theory, principal components, and reliability analysis. NRF knowledge was significantly higher for women, Whites, households without children, and persons without a nutrition-related disease (all p ≤ 0.015). 'Likelihood of eating NRFs' was significantly higher for persons with a nutrition-related disease, Whites, married participants, main food shoppers, and households with children (all p ≤ 0.022). Regressing demographic and HBM constructs on the 'likelihood of eating NRFs' resulted in R2 of 0.435. Nutrition-related disease and HBM constructs of self-efficacy, perceived benefits, and cues to action were predictive of the likelihood of eating NRFs, but higher NRF knowledge was negatively associated.
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Affiliation(s)
- Abigail A. Glick
- Department of Food Science & Human Nutrition, Iowa State University, Ames, IA 50011, USA; (A.A.G.); (M.M.H.)
| | - Donna M. Winham
- Department of Food Science & Human Nutrition, Iowa State University, Ames, IA 50011, USA; (A.A.G.); (M.M.H.)
| | - Michelle M. Heer
- Department of Food Science & Human Nutrition, Iowa State University, Ames, IA 50011, USA; (A.A.G.); (M.M.H.)
| | - Mack C. Shelley
- Departments of Political Science and Statistics, Iowa State University, Ames, IA 50011, USA;
| | - Andrea M. Hutchins
- Department of Human Physiology & Nutrition, University of Colorado Colorado Springs, Colorado Springs, CO 80918, USA;
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26
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Wu W, Graziano T, Salner A, Chen MH, Judge MP, Cong X, Xu W. Acceptability, Effectiveness, and Roles of mHealth Applications in Supporting Cancer Pain Self-Management: Integrative Review. JMIR Mhealth Uhealth 2024; 12:e53652. [PMID: 39024567 PMCID: PMC11294773 DOI: 10.2196/53652] [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: 10/27/2023] [Revised: 02/22/2024] [Accepted: 04/23/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND Cancer pain remains highly prevalent and persistent throughout survivorship, and it is crucial to investigate the potential of leveraging the advanced features of mobile health (mHealth) apps to empower individuals to self-manage their pain. OBJECTIVE This review aims to comprehensively understand the acceptability, users' experiences, and effectiveness of mHealth apps in supporting cancer pain self-management. METHODS We conducted an integrative review following Souza and Whittemore and Knafl's 6 review processes. Literature was searched in PubMed, Scopus, CINAHL Plus with Full Text, PsycINFO, and Embase, from 2013 to 2023. Keywords including "cancer patients," "pain," "self-management," "mHealth applications," and relevant synonyms were used in the search. The Johns Hopkins research evidence appraisal tool was used to evaluate the quality of eligible studies. A narrative synthesis was conducted to analyze the extracted data. RESULTS A total of 20 studies were included, with the overall quality rated as high (n=15) to good (n=5). Using mHealth apps to monitor and manage pain was acceptable for most patients with cancer. The internal consistency of the mHealth in measuring pain was 0.96. The reported daily assessment or engagement rate ranged from 61.9% to 76.8%. All mHealth apps were designed for multimodal interventions. Participants generally had positive experiences using pain apps, rating them as enjoyable and user-friendly. In addition, 6 studies reported significant improvements in health outcomes, including enhancement in pain remission (severity and intensity), medication adherence, and a reduced frequency of breakthrough pain. The most frequently highlighted roles of mHealth apps included pain monitoring, tracking, reminders, education facilitation, and support coordination. CONCLUSIONS mHealth apps are effective and acceptable in supporting pain self-management. They offer a promising multi-model approach for patients to monitor, track, and manage their pain. These findings provide evidence-based insights for leveraging mHealth apps to support cancer pain self-management. More high-quality studies are needed to examine the effectiveness of digital technology-based interventions for cancer pain self-management and to identify the facilitators and barriers to their implementation in real-world practice.
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Affiliation(s)
- Weizi Wu
- School of Nursing, University of Connecticut, Storrs, CT, United States
| | - Teresa Graziano
- School of Nursing, University of Connecticut, Storrs, CT, United States
| | - Andrew Salner
- Hartford HealthCare Cancer Institute, Hartford, CT, United States
| | - Ming-Hui Chen
- Department of Statistics, University of Connecticut, Storrs, CT, United States
| | - Michelle P Judge
- School of Nursing, University of Connecticut, Storrs, CT, United States
| | - Xiaomei Cong
- Yale School of Nursing, Orange, CT, United States
| | - Wanli Xu
- School of Nursing, University of Connecticut, Storrs, CT, United States
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27
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Kühn L, Kleist L, Weißenstein F, Choi KEA. Biomedical Dogmas Still Influence the Delivery of Exercise Therapy in Chronic Low Back Pain Management: Mixed-Methods Study. Patient Prefer Adherence 2024; 18:1493-1507. [PMID: 39050274 PMCID: PMC11268774 DOI: 10.2147/ppa.s462689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 06/20/2024] [Indexed: 07/27/2024] Open
Abstract
Purpose Non-specific, chronic low back pain (NSCLBP) is a leading cause of disability, prompting long-term rehabilitation. Positive patient beliefs and expectations towards lasting exercise engagement play a crucial role for a successful management of this condition. The aim was to investigate beliefs, unmet needs and expectations of NSCLBP patients for exercise-related health behaviour change in the context of rehabilitative care. Patients and Methods In a mono-centric mixed-methods study, we conducted semi-structured interviews with NSCLBP patients and care providers. We recruited in a rehabilitation clinic which is specialized in orthopaedics and internal medicine. Interviews were analysed deductively by combining health behaviour change theories with Donabedian's quality model of care. In a patient survey, disability (RMDQ), exercise behaviours, fear avoidance beliefs (FABQ), self-efficacy in chronic disease management (SES6G), process- and outcome-expectations (OEE-2) were queried and analysed descriptively. Results Twenty-two interviews were conducted and 40 questionnaires completed. Qualitative results revealed that NSCLBP patients had persistent biomedical perspectives on their health condition, marked by strong preferences for biomedical diagnostics and beliefs in the superiority of specific exercise regimes. Based on met expectations and positive movement experiences, patients' motivation was successfully fostered in the motivational phase of health behavior change. In the volitional phase, the postulated desire to receive self-management strategies was largely unmet. Psychosocial aspects of care were not widely accepted. The survey study sample showed a disability score (RMDQ) of M = 6.8 (±4.6). Mean scores of validated scales reflecting on attitudes, beliefs and expectations of chronic NSCLBP management were at FABQ-pa M = 15.4 (±6.0), FABQ-w M = 24.0 (±12.1), SES6G M = 6.4 (±2.3), and OEE-2 M = 2.7 (±0.5). Conclusion In this sample, patients' understanding of NSCLBP was still dominated by biomedical dogmas and perspectives. Inpatient rehabilitation predominantly addressed expectations towards the motivational phase of exercise-related health behaviour change.
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Affiliation(s)
- Lukas Kühn
- Center for Health Services Research, Brandenburg Medical School, Rüdersdorf bei Berlin, 15562, Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School, Neuruppin, 16816, Germany
| | - Lara Kleist
- Center for Health Services Research, Brandenburg Medical School, Rüdersdorf bei Berlin, 15562, Germany
| | - Franziska Weißenstein
- Center for Health Services Research, Brandenburg Medical School, Rüdersdorf bei Berlin, 15562, Germany
| | - Kyung-Eun Anna Choi
- Center for Health Services Research, Brandenburg Medical School, Rüdersdorf bei Berlin, 15562, Germany
- Health Services Research, Research Center MIAAI (Medical Image Analysis & Artificial Intelligence), Danube Private University, Faculty of Medicine/Dentistry, Krems-Stein, 3500, Austria
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28
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Ochandorena-Acha M, Dalmau-Roig A, Dürsteler C, Vilchez-Oya F, Ferrer A, Martin-Villalba I, Obach A, Terradas-Monllor M. Acceptability of multimodal and multidisciplinary group-based program for chronic low back pain: a qualitative study. Physiother Theory Pract 2024:1-17. [PMID: 38994708 DOI: 10.1080/09593985.2024.2377343] [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: 12/20/2023] [Accepted: 07/01/2024] [Indexed: 07/13/2024]
Abstract
BACKGROUND The Programa d'Atenció Integral pels Pacients amb Dolor Crònic (PAINDOC) is a multimodal and multidisciplinary group-based program that integrates pain neuroscience education, mindfulness meditation, pain psychotherapy, Empowered Relief, and therapeutic exercise. It serves as a therapeutic option for individuals with chronic low back pain, providing them with comprehensive adaptive strategies for pain management. OBJECTIVE This qualitative study explores participants' retrospective acceptability of the PAINDOC Program. METHODS To ensure demographic variability and information power, a purposive sampling approach was applied. Twelve participants were interviewed through three focus groups, supplemented with four individual semi-structured interviews. Data was analyzed using reflexive thematic analysis and evaluated based on the Therapeutic Framework of Acceptability. RESULTS Participants provide positive feedback regarding active pain coping strategies and improved self-management. While certain aspects of the Program were more emphasized, participants integrated tools from all components. Strategies included pain reconceptualization, positive self-talk, or problem-solving. The Program's ethicality was closely linked to individual values and may also be influenced by time constraints of certain program elements, the immediate effects of specific approaches, participant perceptions, and individual preferences. CONCLUSIONS The findings provide valuable insights into the acceptability of the PAINDOC Program, guiding future improvements and the development of similar interventions.
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Affiliation(s)
- Mirari Ochandorena-Acha
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain
| | - Anna Dalmau-Roig
- Pain Medicine Section, Anaesthesiology Dept, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Christian Dürsteler
- Pain Medicine Section, Anaesthesiology Dept, Hospital Clinic de Barcelona, Barcelona, Spain
- Surgery Department, Medicine Faculty, Universitat de Barcelona (UB), Barcelona, Spain
| | - Francisco Vilchez-Oya
- Pain Medicine Section, Anaesthesiology Dept, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Anna Ferrer
- Pain Medicine Section, Anaesthesiology Dept, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Ines Martin-Villalba
- Department of Clinical Psychology and Psychobiology, Section of Clinical Health Psychology, Clinical Institute of Neurosciences, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Amadeu Obach
- Department of Clinical Psychology and Psychobiology, Section of Clinical Health Psychology, Clinical Institute of Neurosciences, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Marc Terradas-Monllor
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain
- Pain Medicine Section, Anaesthesiology Dept, Hospital Clinic de Barcelona, Barcelona, Spain
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29
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Guilcher SJT, Mayo AL, Swayze S, de Mestral C, Viana R, Payne MW, Dilkas S, Devlin M, MacKay C, Kayssi A, Hitzig SL. Patterns of inpatient acute care and emergency department utilization within one year post-initial amputation among individuals with dysvascular major lower extremity amputation in Ontario, Canada: A population-based retrospective cohort study. PLoS One 2024; 19:e0305381. [PMID: 38990832 PMCID: PMC11238985 DOI: 10.1371/journal.pone.0305381] [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: 05/04/2023] [Accepted: 05/28/2024] [Indexed: 07/13/2024] Open
Abstract
INTRODUCTION Lower extremity amputation (LEA) is a life altering procedure, with significant negative impacts to patients, care partners, and the overall health system. There are gaps in knowledge with respect to patterns of healthcare utilization following LEA due to dysvascular etiology. OBJECTIVE To examine inpatient acute and emergency department (ED) healthcare utilization among an incident cohort of individuals with major dysvascular LEA 1 year post-initial amputation; and to identify factors associated with acute care readmissions and ED visits. DESIGN Retrospective cohort study using population-level administrative data. SETTING Ontario, Canada. POPULATION Adults individuals (18 years or older) with a major dysvascular LEA between April 1, 2004 and March 31, 2018. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Acute care hospitalizations and ED visits within one year post-initial discharge. RESULTS A total of 10,905 individuals with major dysvascular LEA were identified (67.7% male). There were 14,363 acute hospitalizations and 19,660 ED visits within one year post-discharge from initial amputation acute stay. The highest common risk factors across all the models included age of 65 years or older (versus less than 65 years), high comorbidity (versus low), and low and moderate continuity of care (versus high). Sex differences were identified for risk factors for hospitalizations, with differences in the types of comorbidities increasing risk and geographical setting. CONCLUSION Persons with LEA were generally more at risk for acute hospitalizations and ED visits if higher comorbidity and lower continuity of care. Clinical care efforts might focus on improving transitions from the acute setting such as coordinated and integrated care for sub-populations with LEA who are more at risk.
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Affiliation(s)
- Sara J. T. Guilcher
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- St. John’s Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Amanda L. Mayo
- St. John’s Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Division of Physical Medicine and Rehabilitation, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | - Charles de Mestral
- Institute of Health Policy Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Division of Vascular Surgery, Department of Surgery, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Vascular Surgery, St. Michael’s Hospital, Unity Health Toronto, Toronto, Ontario, Canada
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Ricardo Viana
- Department of Physical Medicine & Rehabilitation, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Michael W. Payne
- Department of Physical Medicine & Rehabilitation, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Steven Dilkas
- Division of Physical Medicine and Rehabilitation, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- West Park Healthcare Centre, Toronto, Ontario, Canada
| | | | - Crystal MacKay
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- West Park Healthcare Centre, Toronto, Ontario, Canada
| | - Ahmed Kayssi
- Division of Vascular Surgery, Department of Surgery, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Schulich Heart Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Sander L. Hitzig
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- St. John’s Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Occupational Science & Occupational Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Yan Y, López-Alcalde J, Stallings E, Jimenez Tejero E, Witt CM, Barth J. Patient motivation as a predictor of digital health intervention effects: A meta-epidemiological study of cancer trials. PLoS One 2024; 19:e0306772. [PMID: 38976673 PMCID: PMC11230537 DOI: 10.1371/journal.pone.0306772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 06/24/2024] [Indexed: 07/10/2024] Open
Abstract
The objective of this meta-epidemiological study was to develop a rating that captures participants' motivation at the study level in digital health intervention (DHI) randomised controlled trials (RCTs). The rating was used to investigate whether participants' motivation is associated with the effect estimates in DHI RCTs for cancer patients. The development of the rating was based on a bottom-up approach involving the collection of information that captures participants' baseline motivation in empirical studies from the Smartphone-RCCT Database. We specified three indicators for rating: indicator 1 captures whether the study team actively selects or enhances the motivation of the potential study participants; indicator 2 captures the study participants' active engagement before the treatment allocation; and indicator 3 captures the potential bond and trust between the study participants and the person/institution referring to the study. The rating of each indicator and the overall rating varies between high motivation, moderate motivation, and low motivation. We applied the rating across 27 DHI RCTs with cancer patients. We performed meta-regression analysis to examine the effect of patient motivation on quality of life (QoL), psychological outcomes, and attrition. The intraclass correlation coefficient (ICC) indicated moderate to poor inter-rater reliability. The meta-regression showed that cancer patients' overall motivation before engaging in the intervention was associated with the treatment effect of QoL. Patient motivation was not found to be associated with psychological outcomes or attrition. Subgroup analyses revealed that the clinical effects of DHIs were more prevalent in the high-motivation subgroups, whereas the low-motivation subgroups were unlikely to show intervention benefits. The likelihood of dropouts from DHIs seems to be especially high among the low-bond (indicator 3) subgroup. We suggest using single indicators since they reflect specific content. Better reporting about baseline motivation is required to enable meaningful interpretations in not only primary studies but also in evidence syntheses.
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Affiliation(s)
- Yuqian Yan
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Jesús López-Alcalde
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
- Faculty of Medicine, Universidad Francisco de Vitoria (UFV), Madrid, Spain
- Unidad de Bioestadística Clínica, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), CIBERESP, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Elena Stallings
- Unidad de Bioestadística Clínica, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), CIBERESP, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Elena Jimenez Tejero
- Faculty of Medicine, Universidad Francisco de Vitoria (UFV), Madrid, Spain
- Unidad de Bioestadística Clínica, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Claudia M Witt
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
- Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Jürgen Barth
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
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Kurpershoek E, Visser LNC, Malekzadeh A, de Bie RMA, Dijk JM, Hillen MA. How Information Affects Patients with Parkinson's Disease: A Scoping Review of the Literature. JOURNAL OF PARKINSON'S DISEASE 2024:JPD240073. [PMID: 38995802 DOI: 10.3233/jpd-240073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/14/2024]
Abstract
Background Patients with Parkinson's disease (PD) need to receive adequate information to manage their disease. However, little is known about how information provision affects patients. Objective To conduct a scoping review of the literature on the relationship between content, timing, manner of delivery, and source of PD-specific information on the one hand, and patient outcomes on the other. Methods All literature reporting about original data and published until April 2024 in peer-reviewed journals was searched in MEDLINE (Ovid), Embase (Ovid) and PsychInfo (Ovid). Subsequently, data were extracted and synthesized. Results 40 publications describing the effects of information provision or patients' evaluation thereof were retrieved. Four categories of patient outcomes were described, namely 1) evaluation and experience of information provision; 2) physical functioning; 3) psychosocial well-being; and 4) quality of life. In intervention studies, patients generally valued the provided information. Findings from cross-sectional and qualitative studies showed the importance of tailoring information to individuals' needs and capabilities. Due to variation in study designs and outcomes, no unambiguous conclusions could be drawn regarding the relationship between information and outcomes. Conclusions This scoping review identified how PD patients acquire information and revealed a lack of systematic research into the effect of information on patient outcomes. Future studies should assess 1) what information is currently provided by clinicians; 2) what additional information might be beneficial to provide; and 3) how information can be effectively aligned to benefit patients. This will eventually yield insight into how information might optimally empower PD patients.
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Affiliation(s)
- Elisabeth Kurpershoek
- Amsterdam UMC, University of Amsterdam, Neurology, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
- Amsterdam UMC, University of Amsterdam, Medical Psychology, Amsterdam, The Netherlands
- Amsterdam Public Health, Quality of Care, Personalized Medicine, Amsterdam, The Netherlands
| | - Leonie N C Visser
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
- Amsterdam UMC, University of Amsterdam, Medical Psychology, Amsterdam, The Netherlands
- Amsterdam Public Health, Quality of Care, Personalized Medicine, Amsterdam, The Netherlands
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Arjan Malekzadeh
- Amsterdam UMC, University of Amsterdam, Medical Library, Amsterdam, The Netherlands
| | - Rob M A de Bie
- Amsterdam UMC, University of Amsterdam, Neurology, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
| | - Joke M Dijk
- Amsterdam UMC, University of Amsterdam, Neurology, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
| | - Marij A Hillen
- Amsterdam UMC, University of Amsterdam, Medical Psychology, Amsterdam, The Netherlands
- Amsterdam Public Health, Quality of Care, Personalized Medicine, Amsterdam, The Netherlands
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Blake H, Chaplin WJ, Gupta A. The effectiveness of digital interventions for self-management of chronic pain in employment settings: a systematic review. Br Med Bull 2024:ldae007. [PMID: 38972661 DOI: 10.1093/bmb/ldae007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 05/29/2024] [Accepted: 06/19/2024] [Indexed: 07/09/2024]
Abstract
INTRODUCTION Chronic pain affects over a quarter of the workforce with high economic burden for individuals, employers and healthcare services. Access to work-related advice for people with chronic pain is variable. This systematic review aims to explore the effectiveness of workplace-delivered digital interventions for the self-management of chronic pain. SOURCE OF DATA MEDLINE, EMBASE, CINAHL, PsycINFO, the Cochrane Library, JBI, Open Science Framework, Epistemonikos and Google Scholar. Articles published between January 2001 and December 2023 were included. Searches were conducted between October 2023 and December 2023. AREAS OF AGREEMENT Workplace-delivered digital interventions to support self-management of chronic pain at work may improve pain and health-related quality of life in vocationally active adults. Delivering interventions outside of clinical services, through the workplace setting, may help to reduce inequity in access to work-related advice for people with chronic pain, and ultimately reduce the burden on individuals, employers and healthcare services. Interventions include mobile apps and web-based programmes. AREAS OF CONTROVERSY Studies were moderate-to-low quality. Most studies focused on exercise, few considered other aspects of pain self-management. Given the limited evidence in the current literature, consensus on best intervention format and delivery is lacking. GROWING POINTS More high-quality studies are needed given the heterogeneity in study design, interventions and outcome measures. AREAS TIMELY FOR DEVELOPING RESEARCH No interventions included advice on work-related adjustments or support. Few studies included work-related outcomes, despite the known impact of pain on work and work on health.
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Affiliation(s)
- Holly Blake
- School of Health Sciences, Faculty of Medicine and Health Sciences, University of Nottingham, Queen's Medical Centre, Derby Road, Nottingham, NG7 2HA, UK
- NIHR Nottingham Biomedical Research Centre, Medical School, Queen's Medical Centre, Derby Road, Nottingham, NG7 2UH, UK
| | - Wendy J Chaplin
- School of Health Sciences, Faculty of Medicine and Health Sciences, University of Nottingham, Queen's Medical Centre, Derby Road, Nottingham, NG7 2HA, UK
- NIHR Nottingham Biomedical Research Centre, Medical School, Queen's Medical Centre, Derby Road, Nottingham, NG7 2UH, UK
| | - Alisha Gupta
- Population Health Sciences Institute, Baddiley-Clark Building, Newcastle University, Newcastleupon-Tyne, NE1 7RU, UK
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Kim SH, Kim KA, Chu SH, Kim H, Joo DJ, Lee JG, Choi J. Self-Management Using eHealth Technologies for Liver Transplant Recipients: Scoping Review. J Med Internet Res 2024; 26:e56664. [PMID: 38963937 PMCID: PMC11258531 DOI: 10.2196/56664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/24/2024] [Accepted: 06/03/2024] [Indexed: 07/06/2024] Open
Abstract
BACKGROUND Liver transplantation has become increasingly common as a last-resort treatment for end-stage liver diseases and liver cancer, with continually improving success rates and long-term survival rates. Nevertheless, liver transplant recipients face lifelong challenges in self-management, including immunosuppressant therapy, lifestyle adjustments, and navigating complex health care systems. eHealth technologies hold the potential to aid and optimize self-management outcomes, but their adoption has been slow in this population due to the complexity of post-liver transplant management. OBJECTIVE This study aims to examine the use of eHealth technologies in supporting self-management for liver transplant recipients and identify their benefits and challenges to suggest areas for further research. METHODS Following the Arksey and O'Malley methodology for scoping reviews, we conducted a systematic search of 5 electronic databases: PubMed, CINAHL, Embase, PsycINFO, and Web of Science. We included studies that (1) examined or implemented eHealth-based self-management, (2) included liver transplant recipients aged ≥18 years, and (3) were published in a peer-reviewed journal. We excluded studies that (1) were case reports, conference abstracts, editorials, or letters; (2) did not focus on the posttransplantation phase; (3) did not focus on self-management; and (4) did not incorporate the concept of eHealth or used technology solely for data collection. The quality of the selected eHealth interventions was evaluated using (1) the Template for Intervention Description and Replication guidelines and checklist and (2) the 5 core self-management skills identified by Lorig and Holman. RESULTS Of 1461 articles, 15 (1.03%) studies were included in the final analysis. Our findings indicate that eHealth-based self-management strategies for adult liver transplant recipients primarily address lifestyle management, medication adherence, and remote monitoring, highlighting a notable gap in alcohol relapse interventions. The studies used diverse technologies, including mobile apps, videoconferencing, and telehealth platforms, but showed limited integration of decision-making or resource use skills essential for comprehensive self-management. The reviewed studies highlighted the potential of eHealth in enhancing individualized health care, but only a few included collaborative features such as 2-way communication or tailored goal setting. While adherence and feasibility were generally high in many interventions, their effectiveness varied due to diverse methodologies and outcome measures. CONCLUSIONS This scoping review maps the current literature on eHealth-based self-management support for liver transplant recipients, assessing its potential and challenges. Future studies should focus on developing predictive models and personalized eHealth interventions rooted in patient-generated data, incorporating digital human-to-human interactions to effectively address the complex needs of liver transplant recipients. This review emphasizes the need for future eHealth self-management research to address the digital divide, especially with the aging liver transplant recipient population, and ensure more inclusive studies across diverse ethnicities and regions.
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Affiliation(s)
- Soo Hyun Kim
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
| | - Kyoung-A Kim
- College of Nursing, Suwon Women's University, Suwon, Republic of Korea
| | - Sang Hui Chu
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Republic of Korea
| | - Hyunji Kim
- School of Nursing, Yale University, Orange, CT, United States
| | - Dong Jin Joo
- Department of Surgery, College of Medicine, Yonsei University, Seoul, Republic of Korea
| | - Jae Geun Lee
- Department of Surgery, College of Medicine, Yonsei University, Seoul, Republic of Korea
| | - JiYeon Choi
- College of Nursing, Mo-Im Kim Nursing Research Institute, Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, Republic of Korea
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Mingels S, Granitzer M, Luedtke K, Dankaerts W. Therapeutic Patient Education as Part of the Physiotherapy Management of Adults with Headache: A Scoping Review. Curr Pain Headache Rep 2024; 28:547-564. [PMID: 38613735 DOI: 10.1007/s11916-024-01253-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2024] [Indexed: 04/15/2024]
Abstract
PURPOSE OF REVIEW Physiotherapy interventions for headache mostly include exercise and manual therapy. Yet, the complex nature of headache, sometimes characterized by symptoms of facilitated central pain mechanisms, demands an individualized approach in which therapeutic patient education could be supportive. This scoping review aimed to summarize the position of therapeutic patient education within the physiotherapy management of adults with headache. PubMed, EMBASE, Web of Science, and Scopus were searched. The search-query comprised terminology relating to "headache", "education", and "physiotherapy". Eligibility criteria were: adults with headache, interventions including education within the domain of physiotherapy, reviews, clinical trials, cohort, case report, case-control studies. RECENT FINDINGS Eleven publications were included from the 281 retrieved publications. These publications were clinical trials (n = 4), reviews (n = 4), case-reports (n = 2), and a guideline (n = 1). Type of headaches studied were migraine (n = 3), post-traumatic headache (n = 2), tension-type headache (n = 2), cervicogenic headache (n = 1), primary headaches (n = 1), chronic daily headache (n = 1), and mixed migraine-cervicogenic headache (n = 1). Education seems an umbrella-term for postural education, lifestyle advice, and pain education. Three themes emerged across the publications: handling headache triggers (migraine, post-traumatic headache), promoting active lifestyle (post-traumatic headache, chronic daily headache, migraine), evaluating posture (post-traumatic headache, chronic daily headache, tension-type headache, cervicogenic headache). All publications recommended education in the management of headache. Only one (of the 11 included) publication described the educational program and determined its efficacy. Based on this scoping review, therapeutic patient education seems supported within physiotherapy management of headache. However, it is unclear how such education is tailored to the specific needs of the individual, the headache subtype, or when it should be added to physiotherapy management of headache.
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Affiliation(s)
- Sarah Mingels
- Musculoskeletal Research Unit, Department of Rehabilitation Sciences, Faculty of Movement and Rehabilitation Sciences, Leuven University, Tervuursevest, 101, 3001, Leuven, Belgium.
- Faculty of Rehabilitation Sciences and Physiotherapy, REVAL Rehabilitation Research Centre, Hasselt University, Hasselt, Belgium.
| | - Marita Granitzer
- Faculty of Rehabilitation Sciences and Physiotherapy, REVAL Rehabilitation Research Centre, Hasselt University, Hasselt, Belgium
| | - Kerstin Luedtke
- Department of Physiotherapy, Pain and Exercise Research, Universität Zu Lübeck, Lübeck, Germany
| | - Wim Dankaerts
- Musculoskeletal Research Unit, Department of Rehabilitation Sciences, Faculty of Movement and Rehabilitation Sciences, Leuven University, Tervuursevest, 101, 3001, Leuven, Belgium
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Elkefi S. Supporting patients' workload through wearable devices and mobile health applications, a systematic literature review. ERGONOMICS 2024; 67:954-970. [PMID: 37830977 DOI: 10.1080/00140139.2023.2270780] [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: 09/19/2022] [Accepted: 08/25/2023] [Indexed: 10/14/2023]
Abstract
Patients face a challenging workload in their course of care. In this study, we investigate the impact of using mobile health technologies in supporting this workload and identify the system challenges of its application through a systematic review of the literature published in the last two decades following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Reviews and Meta-Analysis guidelines PRISMA guidelines. Twenty-two studies that satisfied the inclusion criteria were included. The review revealed various mobile health and wearable devices used to support mental demand, physical demand, frustration, and performance. Better outcomes were related to mobile health use in healthcare for patients in different settings. There were no applications of health that supported the temporal demand of patients. Some populations, such as cancer patients, need more than only physical demand. Mhealth devices are important in supporting the patients' workload in their daily activities and clinical settings.Practitioner summary: This review study shows the importance of mHealth and wearables in supporting patients' workload (physical, mental, emotional) but not the temporal load.
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Affiliation(s)
- Safa Elkefi
- Nursing School, Columbia University, New York, NY, USA
- HPHACTORS Lab, NYC, USA
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Kumar D, Burma A, Peter S, Ansari MA, Patankar A. A cross-sectional study on diabetes self-management practice and its association with glycemic control among type 2 Diabetes patients. J Family Med Prim Care 2024; 13:2616-2622. [PMID: 39071023 PMCID: PMC11272008 DOI: 10.4103/jfmpc.jfmpc_1804_23] [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: 11/09/2023] [Revised: 01/08/2024] [Accepted: 01/15/2024] [Indexed: 07/30/2024] Open
Abstract
Context Diabetes has emerged as a major chronic public health problem throughout the world. Self-management by diabetes patients is very important for controlling blood sugar levels and preventing complications of diabetes. Aims The present study was conducted to study self-management practices among diabetes patients and to analyse socio-demographic factors associated with them. Methods and Materials A cross-sectional analytical study was conducted among 230 randomly selected diabetes patients in the Andaman and Nicobar Islands. The self-management practices were measured by the diabetes self-management questionnaire (DSMQ). Statistical Analysis Used The association of the DSMQ score with socio-demographic factors and blood sugar level was analysed by statistical tests like the T-test, analysis of variance (ANOVA) test, Tukey's honestly significant difference, and Chi-square test. Results The mean DSMQ score of the diabetes patients was 29.55 ± 5.98. There was a significant difference between the mean DSMQ score and the educational level (P value = 0.009), residential status (P value = 0.037), and duration of diabetes (P value = 0.006). The subcomponent analysis of the DSMQ score revealed that the glucose management score of rural people (9.38 ± 3.36) was significantly higher (P value = 0.006) than that of urban people (8.32 ± 2.46), and the diet control score was significantly higher (P value = 0.02) in patients with normal post-prandial blood sugar (PPBS) (7.64 ± 2.18) than in patients with raised PPBS (6.96 ± 2.12). Conclusions Higher educational level, rural background, and long duration of diabetes were associated with better self-management practices. The patients with normal blood sugar levels showed higher diet control scores than the patients with raised blood sugar levels.
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Affiliation(s)
- Deepak Kumar
- Department of Community Medicine, Maharishi Markandeshwar Medical College and Hospital, Kumarhatti, Solan, Himachal Pradesh, India
| | - Amrita Burma
- Department of Community Medicine, Andaman and Nicobar Islands Institute of Medical Sciences, Port Blair, Andaman and Nicobar, India
| | - Sherley Peter
- Lady Medical Officer, Andaman and Nicobar Islands Institute of Medical Sciences, Port Blair, Andaman and Nicobar, India
| | - Mohd A. Ansari
- Department of Community Medicine, Maharishi Markandeshwar Medical College and Hospital, Kumarhatti, Solan, Himachal Pradesh, India
| | - Anand Patankar
- Department of Medicine, SSIMS, Bhilai, Chattisgarh, India
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Finnimore A, Theodoros D, Rumbach AF. The impact of PD Check-In on self-management skills for maintenance of speech after intensive treatment. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2024; 59:1628-1646. [PMID: 38377119 DOI: 10.1111/1460-6984.13024] [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: 06/15/2023] [Accepted: 02/03/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND Maintenance of speech outcomes following speech-language therapy (SLT) in Parkinson's disease (PD) is an unmet expectation of people with PD (PWPD) and poorly defined in SLT practice. PD Check-In, a model for supported self-managed maintenance of speech following Lee Silverman Voice Treatment (LSVT) LOUD was investigated. AIMS To investigate the impact of the semi-structured component of PD Check-In on the adoption of self-management concepts and behaviours and the identification of facilitators, barriers and strategies for speech maintenance by PWPD over 24 months post-treatment. METHODS AND PROCEDURE Following LSVT LOUD, 16 PWPD participated in individual PD Check-In semi-structured discussions with a SLT at 6 and 12 weeks, and 6, 12 and 24 months post treatment. A two-stage qualitative content analysis was applied: directed content analysis using categories from the theoretical framework of PD Check-In followed by inductive content analysis to identify subcategories. OUTCOMES AND RESULTS Statements from PWPD indicated adoption of seven concepts of self-management across participants and across time. Six concepts from the theoretical framework of PD Check-In (partnerships, self-reflection, maintenance barriers and facilitators, revision of LSVT LOUD skill, goal setting and maintenance strategies), and one new category, participation, emerged from the analysis. Self-reflection, maintenance facilitators and barriers and participation were most prevalent in discussions. PWPD identified facilitators, barriers and strategies for maintenance across time points. CONCLUSIONS AND IMPLICATIONS Statements from PWPD indicated a positive impact of SLT-supported self-management of speech using self-tailored strategies for sustainable maintenance according to their individual circumstances and needs. WHAT THIS PAPER ADDS What is already known on this subject People with Parkinson's disease (PWPD) have expressed their need for speech-language therapy (SLT) services that are accessible for the duration of the condition and responsive to their expectation of maintaining speech following treatment. Outcomes for maintenance of the treatment effect following Lee Silverman Voice Treatment (LSVT) LOUD are variable. What this paper adds to existing knowledge This study presents the outcomes of five PD Check-In interventions delivered in semi-structured discussions between PWPD and a SLT over 24 months following LSVT LOUD for the development of self-management skills and behaviours. PWPD adopted self-management positively using self-tailored strategies for sustainable maintenance according to their individual circumstances and needs. What are the potential or actual clinical implications of this work? PWPD responded positively to the individual development of self-management skills and behaviours over time. Individuality and flexible responsivity are features of PD Check-In which resonate with PWPD and speak to SLT supported self-managed maintenance of speech as a long-term model for PD.
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Affiliation(s)
- Ann Finnimore
- The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, Australia
- The Prince Charles Hospital, Metro North Hospital & Health Service, Brisbane, Australia
| | - Deborah Theodoros
- The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, Australia
| | - Anna F Rumbach
- The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, Australia
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Wilson MV, Braithwaite FA, Arnold JB, Crouch SM, Moore E, Heil A, Cooper K, Stanton TR. The effectiveness of peer support interventions for community-dwelling adults with chronic musculoskeletal pain: a systematic review and meta-analysis of randomised trials. Pain 2024:00006396-990000000-00636. [PMID: 38916521 DOI: 10.1097/j.pain.0000000000003293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 04/20/2024] [Indexed: 06/26/2024]
Abstract
ABSTRACT This systematic review and meta-analysis critically examined the evidence for peer support interventions to reduce pain and improve health outcomes in community-dwelling adults with chronic musculoskeletal pain (PROSPERO CRD42022356850). A systematic search (inception-January 2023) of electronic databases and grey literature was undertaken to identify relevant randomised controlled trials, with risk of bias and GRADE assessments performed on included studies. Meta-analyses used a generic, inverse-variance, random-effects model, calculating mean difference (MD) or standardised mean difference (SMD). Of 16,445 records identified, 29 records reporting on 24 studies (n = 6202 participants) were included. All evidence had unclear/high risk of bias and low-very low certainty. Peer support interventions resulted in small improvements in pain (medium-term: MD -3.48, 95% CI -6.61, -0.35; long-term: MD -1.97, 95% CI -3.53, -0.42), self-efficacy (medium-term: SMD 0.26, 95% CI 0.16, 0.36; long-term: SMD 0.21, 95% CI 0.07, 0.36), and function (long-term: SMD -0.10, 95% CI -0.19, -0.00) relative to usual care and greater self-efficacy (medium-term: SMD 0.36, 95% CI 0.20, 0.51) relative to waitlist control. Peer support interventions resulted in similar improvement as active (health professional led) interventions bar long-term self-efficacy (MD -0.41, 95% CI -0.77, -0.05), which favoured active interventions. No point estimates reached minimal clinically important difference thresholds. Pooled health service utilisation outcomes showed unclear estimates. Self-management, quality of life, and social support outcomes had mixed evidence. Despite low-very low evidence certainty, peer support interventions demonstrated small improvements over usual care and waitlist controls for some clinical outcomes, suggesting that peer support may be useful as an adjunct to other treatments for musculoskeletal pain.
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Affiliation(s)
- Monique V Wilson
- Innovation, IMPlementation And Clinical Translation (IIMPACT) in Health, University of South Australia, Kaurna Country, Adelaide, Australia
- Persistent Pain Research Group, Hopwood Centre for Neurobiology, Lifelong Health Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia
| | - Felicity A Braithwaite
- Innovation, IMPlementation And Clinical Translation (IIMPACT) in Health, University of South Australia, Kaurna Country, Adelaide, Australia
- Persistent Pain Research Group, Hopwood Centre for Neurobiology, Lifelong Health Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia
| | - John B Arnold
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Kaurna Country, Adelaide, Australia
| | - Sophie M Crouch
- Innovation, IMPlementation And Clinical Translation (IIMPACT) in Health, University of South Australia, Kaurna Country, Adelaide, Australia
- Faculty of Health and Medical Sciences, University of Adelaide, Kaurna Country, Adelaide, Australia
| | - Emily Moore
- Innovation, IMPlementation And Clinical Translation (IIMPACT) in Health, University of South Australia, Kaurna Country, Adelaide, Australia
| | - Alrun Heil
- Department of Health Sciences, Bern University of Applied Sciences (BFH), Bern, Switzerland
| | - Kay Cooper
- School of Health Sciences, Robert Gordon University, Aberdeen, United Kingdom
- The Scottish Centre for Evidence-based, Multi-professional Practice: A JBI Centre of Excellence, Robert Gordon University, Aberdeen, Scotland
| | - Tasha R Stanton
- Innovation, IMPlementation And Clinical Translation (IIMPACT) in Health, University of South Australia, Kaurna Country, Adelaide, Australia
- Persistent Pain Research Group, Hopwood Centre for Neurobiology, Lifelong Health Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia
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Karcz K, Schwegler U, Schiffmann B, Finger ME. Risk factors and service gaps affecting a sustainable work: a qualitative multi-stakeholder analysis in the context of persons with acquired brain injury living in Switzerland. BMC Health Serv Res 2024; 24:753. [PMID: 38902701 PMCID: PMC11188514 DOI: 10.1186/s12913-024-11128-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 05/21/2024] [Indexed: 06/22/2024] Open
Abstract
INTRODUCTION Along with the social and economic challenges posed by an aging society, creating work conditions that allow persons to stay healthy and work into old age has become a major task of Western societies. Retaining employment after returning to work is particularly difficult for individuals with a disability, as evidenced by the high rate of premature labor market dropout. Individuals with acquired brain injury (ABI) exemplify this challenge, as it often impairs cognitive, technical, and interpersonal abilities that are crucial in today's labor market. To effectively support these individuals, vocational integration practitioners require comprehensive knowledge of risk factors for premature labor market dropout and effective strategies for sustainable work. OBJECTIVE This study aimed to identify perceived risk factors and related service gaps regarding sustainable work for people with ABI, as reported by affected individuals, employers, vocational integration professionals, and health professionals. METHODS Secondary data analysis. Data that was originally collected through seven focus groups and two interviews with persons with ABI, 15 interviews with employers, and 13 interviews with vocational integration and health professionals in the context of the project 'Sustainable employment' was re-analysed thematically. RESULTS Two major themes of risk factors were identified: (1) person-related factors (including the subthemes: post-ABI impairments; lack of understanding of post-ABI impairments; poor health management) and (2) environment-related factors (including the subthemes: challenges related to the service structure; insufficient knowledge and education about ABI; challenges at the workplace; difficulties in private life). While stakeholders noted the variety of the currently available services, they particularly pointed to the missing long-term monitoring and counseling services for persons with ABI following the initial return-to-work, reflecting a major challenge for sustainable work. An overarching gap related to the fragmentation of the service structure and the lack of case coordination along the working life. CONCLUSIONS Multiple stakeholders emphasized the importance of empowering individuals, ensuring easy access to professional support, and providing a suitable work environment to address key risk factors and facilitate sustainable work for individuals with ABI. Continuous coaching, long-term monitoring and counseling following return-to-work, were identified as potential strategies to achieve these goals.
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Affiliation(s)
- Katarzyna Karcz
- Swiss Paraplegic Research, Guido A. Zäch Strasse 4, Nottwil, 6207, Switzerland.
| | - Urban Schwegler
- Swiss Paraplegic Research, Guido A. Zäch Strasse 4, Nottwil, 6207, Switzerland
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Barbara Schiffmann
- Swiss Paraplegic Research, Guido A. Zäch Strasse 4, Nottwil, 6207, Switzerland
| | - Monika E Finger
- Swiss Paraplegic Research, Guido A. Zäch Strasse 4, Nottwil, 6207, Switzerland
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Turner SG, Pillemer K, Demetres M, Heaney K, Joshi S, Luebke M, Messay G, Reid MC. Physical pain among family caregivers to older adults: A scoping review of the literature. J Am Geriatr Soc 2024. [PMID: 38895995 DOI: 10.1111/jgs.19037] [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: 10/12/2023] [Revised: 05/02/2024] [Accepted: 05/12/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND AND OBJECTIVES Scholarship on the health of family caregivers to older adults continues to expand. Although existing research suggests that many family caregivers experience pain, which impacts their ability to perform caregiving tasks and is associated with care recipients' unmet needs, the scope of research on family caregivers' pain remains poorly characterized. We conducted a scoping review of research on pain among family caregivers to older adults to characterize existing evidence and identify knowledge gaps. METHODS We searched multiple databases spanning from January 2012 to July 2023, identified eligible studies using predefined inclusion/exclusion criteria, and extracted key data (e.g., study design/methodology, pain measurement, caregiver pain type, and major findings). RESULTS We identified 46 eligible studies conducted in the United States (n = 19) and internationally (n = 27). Studies often focused on caregivers for older adults with specific health conditions, such as cancer (n = 11), dementia (n = 8), or stroke (n = 3). The most commonly employed pain measure was a single-item dichotomous question about pain (n = 16), followed by a visual numeric or visual analog scale (n = 11). Nine studies (five randomized controlled trials) reported on five caregiver pain management interventions, including yoga/exercise programs and caregiver education programs. DISCUSSION Existing research on family caregivers' pain offers an important foundation. However, more robust research designs are necessary. We identify possibilities for future studies in addition to opportunities for systematic investigations to support the family caregivers being relied upon to care for the increasing number of older adults.
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Affiliation(s)
- Shelbie G Turner
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine, New York, New York, USA
- Translational Research Institute on Pain in Later Life, Weill Cornell Medicine, New York, New York, USA
| | - Karl Pillemer
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine, New York, New York, USA
- Translational Research Institute on Pain in Later Life, Weill Cornell Medicine, New York, New York, USA
- College of Human Ecology, Cornell University, Ithaca, New York, USA
| | - Michelle Demetres
- Samuel J. Wood Library and C.V. Starr Biomedical Information Center, Weill Cornell Medicine, New York, New York, USA
| | - Kathleen Heaney
- Translational Research Institute on Pain in Later Life, Weill Cornell Medicine, New York, New York, USA
- Vagelos College of Physicians and Surgeons, Columbia University, New York, USA
| | - Sama Joshi
- Translational Research Institute on Pain in Later Life, Weill Cornell Medicine, New York, New York, USA
- School of Medicine, University of Maryland, Baltimore, Maryland, USA
| | - Matthew Luebke
- College of Human Ecology, Cornell University, Ithaca, New York, USA
- Hackensack Meridian School of Medicine, Hackensack, New Jersey, USA
| | - Gelila Messay
- Translational Research Institute on Pain in Later Life, Weill Cornell Medicine, New York, New York, USA
| | - M Carrington Reid
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine, New York, New York, USA
- Translational Research Institute on Pain in Later Life, Weill Cornell Medicine, New York, New York, USA
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Krieger T, Jozwiak L, Ebersbach G, Suess T, Falkenburger B, Feige T, Eggers C, Warnecke T, Scholl W, Schmidt-Heisch C, Folkerts AK, Kalbe E, Seven ÜS. Exploring the lived experiences of individuals with Parkinson's disease and their relatives: insights into care provision experiences, disease management support, self-management strategies, and future needs in Germany (qualitative study). BMC Neurol 2024; 24:208. [PMID: 38890614 PMCID: PMC11184701 DOI: 10.1186/s12883-024-03696-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 05/29/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Parkinson's disease (PD) significantly impacts the health-related quality of life of affected individuals and their relatives. In order to support the affected individuals and their families in coping with PD, it is essential to offer comprehensive information about their experiences. A comprehensive understanding of their lived experiences with the disease, the healthcare system, applied self-management strategies and their needs is considered crucial for developing a PD support program. Therefore, we aimed to explore the lived experiences and support needs of individuals with PD and their relatives in Germany. METHODS This non-interventional, qualitative study conducted an explorative status quo and needs assessment. It generated knowledge through semi-structured focus groups and interviews with individuals with PD at various disease stages and their relatives. The interviews were digitally recorded, transcribed verbatim, and analysed using content analysis. RESULTS Fifty-two individuals with PD and 29 relatives participated in eight focus groups and 13 paired and 13 individual interviews. Four themes with corresponding subthemes emerged: (1) experiences, revealing individuals' experiences around their diagnosis and with disease-specific care provision; (2) management support offers, clarifying who provides support and the type of support offered; (3) self-management, including comprehensibility, meaningfulness and manageability; and (4) future needs, differentiating between deficits and needs. Most participants expressed a sense of abandonment when obtaining self-management strategies and mastering their lives with PD, often referred to as 'life 2.0'. They identified the lack of structured and adequate provision of information, system orientation and social awareness. CONCLUSIONS In Germany, there is an urgent need for a comprehensive PD care program that addresses the needs of individuals with PD and their relatives from the start of their care trajectory. It could assist individuals in gaining a comprehensive understanding of the disease, obtaining self-management strategies, building a support network, and becoming experts in self-managing their disease. Moreover, it may positively influence their care trajectory and reduce burdens, such as overburdening, fear of progression, and health anxiety. TRIAL REGISTRATION German Clinical Studies Register ( https://www.drks.de/DRKS00030090 , No. DRKS00030090, Date of registration: 15.12.2022).
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Affiliation(s)
- Theresia Krieger
- Medical Psychology | Neuropsychology and Gender Studies, Centre for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany.
| | - Leonie Jozwiak
- Medical Psychology | Neuropsychology and Gender Studies, Centre for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Georg Ebersbach
- Movement Disorder Clinic, Kliniken Beelitz, Beelitz-Heilstätten, Germany
| | - Thorsten Suess
- Movement Disorder Clinic, Kliniken Beelitz, Beelitz-Heilstätten, Germany
| | - Björn Falkenburger
- Department of Neurology, University of Technology Dresden, Dresden, Germany
| | - Tim Feige
- Department of Neurology, University of Technology Dresden, Dresden, Germany
| | - Carsten Eggers
- Knappschaftskrankenhaus Bottrop, Department of Neurology, Bottrop, Germany
| | - Tobias Warnecke
- Department of Neurology, University Hospital Munster, Munster, Germany
| | | | | | - Ann-Kristin Folkerts
- Medical Psychology | Neuropsychology and Gender Studies, Centre for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Elke Kalbe
- Medical Psychology | Neuropsychology and Gender Studies, Centre for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ümran Sema Seven
- Medical Psychology | Neuropsychology and Gender Studies, Centre for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
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Bosveld MH, Smits AGM, Mertens HJMM, Zandvoort MJJMV, Mook WNKAV, Bokhoven MAV. Patients and informal caregivers in the lead: a qualitative study on the experiences of patients, informal caregivers, and healthcare professionals with involvement in treatment, e-health and self-management programs. BMC Health Serv Res 2024; 24:713. [PMID: 38858686 PMCID: PMC11165740 DOI: 10.1186/s12913-024-11156-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 05/31/2024] [Indexed: 06/12/2024] Open
Abstract
BACKGROUND A significant proportion of patients and informal caregivers favor an active role in decisions concerning their health. Simultaneously, governments aim to shift treatment from a professional care setting to a community setting, in light of an ageing population, a decreasing number of health workers and allocation of scarce resources. This transition of care solicits patients' and informal caregivers' ability to self-manage. Therefore, the Maastricht University Medical Centre + has established the Academy for Patients and Informal caregivers. The aim is to proactively and professionally support patients and their informal caregivers to enhance their self-management. For that, the Academy offers activities in three categories: (1) instruction of nursing techniques, (2) training of e-health competencies and (3) the provision of self-management programs. Both patients with an episodic care need, as well as patients and informal caregivers with chronic illness, are eligible to participate in the Academy's activities. However, little is known about the experience of these interventions from the perspective of patients, informal caregivers and healthcare professionals. METHODS We conducted semi-structured interviews with 15 patients, 8 informal caregivers and 19 health care professionals who either participated in, referred to or received patients from the Academy. Topics revolved around self-management and the Quadruple aim, covering topics such as patient experiences, healthcare costs, health and well-being of the population and improving work life for health professionals. Data were analyzed using thematic analysis. RESULTS Patients and caregivers experienced an increase in the ability to manage health needs independently, leading to increased mental well-being and self-efficacy. They felt recognized as partners in care, although managing illness needs came with its own burdens. Health care professionals indicated that they felt assured of the quality, uniformity and availability of activities due to its central organization, with instruction nurses finding greater meaning in their work. On the level of health care systems, participants in this study mentioned a decrease in use of formal healthcare, whilst enabling a more equitable division of care. CONCLUSION Stakeholders' experiences with the Academy for Patients and Informal caregivers indicate that participation contributes to development of self-management, whilst also improving working conditions, reducing the appeal to formal care and advancing equity in healthcare. The burden for patients and informal caregivers is to be considered in future developments.
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Affiliation(s)
- Matthijs H Bosveld
- Care and Public Health Research Institute (CAPHRI; department of Family Medicine), Maastricht University, Maastricht, The Netherlands.
- School of Health Professions Education (SHE), Maastricht University, Maastricht, The Netherlands.
| | - Anne G M Smits
- Care and Public Health Research Institute (CAPHRI; department of Family Medicine), Maastricht University, Maastricht, The Netherlands
| | - Helena J M M Mertens
- Maastricht University Medical Centre+ (board of directors), Maastricht, The Netherlands
| | | | - Walther N K A van Mook
- Maastricht University Medical Centre+ (department of Intensive Care), School of Health Professions Education, Maastricht University, Maastricht, The Netherlands
- School of Health Professions Education (SHE), Maastricht University, Maastricht, The Netherlands
| | - Marloes A van Bokhoven
- Care and Public Health Research Institute (CAPHRI; department of Family Medicine), Maastricht University, Maastricht, The Netherlands
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Hurmuz MZM, Jansen-Kosterink SM, Mork PJ, Bach K, Hermens HJ. Factors influencing the use of an artificial intelligence-based app (selfBACK) for tailored self-management support among adults with neck and/or low back pain. Disabil Rehabil 2024:1-10. [PMID: 38853677 DOI: 10.1080/09638288.2024.2361811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 05/22/2024] [Indexed: 06/11/2024]
Abstract
PURPOSE Tailored self-management support is recommended as first-line treatment for neck and low back pain, for which mHealth applications could be promising. However, there is limited knowledge about factors influencing the engagement with such apps. The aim of this study was to assess barriers and facilitators for engaging with a self-management mHealth app among adults suffering from neck and/or low back pain. MATERIALS AND METHODS We carried out a qualitative descriptive study among adults with neck and/or low back pain. The artificial intelligence-based selfBACK app supports tailored self-management of neck and low back pain and was used for 6 weeks. After these 6 weeks, participants were interviewed by phone. RESULTS Thirty-two adults (17 males) with neck and/or low back pain participated (mean age = 54.9 (SD = 15.8)). Our results show that the mode of delivery and the novelty of the selfBACK app were perceived most often as a barrier to use the app. The action plans of the app and health-related factors were perceived most often as facilitating factors. CONCLUSIONS This study provides insight into possible strategies to improve an mHealth service. Furthermore, it shows that adults with neck and/or low back pain are willing and ready to receive blended treatment.
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Affiliation(s)
- M Z M Hurmuz
- Roessingh Research and Development, Enschede, The Netherlands
- Biomedical Signal and Systems group, University of Twente, Enschede, The Netherlands
| | - S M Jansen-Kosterink
- Roessingh Research and Development, Enschede, The Netherlands
- Biomedical Signal and Systems group, University of Twente, Enschede, The Netherlands
| | - P J Mork
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - K Bach
- Department of Computer Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - H J Hermens
- Roessingh Research and Development, Enschede, The Netherlands
- Biomedical Signal and Systems group, University of Twente, Enschede, The Netherlands
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Kessler D, Franz M, Malakouti N, Rajachandrakumar R, Baharnoori M, Finlayson M. Randomized Controlled Trial of Occupational Performance Coaching for Adults With Multiple Sclerosis. Arch Phys Med Rehabil 2024:S0003-9993(24)01042-6. [PMID: 38851554 DOI: 10.1016/j.apmr.2024.05.022] [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: 12/21/2023] [Revised: 05/22/2024] [Accepted: 05/23/2024] [Indexed: 06/10/2024]
Abstract
OBJECTIVE To determine if the receipt of occupational performance coaching (OPC) by adults living with multiple sclerosis (MS) improves participants' satisfaction with performance in daily activities (primary outcome); improves perceived performance in daily activities, resilience, autonomy, and participation; and reduces illness intrusiveness and effect of MS (secondary outcomes). DESIGN Two-group randomized clinical trial with a waitlist control. SETTING Community. PARTICIPANTS Convenience sample of adults with MS were recruited through a research registry. Eighty-three individuals were approached; 35 were assessed for eligibility and 31 were enrolled and 30 completed baseline assessment (Final sample size, N=30). Participants were English-speaking, were without serious cognitive impairment or severe depression, and were not receiving other coaching interventions. INTERVENTIONS Six telephone sessions of OPC were delivered by a trained facilitator over 10 weeks. Initial sessions focused on goal setting, prioritization, and action planning. Subsequent sessions involved goal and action plan review, discussion of facilitators and barriers, and goal and plan refinement. MAIN OUTCOME MEASURES Primary outcome was participants' satisfaction with performance in daily activities, as measured by the Canadian Occupational Performance Measure (COPM). Secondary outcome measures included the COPM performance rating, Connor-Davidson Resilience Scale, Impact on Participation and Autonomy Questionnaire, Adapted Illness Intrusiveness Rating Scale, and MS Impact Scale. Measures were administered by a blinded assessor at baseline, 10 weeks, and 2 months. RESULTS Participants in the intervention and waitlist control groups were equivalent on demographic and outcome measures at baseline. At 10 weeks, the intervention group had significantly higher COPM ratings for both satisfaction (P<.001) and performance (P=.002). No other outcomes were significantly different. For the intervention group, the benefits of OPC were maintained at 2 months. CONCLUSIONS OPC led to improved satisfaction with performance and performance in daily activities. Future research with a larger sample is needed to determine other effects and who benefits most from OPC.
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Affiliation(s)
- Dorothy Kessler
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada.
| | - Martina Franz
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
| | - Niloufar Malakouti
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
| | | | - Moogeh Baharnoori
- Department of Medicine, Division of Neurology, Queen's University, Kingston, Ontario, Canada
| | - Marcia Finlayson
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
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O’Brien-Kelly J, Moore D, O’Leary I, O’Connor T, Moore Z, Patton D, Nugent L. Development and impact of a tailored eHealth resource on fibromyalgia patient's self-management and self-efficacy: A mixed methods approach. Br J Pain 2024; 18:292-307. [PMID: 38751562 PMCID: PMC11092935 DOI: 10.1177/20494637231221647] [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] [Indexed: 05/18/2024] Open
Abstract
Aim To develop an eHealth resource to support fibromyalgia patients and explore it for usability and impact on their self-management and self-efficacy. Background Fibromyalgia is a complex, non-progressive chronic condition characterised by a bewildering array of symptoms for patients to self-manage. International guidelines recommend patients receive illness-specific information once diagnosed to promote self-management and improve health-related quality of life. Design A 3-phase mixed methods exploratory sequential design. Methods Qualitative interviews explored the information and self-management needs of fibromyalgia patients attending a large tertiary hospital in Dublin. Identified themes together with an extensive review of the literature of interventions proven to be impactful by patients with fibromyalgia were utilised in the design and development of the eHealth resource. The resource was tested for usability and impact using pre and post-intervention outcomes measures. Results Patient interviews highlighted a lack of easy accessible evidenced information to support self-management implicating the urgent need for a practical solution through development of a tailored eHealth resource. Six themes emerged for inclusion; illness knowledge, primary symptoms, treatment options, self-management strategies, practical support and reliable resources. Forty-five patients who tested the site for usability and impact demonstrated a statistically significant improvement in self-efficacy after 4 weeks access with a medium positive effect size. Patients with the most severe fibromyalgia impact scores pre-intervention demonstrated the most improvement after 4 weeks. Patients gave the resource a System Usability Score A rating, highly recommending it for fellow patients diagnosed with fibromyalgia. Conclusions The study demonstrated how the development of a novel eHealth resource positively impacted fibromyalgia patients' self-efficacy to cope with this debilitating condition. Impact This study suggests that access to eHealth can positively impact patients self-efficacy, has the potential to be a template for eHealth development in other chronic conditions, supporting advanced nurse practitioners working in chronic disease management.
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Affiliation(s)
- Joanne O’Brien-Kelly
- Department of Pain Management, Beaumont Hospital, Dublin, Ireland
- School of Nursing and Midwifery, Royal College of Surgeons, University of Medicine and Health Sciences, Dublin, Ireland
| | - David Moore
- Department of Pain Management, Beaumont Hospital, Dublin, Ireland
| | - Ian O’Leary
- Multimedia Cork Institute of Technology, Cork, Ireland
| | - Tom O’Connor
- School of Nursing and Midwifery, Royal College of Surgeons, University of Medicine and Health Sciences, Dublin, Ireland
| | - Zena Moore
- School of Nursing and Midwifery, Royal College of Surgeons, University of Medicine and Health Sciences, Dublin, Ireland
| | - Declan Patton
- School of Nursing and Midwifery, Royal College of Surgeons, University of Medicine and Health Sciences, Dublin, Ireland
| | - Linda Nugent
- School of Nursing and Midwifery, Royal College of Surgeons, University of Medicine and Health Sciences, Dublin, Ireland
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M H Jagodage H, McGuire A, Seib C, Bonner A. Effectiveness of teach-back for chronic kidney disease patient education: A systematic review. J Ren Care 2024; 50:92-103. [PMID: 37010245 DOI: 10.1111/jorc.12462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 01/25/2023] [Accepted: 02/25/2023] [Indexed: 04/04/2023]
Abstract
BACKGROUND Education is an essential component in optimising chronic disease self-management. Teach-back is a robust approach in patient education, which is suitable for varying health literacy although its effectiveness in chronic kidney disease patient education is unknown. OBJECTIVE To evaluate the impact of teach-back method in health education for improving self-management and adherence to treatment regimens in chronic kidney disease. DESIGN Systematic review. PARTICIPANTS Adults with any chronic kidney disease grade or treatment modality. MEASUREMENTS A comprehensive search was undertaken in MEDLINE, CINHAL, EMBASE, Cochrane library, PsychINFO, Web of Science, ERIC, JBI library and WHO International Clinical Trial Registry to identify published studies from September 2013 to December 2022. The methodological quality of studies was assessed using Joanna Briggs Institute guidelines. RESULTS Six studies involving 520 participants were retrieved for this review. A meta-analysis could not be conducted due to substantial heterogeneity between studies. Nevertheless, there was some evidence that teach-back could improve self-management, self-efficacy and knowledge. There was limited evidence on improvement in psychological outcomes or health-related quality of life. CONCLUSION Teach-back seems to improve both objective and patient-reported outcomes, although further studies are needed. Using teach-back can improve both understanding of health information and the development of skills. Kidney care teams could use teach-back for all patients as it takes account of varying patient health literacy abilities. Teach-back assists with communicating important health information to improve patients' knowledge, confidence and skills in self-managing this disease and its treatment.
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Affiliation(s)
- Hemamali M H Jagodage
- School of Nursing and Midwifery and Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
- Department of Nursing, Faculty of Allied Health Sciences, University of Ruhuna, Sri Lanka
| | - Amanda McGuire
- School of Nursing and Midwifery and Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| | - Charrlotte Seib
- School of Nursing and Midwifery and Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| | - Ann Bonner
- School of Nursing and Midwifery and Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
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Darby M, Smith L, Waldron B, Fiandt K. Intensive Primary Care Nursing: Exploring the Impact of a Nurse-Led Model for Medically and Social Complex Patients. Clin Nurs Res 2024; 33:384-394. [PMID: 38757758 DOI: 10.1177/10547738241253654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
Lack of access to primary care contributes to health inequities. Treatment settings that utilize the full experience and training of nurses, both registered nurses (RNs) and advanced practice registered nurses (APRNs), can expand in primary care and successfully address health inequities. This small study describes the implementation of a model of primary care called intensive primary care (IPC), which has eight elements that support the full utilization of a nurse's experience and training. This is a mixed method qualitative study, which reports the observations of the implementation and pre- and post-intervention measures. The IPC model was implemented at a free clinic, which targeted underserved population between 2020 and 2023. Participants were selected as a convenience sample. Participants were to have two or more chronic health problems The participants received primary care using the IPC model, which included setting self-management goals, and meeting with RN or APRN on a monthly basis (face to face, via phone or zoom) to monitor progress toward goals. Twenty-two people were approached, and 19 completed the intervention. Pre- and Post-intervention measures (Patient Assessment of Chronic Illness Care [PACIC]-20); Functional, Communicative, Critical Thinking Health Literacy; Perceived Stress; Patient Activation; Perceived Self Efficacy for Chronic Disease; EuroQo- 5 Dimension (EQ-5D); Trust in Provider; Emotional Support-Patient Reported Outcome Measure Information System (PROMIS); and Patient Health Questionnaire-9) were obtained and analyzed with paired T test (α < .05). Nurses involved meet weekly to share observations recorded in free form notes. These observations were summarized by two of the authors (MD and KF) at the end of the study. All patients had improved physical health outcomes, but more importantly, there were significant improvements in measures known to impact health and health outcomes, specifically, patient activation, self-efficacy for chronic illness, PACIC, and trust in provider. Time spent with patients, both duration and frequency of contact, was observed to have significant impacts.
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Affiliation(s)
- Mark Darby
- University of Nebraska Medical Center College of Nursing, Omaha, USA
| | - Linda Smith
- University of Nebraska Medical Center College of Nursing, Omaha, USA
| | - Bailey Waldron
- University of Nebraska Medical Center College of Nursing, Omaha, USA
| | - Kathryn Fiandt
- University of Nebraska Medical Center College of Nursing, Omaha, USA
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Gerschel T, Prokop S, Schulze L, Feige T, Zschieschang A, Barbe MT, Bitterlich R, Caffier J, Csoti I, Eggers C, Gaßner H, Gülke E, Hähnel T, Herbst H, Jochim A, Kiparski A, Klietz M, von Liel A, Lingor P, Loewenbrück K, Maetzler W, Pürner D, van Riesen C, Schmitz-Pfeiffer H, Süß T, Tönges L, Weiß D, Wolz M, Falkenburger B. [How the implementation of a school for people with Parkinson's disease can succeed-Results of a consensus study and a formative evaluation]. DER NERVENARZT 2024; 95:539-543. [PMID: 38483548 PMCID: PMC11178552 DOI: 10.1007/s00115-024-01639-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/14/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND As the most rapidly increasing neurodegenerative disease worldwide, Parkinson's disease is highly relevant to society. Successful treatment requires active patient participation. Patient education has been successfully implemented for many chronic diseases, such as diabetes and could also provide people with Parkinson's disease with skills to manage the disease better and to participate in shared decision making. MATERIAL AND METHODS To prepare the implementation of a concept for patient education for people with Parkinson's disease, a structured consensus study was conducted and a pilot project formatively evaluated. The structured consensus study included experts from all over Germany. It consisted of two online surveys and an online consensus conference. The formative evaluation was conducted as three focus groups. Transcripts were evaluated using content-structuring qualitative content analysis. RESULTS From the consensus procedure 59 consented statements emerged, mainly regarding the contents of a patient school and a group size of 6-8 persons. Only two statements could not be consented. The formative evaluation detected a tendency towards a positive attitude for a digital training format and a very positive evaluation of the contents. DISCUSSION Overall, important recommendations for a patient school can be drawn from this study. The following subjects require further investigation: format, inclusion criteria, group composition and inclusion of caregivers.
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Affiliation(s)
- Tanita Gerschel
- Klinik und Poliklinik für Neurologie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Deutschland
| | - Scally Prokop
- Klinik und Poliklinik für Neurologie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Deutschland
| | - Lara Schulze
- Klinik und Poliklinik für Neurologie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Deutschland
| | - Tim Feige
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Standort Dresden, Dresden, Deutschland
| | - Anja Zschieschang
- Klinik und Poliklinik für Kinderchirurgie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Deutschland
| | - Michael Thomas Barbe
- Klinik für Neurologie, Universität zu Köln, Medizinische Fakultät und Uniklinik Köln, Köln, Deutschland
| | - Robert Bitterlich
- Klinik und Poliklinik für Neurologie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Deutschland
| | - Julian Caffier
- Universitätsklinikum Hamburg Eppendorf, Hamburg, Deutschland
| | - Ilona Csoti
- Fachabteilung für Neurologie, Fachklinik für Parkinson, Gertrudis Klinik, Biskirchen, Deutschland
| | - Carsten Eggers
- Klinik für Neurologie, Knappschaftskrankenhaus Bottrop, Bottrop, Deutschland
| | - Heiko Gaßner
- Molekulare Neurologie, Arbeitsgruppe Bewegungsanalyse und digitale Medizin, Universitätsklinikum Erlangen, Erlangen, Deutschland
- Fraunhofer Institut für integrierte Schaltungen IIS, Fraunhofer IIS, Erlangen, Deutschland
| | - Eileen Gülke
- Klinik und Poliklinik für Neurologie, Universitätsklinikum Hamburg Eppendorf, Hamburg, Deutschland
| | - Tom Hähnel
- Klinik und Poliklinik für Neurologie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Deutschland
| | | | - Angela Jochim
- Klinik und Poliklinik für Neurologie, Klinikum rechts der Isar der Technischen Universität München, München, Deutschland
| | - Anni Kiparski
- Klinik und Poliklinik für Neurologie, Klinikum rechts der Isar der Technischen Universität München, München, Deutschland
| | - Martin Klietz
- Klinik für Neurologie mit Klinischer Neurophysiologie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - Alexa von Liel
- Klinik und Poliklinik für Neurologie, Klinikum rechts der Isar der Technischen Universität München, München, Deutschland
| | - Paul Lingor
- Klinik und Poliklinik für Neurologie, Klinikum rechts der Isar der Technischen Universität München, München, Deutschland
| | - Kai Loewenbrück
- Klinik und Poliklinik für Neurologie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Deutschland
| | - Walter Maetzler
- Klinik für Neurologie, Universitätsklinikum Schleswig-Holstein Campus Kiel und Christian-Albrechts-Universität Kiel, Kiel, Deutschland
| | - Dominik Pürner
- Klinik und Poliklinik für Neurologie, Klinikum rechts der Isar der Technischen Universität München, München, Deutschland
| | | | - Henning Schmitz-Pfeiffer
- Klinik und Poliklinik für Neurologie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Deutschland
| | - Thorsten Süß
- Neurologisches Fachkrankenhaus für Bewegungsstörungen/Parkinson, Beelitz, Deutschland
| | - Lars Tönges
- Klinik für Neurologie, St. Josef-Hospital, Ruhr-Universität Bochum, Bochum, Deutschland
- Zentrum für Proteindiagnostik (ProDi), Ruhr-Universität Bochum, Bochum, Deutschland
| | - Daniel Weiß
- Klinik für Neurologie, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - Martin Wolz
- Klinik für Neurologie und Geriatrie, Elblandklinikum Meißen, Meißen, Deutschland
| | - Björn Falkenburger
- Klinik und Poliklinik für Neurologie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Deutschland.
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Nair D, Schildcrout JS, Shi Y, Trochez R, Nwosu S, Bell SP, Mixon AS, Welch SA, Goggins K, Bachmann JM, Vasilevskis EE, Cavanaugh KL, Rothman RL, Kripalani SB. Patient-reported predictors of postdischarge mortality after cardiac hospitalization. J Hosp Med 2024; 19:475-485. [PMID: 38560772 PMCID: PMC11147709 DOI: 10.1002/jhm.13336] [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: 10/29/2023] [Revised: 03/07/2024] [Accepted: 03/09/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Adults hospitalized for cardiovascular events are at high risk for postdischarge mortality. Screening of psychosocial risk is prioritized by the Joint Commission. We tested whether key patient-reported psychosocial and behavioral measures could predict posthospitalization mortality in a cohort of adults hospitalized for a cardiovascular event. METHODS We conducted a prospective cohort study to test the prognostic utility of validated patient-reported measures, including health literacy, social support, health behaviors and disease management, and socioeconomic status. Cox survival analyses of mortality were conducted over a median of 3.5 years. RESULTS Among 2977 adults hospitalized for either acute coronary syndrome or acute decompensated heart failure, the mean age was 53 years, and 60% were male. After adjusting for demographic, clinical, and other psychosocial factors, mortality risk was greatest among patients who reported being unemployed (hazard ratio [HR]: 1.99, 95% confidence interval [CI]): 1.30-3.06), retired (HR: 2.14, 95% CI: 1.60-2.87), or unable to work due to disability (HR: 2.36, 95% CI: 1.73-3.21), as compared to those who were employed. Patient-reported perceived health competence (PHCS-2) and exercise frequency were also associated with mortality risk after adjusting for all other variables (HR: 0.86, 95% CI: 0.73-1.00 per four-point increase in PHCS-2; HR: 0.86, 95% CI: 0.77-0.96 per 3-day increase in exercise frequency, respectively). CONCLUSIONS Patient-reported measures of employment status, perceived health competence, and exercise frequency independently predict mortality after a cardiac hospitalization. Incorporating these brief, valid measures into hospital-based screening may help with prognostication and targeting patients for resources during post-discharge transitions of care.
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Affiliation(s)
- Devika Nair
- Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
- Vanderbilt O’Brien Center for Kidney Disease, Nashville, Tennessee
- Vanderbilt Center for Health Services Research, Nashville, Tennessee
| | | | - Yaping Shi
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Ricardo Trochez
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Sam Nwosu
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Susan P. Bell
- Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Amanda S. Mixon
- Section of Hospital Medicine, Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
- Department of Veterans Affairs, Geriatric Research Education and Clinical Center (GRECC), Tennessee Valley Healthcare System, Nashville, Tennessee
| | - Sarah A. Welch
- Department of Veterans Affairs, Geriatric Research Education and Clinical Center (GRECC), Tennessee Valley Healthcare System, Nashville, Tennessee
- Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Kathryn Goggins
- Vanderbilt Center for Health Services Research, Nashville, Tennessee
- Section of Hospital Medicine, Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Justin M. Bachmann
- Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Eduard E. Vasilevskis
- Vanderbilt Center for Health Services Research, Nashville, Tennessee
- Section of Hospital Medicine, Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
- Department of Veterans Affairs, Geriatric Research Education and Clinical Center (GRECC), Tennessee Valley Healthcare System, Nashville, Tennessee
- Center for Clinical Quality and Implementation Research, VUMC, Nashville, TN
| | - Kerri L. Cavanaugh
- Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
- Vanderbilt O’Brien Center for Kidney Disease, Nashville, Tennessee
- Vanderbilt Center for Health Services Research, Nashville, Tennessee
| | - Russell L. Rothman
- Institute of Medicine and Public Health, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Sunil B. Kripalani
- Vanderbilt Center for Health Services Research, Nashville, Tennessee
- Section of Hospital Medicine, Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
- Center for Clinical Quality and Implementation Research, VUMC, Nashville, TN
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50
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Zhang W, Ji H, Wu Y, Sun K, Li J, Xu Z, Wang C, Zhao F, Sun Q. Patient Self-Management Scale After Total Knee Arthroplasty (PSMS-TKA): Instrument Development and Cross-Sectional Validation Study. J Arthroplasty 2024:S0883-5403(24)00554-0. [PMID: 38830430 DOI: 10.1016/j.arth.2024.05.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 05/24/2024] [Accepted: 05/27/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND Effective self-management after total knee arthroplasty (TKA) not only improves patients' knee pain and physical function but also improves quality of life. However, there is no assessment tool that can be targeted to evaluate the self-management level of patients after TKA. This study aimed to develop and validate a scale to specifically assess the level of self-management in patients after TKA. METHODS The study was conducted in 2 steps: (1) instrument development and (2) psychological tests (n = 428). For the instrument development portion, scale items were generated through a literature review and semi-structured interviews, then reviewed and revised by a panel of experts, and assessed for content validity and pilot testing. For the psychometric tests component, items were analyzed using corrected item-total scale correlations, the critical ratio method, and Cronbach's α. Construct validity was evaluated using exploratory factor analysis and validation factor analysis. Criterion correlation validity was checked by calculating Pearson's correlation coefficient using the Arthritis Self-Efficacy Scale-8 and the scale developed in this study. Internal consistency reliability was evaluated using Cronbach's α and fold-half reliability, and retest reliability was assessed using intragroup correlation coefficients. RESULTS The Patient Self-Management Scale after Total Knee Arthroplasty (PSMS-TKA) comprises 4 factors and 23 items that assess daily behavior management, disease information management, psychosocial management, and exercise rehabilitation management. Exploratory factor analysis and validation factor analysis yielded a stable 4-factor model for the 23 items. The PSMS-TKA demonstrated good criterion-related validity when using the Arthritis Self-Efficacy-8 as a criterion. The Cronbach's α of the PSMS-TKA was 0.903, the split-half reliability was 0.934, and the test-retest reliability correlation coefficient was 0.887 (P < .01); thus, the reliability of the scale is good. CONCLUSIONS The PSMS-TKA developed in this study has good validity and reliability and can be used to assess the level of self-management in patients after TKA. The scale helps healthcare professionals understand the level of self-management of patients undergoing TKA.
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Affiliation(s)
- Wenzhong Zhang
- Shandong University of Traditional Chinese Medicine School of Nursing, Jinan, China
| | - Hong Ji
- Nursing Department, The First Affiliated Hospital of Shandong First Medical University, Jinan, China
| | - Yan Wu
- Nursing Department, The First Affiliated Hospital of Shandong First Medical University, Jinan, China
| | - Kangming Sun
- Nursing Department, The First Affiliated Hospital of Shandong First Medical University, Jinan, China
| | - Jing Li
- Shandong University of Traditional Chinese Medicine School of Nursing, Jinan, China
| | - Zhenzhen Xu
- Shandong University of Traditional Chinese Medicine School of Nursing, Jinan, China
| | - Chunlei Wang
- Shandong University of Traditional Chinese Medicine School of Nursing, Jinan, China
| | - Fengyi Zhao
- Shandong University of Traditional Chinese Medicine School of Nursing, Jinan, China
| | - Qingxiang Sun
- Shandong University of Traditional Chinese Medicine School of Nursing, Jinan, China
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