1
|
Glans A, Wilén J, Hansson B, Audulv Å, Lindgren L. Managing acoustic noise within MRI: A qualitative interview study among Swedish radiographers. Radiography (Lond) 2024; 30:889-895. [PMID: 38603992 DOI: 10.1016/j.radi.2024.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 03/22/2024] [Accepted: 04/01/2024] [Indexed: 04/13/2024]
Abstract
INTRODUCTION Acoustic noise from magnetic resonance imaging (MRI) can cause hearing loss and needs to be mitigated to ensure the safety of patients and personnel. Capturing MR personnel's insights is crucial for guiding the development and future applications of noise-reduction technology. This study aimed to explore how MR radiographers manage acoustic noise in clinical MR settings. METHODS Using a qualitative design, we conducted semi-structured individual interviews with fifteen MR radiographers from fifteen hospitals around Sweden. We focused on the clinical implications of participants' noise management, using an interpretive description approach. We also identified sociotechnical interactions between People, Environment, Tools, and Tasks (PETT) by adopting a Human Factors/Ergonomics framework. Interview data were analyzed inductively with thematic analysis (Braun and Clarke). RESULTS The analysis generated three main themes regarding MR radiographers' noise management: (I) Navigating Occupational Noise: Risk Management and Adaptation; (II) Protecting the Patient and Serving the Exam, and (III) Establishing a Safe Healthcare Environment with Organizational Support. CONCLUSION This study offers insights into radiographers' experiences of managing acoustic noise within MRI, and the associated challenges. Radiographers have adopted multiple strategies to protect patients and themselves from adverse noise-related effects. However, they require tools and support to manage this effectively, suggesting a need for organizations to adopt more proactive, holistic approaches to safety initiatives. IMPLICATIONS FOR PRACTICE The radiographers stressed the importance of a soundproofed work environment to minimize occupational adverse health effects and preserve work performance. They acknowledge noise as a common contributor to patient distress and discomfort. Providing options like earplugs, headphones, mold putty, software-optimized "quiet" sequences, and patient information were important tools. Fostering a safety culture requires proactive safety efforts and support from colleagues and management.
Collapse
Affiliation(s)
- A Glans
- Department of Nursing, Umeå University, Umeå, Sweden; Department of Diagnostics and Intervention, Radiation Physics, Umeå University, Umeå, Sweden.
| | - J Wilén
- Department of Diagnostics and Intervention, Radiation Physics, Umeå University, Umeå, Sweden
| | - B Hansson
- Department of Clinical Sciences Lund, Diagnostic Radiology, Lund University, Lund, Sweden
| | - Å Audulv
- Department of Nursing, Umeå University, Umeå, Sweden
| | - L Lindgren
- Department of Nursing, Umeå University, Umeå, Sweden
| |
Collapse
|
2
|
Audulv Å, Westergren T, Ludvigsen MS, Pedersen MK, Fegran L, Hall EOC, Aagaard H, Robstad N, Kneck Å. Time and change: a typology for presenting research findings in qualitative longitudinal research. BMC Med Res Methodol 2023; 23:284. [PMID: 38057741 PMCID: PMC10698947 DOI: 10.1186/s12874-023-02105-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 11/16/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Qualitative longitudinal research (QLR) is an emerging methodology used in health research. The method literature states that the change in a phenomenon through time should be the focus of any QLR study, but in empirical studies, the analysis of changes through time is often poorly described, and the emphasis on time/change in the findings varies greatly. This inconsistency might depend on limitations in the existing method literature in terms of describing how QLR studies can present findings. The aim of this study was to develop and describe a typology of alternative approaches for integrating time and/or change in QLR findings. METHODS In this method study, we used an adapted scoping review design. Articles were identified using EBSCOhost. In total, methods and results sections from 299 QLR articles in the field of health research were analyzed with inspiration from content analysis. RESULTS We constructed a typology of three types and seven subtypes. The types were based on the underlying structural principles of how time/change was presented: Type A) Findings have a low utilization of longitudinal data, Type B) Findings are structured according to chronological time, and Type C) Findings focus on changes through time. These types differed in 1) the way the main focus was on time, change or neither; 2) the level of interpretation in the findings; and 3) how theoretical understandings of time/change were articulated in the articles. Each type encompassed two or three subtypes that represented distinct approaches to the aim and results presentation of QLR findings. CONCLUSIONS This method study is the first to describe a coherent and comprehensive typology of alternative approaches for integrating time/change into QLR findings in health research. By providing examples of various subtypes that can be used for results presentations, it can help researchers make informed decisions suitable to their research intent.
Collapse
Affiliation(s)
- Åsa Audulv
- Department of Nursing, Umeå University, Umeå, Sweden.
| | - Thomas Westergren
- Department of Health and Nursing Science, University of Agder, Kristiansand, Norway
- Department of Public Health, University of Stavanger, Stavanger, Norway
| | - Mette Spliid Ludvigsen
- Department of Clinical Medicine, Randers Regional Hospital, Aarhus University, Aarhus, Denmark
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
| | - Mona Kyndi Pedersen
- Centre for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Liv Fegran
- Department of Health and Nursing Science, University of Agder, Kristiansand, Norway
| | - Elisabeth O C Hall
- Faculty of Health, Aarhus University, Aarhus, Denmark
- Faculty of Health Sciences and Nursing, University of Faroe Islands, Torshavn, Faroe Islands
| | - Hanne Aagaard
- Lovisenberg Diaconal University College, Oslo, Norway
| | - Nastasja Robstad
- Department of Health and Nursing Science, University of Agder, Kristiansand, Norway
| | - Åsa Kneck
- Department of Health Care Sciences, Marie Cederschöld University, Stockholm, Sweden
| |
Collapse
|
3
|
Audulv Å, Hall EOC, Kneck Å, Westergren T, Fegran L, Pedersen MK, Aagaard H, Dam KL, Ludvigsen MS. Qualitative longitudinal research in health research: a method study. BMC Med Res Methodol 2022; 22:255. [PMID: 36182899 PMCID: PMC9526289 DOI: 10.1186/s12874-022-01732-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 09/22/2022] [Indexed: 12/04/2022] Open
Abstract
Background Qualitative longitudinal research (QLR) comprises qualitative studies, with repeated data collection, that focus on the temporality (e.g., time and change) of a phenomenon. The use of QLR is increasing in health research since many topics within health involve change (e.g., progressive illness, rehabilitation). A method study can provide an insightful understanding of the use, trends and variations within this approach. The aim of this study was to map how QLR articles within the existing health research literature are designed to capture aspects of time and/or change. Methods This method study used an adapted scoping review design. Articles were eligible if they were written in English, published between 2017 and 2019, and reported results from qualitative data collected at different time points/time waves with the same sample or in the same setting. Articles were identified using EBSCOhost. Two independent reviewers performed the screening, selection and charting. Results A total of 299 articles were included. There was great variation among the articles in the use of methodological traditions, type of data, length of data collection, and components of longitudinal data collection. However, the majority of articles represented large studies and were based on individual interview data. Approximately half of the articles self-identified as QLR studies or as following a QLR design, although slightly less than 20% of them included QLR method literature in their method sections. Conclusions QLR is often used in large complex studies. Some articles were thoroughly designed to capture time/change throughout the methodology, aim and data collection, while other articles included few elements of QLR. Longitudinal data collection includes several components, such as what entities are followed across time, the tempo of data collection, and to what extent the data collection is preplanned or adapted across time. Therefore, there are several practices and possibilities researchers should consider before starting a QLR project. Supplementary Information The online version contains supplementary material available at 10.1186/s12874-022-01732-4.
Collapse
Affiliation(s)
- Åsa Audulv
- Department of Nursing, Umeå University, Umeå, Sweden.
| | - Elisabeth O C Hall
- Faculty of Health, Aarhus University, Aarhus, Denmark.,Faculty of Health Sciences, University of Faroe Islands, Thorshavn, Faroe Islands, Denmark
| | - Åsa Kneck
- Department of Health Care Sciences, Ersta Sköndal Bräcke University College, Stockholm, Sweden
| | - Thomas Westergren
- Department of Health and Nursing Science, University of Agder, Kristiansand, Norway.,Department of Public Health, University of Stavanger, Stavanger, Norway
| | - Liv Fegran
- Department of Health and Nursing Science, University of Agder, Kristiansand, Norway
| | - Mona Kyndi Pedersen
- Center for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Hanne Aagaard
- Lovisenberg Diaconale Univeristy of College, Oslo, Norway
| | - Kristianna Lund Dam
- Faculty of Health Sciences, University of Faroe Islands, Thorshavn, Faroe Islands, Denmark
| | - Mette Spliid Ludvigsen
- Department of Clinical Medicine-Randers Regional Hospital, Aarhus University, Aarhus, Denmark.,Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
| |
Collapse
|
4
|
Kephart G, Packer T, Audulv Å, Chen YT, Robinson A, Olsson I, Warner G. Item selection, scaling and construct validation of the Patient-Reported Inventory of Self-Management of Chronic Conditions (PRISM-CC) measurement tool in adults. Qual Life Res 2022; 31:2867-2880. [PMID: 35759127 PMCID: PMC9356954 DOI: 10.1007/s11136-022-03165-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2022] [Indexed: 11/28/2022]
Abstract
Purpose To select and scale items for the seven domains of the Patient-Reported Inventory of Self-Management of Chronic Conditions (PRISM-CC) and assess its construct validity. Methods Using an online survey, data on 100 potential items, and other variables for assessing construct validity, were collected from 1055 adults with one or more chronic health conditions. Based on a validated conceptual model, confirmatory factor analysis (CFA) and item response models (IRT) were used to select and scale potential items and assess the internal consistency and structural validity of the PRISM-CC. To further assess construct validity, hypothesis testing of known relationships was conducted using structural equation models. Results Of 100 potential items, 36 (4–8 per domain) were selected, providing excellent fit to our hypothesized correlated factors model and demonstrating internal consistency and structural validity of the PRISM-CC. Hypothesized associations between PRISM-CC domains and other measures and variables were confirmed, providing further evidence of construct validity. Conclusion The PRISM-CC overcomes limitations of assessment tools currently available to measure patient self-management of chronic health conditions. This study provides strong evidence for the internal consistency and construct validity of the PRISM-CC as an instrument to assess patient-reported difficulty in self-managing different aspects of daily life with one or more chronic conditions. Further research is needed to assess its measurement equivalence across patient attributes, ability to measure clinically important change, and utility to inform self-management support. Supplementary Information The online version contains supplementary material available at 10.1007/s11136-022-03165-4.
Collapse
Affiliation(s)
- George Kephart
- Department of Community Health and Epidemiology, Dalhousie University, 5790 University Avenue, Halifax, NS, B3H 1V7, Canada. .,School of Health Administration, Dalhousie University, Halifax, Canada. .,Department of Nursing, Umeå University, Umeå, Sweden.
| | - Tanya Packer
- School of Health Administration, Dalhousie University, Halifax, Canada.,School of Occupational Therapy, Dalhousie University, Halifax, Canada.,Department of Nursing, Umeå University, Umeå, Sweden
| | - Åsa Audulv
- Department of Nursing, Umeå University, Umeå, Sweden
| | - Yu-Ting Chen
- School of Occupational Therapy, Dalhousie University, Halifax, Canada
| | - Alysia Robinson
- Department of Community Health and Epidemiology, Dalhousie University, 5790 University Avenue, Halifax, NS, B3H 1V7, Canada
| | - Ingrid Olsson
- Department of Nursing, Umeå University, Umeå, Sweden
| | - Grace Warner
- School of Occupational Therapy, Dalhousie University, Halifax, Canada
| |
Collapse
|
5
|
Nyberg A, Lundell S, Pesola UM, Audulv Å, Wadell K. Evaluation of a Digital COPD Education Program for Healthcare Professionals in Long-Term Care – A Mixed Methods Study. Int J Chron Obstruct Pulmon Dis 2022; 17:905-918. [PMID: 35497374 PMCID: PMC9045592 DOI: 10.2147/copd.s353187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 03/28/2022] [Indexed: 11/23/2022] Open
Abstract
Background Purpose Methods Results Conclusion
Collapse
Affiliation(s)
- André Nyberg
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
- Correspondence: André Nyberg, Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, 901 87, Sweden, Tel +46 90 786 66 39, Email
| | - Sara Lundell
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| | - Ulla-Maija Pesola
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| | - Åsa Audulv
- Department of Nursing, Umeå University, Umeå, Sweden
| | - Karin Wadell
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
- Department of Public Health and Clinical Medicine, Division of Medicine, Umeå University, Umeå, Sweden
| |
Collapse
|
6
|
Audulv Å, Hutchinson S, Warner G, Kephart G, Versnel J, Packer TL. Managing everyday life: Self-management strategies people use to live well with neurological conditions. Patient Educ Couns 2021; 104:413-421. [PMID: 32819756 DOI: 10.1016/j.pec.2020.07.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 06/30/2020] [Accepted: 07/26/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE This paper uses the Taxonomy of Everyday Self-management Strategies (TEDSS) to provide insight and understanding into the complex and interdependent self-management strategies people with neurological conditions use to manage everyday life. METHODS As part of a national Canadian study, structured telephone interviews were conducted monthly for eleven months, with 117 people living with one or more neurological conditions. Answers to five open-ended questions were analyzed using qualitative content analysis. A total of 7236 statements were analyzed. RESULTS Findings are presented in two overarching patterns: 1) self-management pervades all aspects of life, and 2) self-management is a chain of decisions and behaviours. Participants emphasized management of daily activities and social relationships as important to maintaining meaning in their lives. CONCLUSION Managing everyday life with a neurological condition includes a wide range of diverse strategies that often interact and complement each other. Some people need to intentionally manage every aspect of everyday life. PRACTICE IMPLICATIONS For people living with neurological conditions, there is a need for health providers and systems to go beyond standard advice for self-management. Self-management support is best tailored to each individual, their life context and the realities of their illness trajectory.
Collapse
Affiliation(s)
- Åsa Audulv
- Department of Nursing, Umeå University, Sweden & Department of Nursing Science, Mid Sweden University, Sweden.
| | - Susan Hutchinson
- School of Health and Human Performance, Dalhousie University, Halifax, Canada
| | - Grace Warner
- School of Occupational Therapy, Dalhousie University, Halifax, Canada
| | - George Kephart
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Canada
| | - Joan Versnel
- School of Occupational Therapy, Dalhousie University, Halifax, Canada
| | - Tanya L Packer
- Schools of Occupational Therapy and Health Administration, Dalhousie University, Halifax, Canada; Radboud University Medical Centre, Nijmegen, the Netherlands
| |
Collapse
|
7
|
Keddy AC, Packer TL, Audulv Å, Sutherland L, Sampalli T, Edwards L, Kephart G. The Team Assessment of Self-Management Support (TASMS): A new approach to uncovering how teams support people with chronic conditions. Healthc Manage Forum 2021; 34:43-48. [PMID: 32729329 DOI: 10.1177/0840470420942262] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Canadian and other healthcare systems are adopting primary care models founded on multidisciplinary, team-based care. This paper describes the development and use of a new tool, the Team Assessment of Self-Management Support (TASMS), designed to understand and improve the self-management support teams provide to patients with chronic conditions. Team Assessment of Self-Management Support captures the time providers spend supporting seven different types of self-management support (process strategies, resources strategies, disease controlling strategies, activities strategies, internal strategies, social interactions strategies, and healthy behaviours strategies), their referral patterns and perceived gaps in care. Four unique features make TASMS user-friendly: it is patient-centred, it uses provider-level data to create a team profile, it has the ability to be tailored to needs (diagnosis and visit type), and visual presentation of results are quickly and intuitively understood by both providers and planners. Currently being used by providers and planners in Nova Scotia, scaling up will allow more widespread use.
Collapse
Affiliation(s)
| | | | | | | | - Tara Sampalli
- 432234Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Lynn Edwards
- 432234Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | | |
Collapse
|
8
|
Westergren T, Ludvigsen MS, Audulv Å, Aagaard H, Hall EOC, Pedersen MK, Fegran L. Physical activity experiences of children and adolescents with asthma: a qualitative systematic review protocol. JBI Evid Synth 2020; 18:2390-2395. [PMID: 32868707 DOI: 10.11124/jbies-20-00004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objective of the review is to synthesize existing knowledge about experiences of children and adolescents with asthma related to participation in, or limitation of, physical activity. INTRODUCTION Limitations of physical activity, expressed as a barrier of bodily movement, may relate to physiological restraints, as well as emotional and social delimitation, in children and adolescents with asthma. Participation in physical activity is related to management of asthma and is important for social inclusion. Through childhood and adolescence, physical activity enhances physical, cognitive, and social development, and a dose-response relationship between physical activity and several indicators of improved health has been established. Knowledge is needed about experiences of physical activity in children and adolescents with asthma to tailor care and implement exercise and physical activity supporting interventions into clinical practice. INCLUSION CRITERIA This review will consider qualitative studies that include subjective experiences related to participation in, or limitation of, physical activity in children and adolescents (six to 18 years of age) with asthma. All contexts and countries will be included. METHODS MEDLINE, Embase, PsycINFO, CINAHL, SPORTDiscus, SocINDEX, and Social Science Citation Index List will be searched for relevant studies. Studies published in English with no date limitation will be included. Study selection, assessment of methodological quality, data extraction, synthesis, and assessment of confidence in the findings will be conducted using the JBI meta-aggregation approach. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42020164797.
Collapse
Affiliation(s)
- Thomas Westergren
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Mette Spliid Ludvigsen
- Department of Clinical Medicine, Randers Regional Hospital, Aarhus University, Aarhus, Denmark
- Danish Centre of Systematic Reviews: A JBI Centre of Excellence, Aalborg, Denmark
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
| | - Åsa Audulv
- Department of Nursing, Umea University, Umea, Sweden
| | - Hanne Aagaard
- Institute of Public Health, Aarhus University, Denmark
- Lovisenberg Diaconal University College, Oslo, Norway
| | - Elisabeth O C Hall
- Section of Nursing, Department of Public Health, Health, Aarhus University, Denmark
- Faculty of Health Sciences and Nursing, University of Faroe Islands, Thorshavn, Faroe Islands
| | - Mona Kyndi Pedersen
- Centre for Clinical Research North Denmark Regional Hospital, Hjørring, Denmark
| | - Liv Fegran
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
- Department of Paediatrics, Southern Norway Hospital, Kristiansand, Norway
| |
Collapse
|
9
|
Packer T, Kephart G, Audulv Å, Keddy A, Warner G, Peacock K, Sampalli T. Protocol for development, calibration and validation of the Patient-Reported Inventory of Self-Management of Chronic Conditions (PRISM-CC). BMJ Open 2020; 10:e036776. [PMID: 32998919 PMCID: PMC7528366 DOI: 10.1136/bmjopen-2020-036776] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
INTRODUCTION Assessing and measuring patients' chronic condition self-management needs are critical to quality health care and to related research. One in three adults around the world live with multiple chronic conditions. While many patient-reported measures of self-management have been developed, none has emerged as the gold standard, and all have one or more of the following limitations: (1) they fail to measure the different domains of self-management important to patients, (2) they lack sufficient specificity to support patient-centred care or identify the specific components of self-management interventions that work and/or (3) they lack suitability for patients with multiple chronic conditions. METHODS AND ANALYSIS The Patient-Reported Inventory of Self-Management of Chronic Conditions (PRISM-CC) is being developed to overcome these shortcomings. It will measure respondents' perceived success (or difficulty) in self-managing seven domains important to patients. The protocol has three phases. Phase 1 is conceptual model development and item generation. Phase 2 is assessment of the relevance and understanding of items by people with chronic conditions. Phase 3 is item analysis, dimensionality assessment, scaling and preliminary validation of the PRISM-CC using an online survey of people with chronic conditions (n~750). The expected completion date is early 2021. ETHICS AND DISSEMINATION This study will adhere to the Canadian Tri-Council Policy Statement on Ethical Conduct for Research Involving Humans. Ethics approval for all phases has been obtained from the Nova Scotia Health Authority Research Ethics Board. Once completed, the PRISM-CC will be made available for research and healthcare at minimal to no cost.
Collapse
Affiliation(s)
- Tanya Packer
- Schools of Occupational Therapy and Health Administration, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
- Rehabilitation Department, Radboud Unversity Medical Centre, Nijmegen, Gelderland, The Netherlands
| | - George Kephart
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Åsa Audulv
- Department of Nursing, Umeå Universitet Medicinska fakulteten, Umea, Sweden
| | - America Keddy
- School of Occupational Therapy, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Grace Warner
- School of Occupational Therapy, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Kylie Peacock
- School of Occupational Therapy, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Tara Sampalli
- Research, Innovation and Discovery, Nova Scotia Health, Halifax, Nova Scotia, Canada
| |
Collapse
|
10
|
Warner G, Packer TL, Kervin E, Sibbald K, Audulv Å. A systematic review examining whether community-based self-management programs for older adults with chronic conditions actively engage participants and teach them patient-oriented self-management strategies. Patient Educ Couns 2019; 102:2162-2182. [PMID: 31301922 DOI: 10.1016/j.pec.2019.07.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 06/27/2019] [Accepted: 07/01/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To identify whether community-based Self-Management Programs (SMPs) actively engaged, or taught, individuals patient-oriented strategies; and whether having these attributes led to significant differences in outcomes. METHODS This systematic review included randomized controlled trials (RCTs)and cluster RCTs reporting on community-based SMPs with a group component for older adults with chronic conditions. The ways SMPS actively engaged participants and whether they taught patient-oriented strategies were analyzed. All study outcomes were reported. RESULTS The 31 included studies demonstrated community-based SMP programs actively engaged participants and provided strategies to improve health behaviour or care of their condition. Few included strategies to help manage the impact of conditions on their everyday lives. Seventy-nine percent of studies reported significant differences; variations in sample sizes and outcomes made it difficult to conclude whether having these attributes led to significant differences. CONCLUSION SMPs are not supporting older adults to use strategies to address the impact of conditions on their everyday lives, addressing the needs of older adults with multiple conditions, nor assessing outcomes that align with the strategies taught. PRACTICE IMPLICATIONS Health-care providers delivering SMPs to older adults need to tailor programs to the needs of older adults and assess whether participants are using strategies being proposed.
Collapse
Affiliation(s)
- Grace Warner
- School of Occupational Therapy, Dalhousie University, Halifax, Nova Scotia, Canada.
| | - Tanya L Packer
- School of Occupational Therapy, Dalhousie University, Halifax, Nova Scotia, Canada; Radboud University Medical Center and HAN University of Applied Sciences, Nijmegen, the Netherlands.
| | - Emily Kervin
- Gerontology, Mount Saint Vincent University, Halifax, Nova Scotia, Canada.
| | - Kaitlin Sibbald
- School of Occupational Therapy, Dalhousie University, Halifax, Nova Scotia, Canada.
| | - Åsa Audulv
- Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden.
| |
Collapse
|
11
|
Kneck Å, Audulv Å. Analyzing variations in changes over time: development of the Pattern-Oriented Longitudinal Analysis approach. Nurs Inq 2019; 26:e12288. [PMID: 30834658 DOI: 10.1111/nin.12288] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 01/21/2019] [Accepted: 01/24/2019] [Indexed: 11/30/2022]
Abstract
Longitudinal qualitative research in nursing is rare but becoming more common. Data collection and analysis over time provide some intriguing possibilities to better understand processes, development, and change in illness experience, healthcare organizations, and self-management. This paper aims to present a process for analyzing qualitative longitudinal data material, namely the Pattern-Oriented Longitudinal Analysis approach (POLA). We developed this approach after synthesizing experiences from two longitudinal qualitative projects and comparing our procedures and reflections with the relevant literature. Using the POLA approach, researchers can describe complexity and variation in changes over time. During the analysis process, emphasis is put on visualizing and identifying change at both an individual and a group level. Ontological and epistemological assumptions for the approach are also described. The benefit of this approach is the possibility to describe complexity and diversity in processes over time, which is important for the development of nursing knowledge. The analysis approach can be further used and developed by researchers seeking to understand variance or contextual features in processes and changes over time.
Collapse
Affiliation(s)
- Åsa Kneck
- Department of Health Care Sciences, Ersta Sköndal Bräcke University College, Stockholm, Sweden
| | - Åsa Audulv
- Department of Nursing Sciences, Mid Sweden University, Sundsvall/Östersund, Sweden
| |
Collapse
|
12
|
Audulv Å, Ghahari S, Kephart G, Warner G, Packer TL. The Taxonomy of Everyday Self-management Strategies (TEDSS): A framework derived from the literature and refined using empirical data. Patient Educ Couns 2019; 102:367-375. [PMID: 30197252 DOI: 10.1016/j.pec.2018.08.034] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 08/23/2018] [Accepted: 08/30/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To extend our understanding of self-management by using original data and a recent concept analysis to propose a unifying framework for self-management strategies. METHODS Longitudinal interview data with 117 people with neurological conditions were used to test a preliminary framework derived from the literature. Statements from the interviews were sorted according to the predefined categories of the preliminary framework to investigate the fit between the framework and the qualitative data. Data on frequencies of strategies complemented the qualitative analysis. RESULTS The Taxonomy of Every Day Self-management Strategies (TEDSS) Framework includes five Goal-oriented Domains (Internal, Social Interaction, Activities, Health Behaviour and Disease Controlling), and two additional Support-oriented Domains (Process and Resource). The Support-oriented Domain strategies (such as information seeking and health navigation) are not, in and of themselves, goal focused. Instead, they underlie and support the Goal-oriented Domain strategies. Together, the seven domains create a comprehensive and unified framework for understanding how people with neurological conditions self-manage all aspects of everyday life. CONCLUSIONS The resulting TEDSS Framework provides a taxonomy that has potential to resolve conceptual confusion within the field of self-management science. PRACTICE IMPLICATIONS The TEDSS Framework may help to guide health service delivery and research.
Collapse
Affiliation(s)
- Åsa Audulv
- Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden.
| | - Setareh Ghahari
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada.
| | - George Kephart
- Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
| | - Grace Warner
- Schools of Occupational Therapy and Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada.
| | - Tanya L Packer
- Schools of Occupational Therapy and Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada; Radboud University Medical Center, Nijmegen, The Netherlands.
| |
Collapse
|
13
|
Rönngren Y, Björk A, Audulv Å, Enmarker I, Kristiansen L, Haage D. Educational nurse-led lifestyle intervention for persons with mental illness. Int J Ment Health Nurs 2018; 27:1022-1031. [PMID: 29171905 DOI: 10.1111/inm.12410] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/09/2017] [Indexed: 12/17/2022]
Abstract
Although persons with severe mental illness face an increased risk of mortality and of developing negative health outcomes, research has shown that lifestyle interventions can sufficiently support their health. In response, this study examined a nurse-led lifestyle intervention developed in cooperation with members of municipal and county councils to gauge its impact on the quality of life, cognitive performance, walking capacity, and body composition of persons with severe mental illness. Lasting 26 weeks and involving 38 persons with severe mental illness, the intervention prioritised two components: the interpersonal relationships of persons with severe mental illness, staff, and group leaders and group education about physical and mental health. Pre-post intervention measurements of quality of life collected with the Manchester Short Assessment of Quality of Life, cognitive performance with the Frontal Systems Behaviour Scale, walking capacity with a 6-min walk test, and body composition in terms of waist circumference and body mass index were analysed using a nonparametric test Wilcoxon signed-rank test. Results suggest that the intervention afforded significant improvements in the health-related variables of quality of life, cognitive performance, walking capacity, and waist circumference for persons with severe mental illness. However, long-term studies with control groups and that examine parameters related to cardiovascular risk factors are essential to ensure the sustained impact of the intervention.
Collapse
Affiliation(s)
- Ylva Rönngren
- Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden
| | - Annette Björk
- Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden
| | - Åsa Audulv
- Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden
| | - Ingela Enmarker
- Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden.,Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden.,Center for Care Research, Mid-Norway, Steinkjer, Norway
| | | | - David Haage
- Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden
| |
Collapse
|
14
|
Rönngren Y, Björk A, Haage D, Audulv Å, Kristiansen L. Perspectives of a tailored lifestyle program for people with severe mental illness receiving housing support. Perspect Psychiatr Care 2018; 54:309-316. [PMID: 28901554 DOI: 10.1111/ppc.12239] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 08/06/2017] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The purpose of the present study was to describe the acceptability of the lifestyle program PHYS/CAT and to get information about the tools used for assessment of functional exercise capacity, cognitive performance, and self-health-related quality of life. DESIGN AND METHODS The findings are based on focus groups and the researchers' experiences of conducting the program as well as using the assessment tools. FINDINGS The acceptability of the program and the assessment tools was mainly satisfactory. PRACTICE IMPLICATIONS The program with relational, educational, and supportive dimensions may be a promising tool to be integrated into daily nursing care.
Collapse
Affiliation(s)
- Ylva Rönngren
- Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden
| | - Annette Björk
- Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden
| | - David Haage
- Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden
| | - Åsa Audulv
- Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden
| | | |
Collapse
|
15
|
Packer TL, Fracini A, Audulv Å, Alizadeh N, van Gaal BGI, Warner G, Kephart G. What we know about the purpose, theoretical foundation, scope and dimensionality of existing self-management measurement tools: A scoping review. Patient Educ Couns 2018; 101:579-595. [PMID: 29239734 DOI: 10.1016/j.pec.2017.10.014] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 10/10/2017] [Accepted: 10/21/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES To identify self-report, self-management measures for adults with chronic conditions, and describe their purpose, theoretical foundation, dimensionality (multi versus uni), and scope (generic versus condition specific). METHODS A search of four databases (8479 articles) resulted in a scoping review of 28 self-management measures. RESULTS Although authors identified tools as measures of self-management, wide variation in constructs measured, purpose, and theoretical foundations existed. Subscales on 13 multidimensional tools collectively measure domains of self-management relevant to clients, however no one tool's subscales cover all domains. CONCLUSIONS Viewing self-management as a complex, multidimensional whole, demonstrated that existing measures assess different, related aspects of self-management. Activities and social roles, though important to patients, are rarely measured. Measures with capacity to quantify and distinguish aspects of self-management may promote tailored patient care. PRACTICE IMPLICATIONS In selecting tools for research or assessment, the reason for development, definitions, and theories underpinning the measure should be scrutinized. Our ability to measure self-management must be rigorously mapped to provide comprehensive and system-wide care for clients with chronic conditions. Viewing self-management as a complex whole will help practitioners to understand the patient perspective and their contribution in supporting each individual patient.
Collapse
Affiliation(s)
- Tanya L Packer
- School of Occupational Therapy, Dalhousie University, Halifax, Canada; Radboud University Radboud university medical center, Radboud Institute for Health Sciences, IQ healthcare, Nijmegen, The Netherlands; Faculty of Health and Social Studies, Han University of Applied Sciences, Nijmegen, The Netherlands.
| | - America Fracini
- School of Occupational Therapy, Dalhousie University, Halifax, Canada.
| | - Åsa Audulv
- Department of Nursing Science, Mid Sweden University, Sundsvall, Sweden.
| | - Neda Alizadeh
- School of Occupational Therapy, Dalhousie University, Halifax, Canada.
| | - Betsie G I van Gaal
- Radboud University Radboud university medical center, Radboud Institute for Health Sciences, IQ healthcare, Nijmegen, The Netherlands; Faculty of Health and Social Studies, Han University of Applied Sciences, Nijmegen, The Netherlands.
| | - Grace Warner
- School of Occupational Therapy, Dalhousie University, Halifax, Canada.
| | - George Kephart
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada.
| |
Collapse
|
16
|
Rönngren Y, Björk A, Kristiansen L, Haage D, Enmarker I, Audulv Å. Meeting the needs? Perceived support of a nurse-led lifestyle programme for young adults with mental illness in a primary health-care setting. Int J Ment Health Nurs 2018; 27:390-399. [PMID: 28374967 DOI: 10.1111/inm.12333] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/19/2017] [Indexed: 11/28/2022]
Abstract
Being a young adult with mental illness challenges all aspects of health, including an increased risk for developing lifestyle-related diseases. There is a lack of lifestyle programmes in primary health care that target physical, mental, and social needs for young adults with mental illness. The aim of the present study was to describe the experiences of young adults with mental illness receiving support from a nurse-led lifestyle programme, and how this support was related to their life context, including challenges and coping strategies. Two focus groups and six individual interviews were performed with 13 young adults (16-25 years), and analysed using a qualitative content analysis. The findings showed that the young adults experienced challenges in their daily lives, including psychiatric symptoms, lack of social understanding, and loneliness. The study indicated that the programme could support lifestyle habits with its components of supportive interpersonal relationships, awareness of coping strategies, understanding of health and illness, and cognitive support (e.g. schedules and reminders). However, the programme could not meet everyone's needs for new social relationships or more comprehensive support. Even so, this nurse-led programme provides health information-management strategies that could easily be integrated in a primary health-care setting.
Collapse
Affiliation(s)
- Ylva Rönngren
- Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden
| | - Annette Björk
- Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden
| | | | - David Haage
- Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden
| | - Ingela Enmarker
- Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden.,Department of Health and Occupational Studies, University of Gävle, Gävle, Sweden.,Center for Care Research, Mid-Norway, Steinkjer, Norway
| | - Åsa Audulv
- Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden
| |
Collapse
|
17
|
Rising Holmström M, Häggström M, Audulv Å, Junehag L, Coyne I, Söderberg S. To integrate and manage diabetes in school: Youth’s experiences of living with Type 1 diabetes in relation to school – a qualitative study. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/20573316.2017.1375599] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | - Marie Häggström
- Department of Nursing Science, Mid Sweden University, SE-851 70 Sundsvall, Sweden
| | - Åsa Audulv
- Department of Nursing Science, Mid Sweden University, SE-851 70 Sundsvall, Sweden
| | - Lena Junehag
- Department of Nursing Science, Mid Sweden University Sundsvall, SE-83125 Östersund, Sweden
| | - Imelda Coyne
- School of Nursing & Midwifery, Trinity College Dublin, 24 D’Olier street, Dublin 2, Ireland
| | - Siv Söderberg
- Department of Nursing Science, Mid Sweden University Sundsvall, SE-83125 Östersund, Sweden
| |
Collapse
|
18
|
Polit DF, Sidani S, Richards DA, Willman A, Kitson A, Huijben-Schoenmakers M, Rademaker A, Scherder E, Bjuresäter K, Larsson M, Bergsten U, Smith MC, Pearson C, Tropea S, O’May F, Irvine L, Rush R, Wilson R, Rahn AC, Behncke A, Buhl A, Köpke S, Rodrigues MGDR, Shaha M, Hjelm M, Bohman DM, Willman A, Kristensson J, Holst G, Øverlie A, Machiels M, Zwakhalen SMG, Metzelthin SF, Hamers JPH, Darcy L, Karlsson K, Galvin K, Van Hecke A, Malfait S, Eeckloo K, Råberus A, Holmström IK, Sundler AJ, Dijkstra A, Gesar B, Bååth C, Hedin H, Hommel A, Helou N, Shaha M, Zanchi A, Varsi C, Børøsund E, Mirkovic J, Marcheschi E, Von Koch L, Pessah-Rasmussen H, Elf M, Audulv Å, Kneck Å, Koppitz A, de Wolf-Linder S, Blanc G, Bosshard G, Volken T. European Academy of Nursing Science and the Swedish Society of Nursing Summer Conference 2017: The Future Direction of European Nursing and Nursing Research. BMC Nurs 2017. [PMCID: PMC5498859 DOI: 10.1186/s12912-017-0218-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
19
|
Audulv Å, Packer T, Hutchinson S, Roger KS, Kephart G. Coping, adapting or self-managing - what is the difference? A concept review based on the neurological literature. J Adv Nurs 2016; 72:2629-2643. [PMID: 27272388 DOI: 10.1111/jan.13037] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2016] [Indexed: 11/30/2022]
Abstract
AIM The aim of this study was to report: (1) an analysis of the concepts of coping, adaptation and self-management in the context of managing a neurological condition; and (2) the overlap between the concepts. BACKGROUND The three concepts are often confused or used interchangeably. Understanding similarities and differences between concepts will avoid misunderstandings in care. The varied and often unpredictable symptoms and degenerative nature of neurological conditions make this an ideal population in which to examine the concepts. DESIGN Concept analysis. DATA SOURCES Articles were extracted from a large literature review about living with a neurological condition. The original searches were conducted using SCOPUS, EMBASE, CINAHL and Psych INFO. Seventy-seven articles met the inclusion criteria of: (1) original article concerning coping, adaptation or self-management of a neurological condition; (2) written in English; and (3) published between 1999-2011. METHODS The concepts were examined according to Morse's concept analysis method; structural elements were then compared. RESULTS Coping and adaptation to a neurological condition showed statistically significant overlap with a common focus on internal management. In contrast, self-management appears to focus on disease-controlling and health-related management strategies. Coping appears to be the most mature concept, whereas self-management is least coherent in definition and application. CONCLUSION All three concepts are relevant for people with neurological conditions. Healthcare teams need to be cautious when using these terms to avoid miscommunication and to ensure clients have access to all needed interventions. Viewing the three concepts as a complex whole may be more aligned with client experience.
Collapse
Affiliation(s)
- Åsa Audulv
- Department of Nursing, Mid-Sweden University, Sundsvall, Sweden.
| | - Tanya Packer
- School of Occupational Therapy, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Susan Hutchinson
- School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Kerstin S Roger
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - George Kephart
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| |
Collapse
|
20
|
Olsson H, Audulv Å, Strand S, Kristiansen L. Reducing or increasing violence in forensic care: a qualitative study of inpatient experiences. Arch Psychiatr Nurs 2015; 29:393-400. [PMID: 26577553 DOI: 10.1016/j.apnu.2015.06.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 06/26/2015] [Indexed: 11/16/2022]
Abstract
Semi-structured interviews with 13 forensic psychiatric inpatients that had decreased their assessed risk of violence were analyzed using interpretive description. The main contribution from this study is a detailed description of patients' own strategies to avoid violence. Participants described having an ongoing inner dialog in which they encouraged themselves, thereby increasing their self-esteem and trying to accept their current situation. An unsafe and overcrowded ward with uninterested and nonchalant staff increased the risk of aggressive behavior. In the process of decreasing violence, the patients and the forensic psychiatric nursing staff interacted to create and maintain a safe environment.
Collapse
Affiliation(s)
| | | | - Susanne Strand
- Mid Sweden University & Sundsvall Forensic Psychiatric Hospital
| | | |
Collapse
|
21
|
Packer TL, Kephart G, Ghahari S, Audulv Å, Versnel J, Warner G. The Patient Activation Measure: a validation study in a neurological population. Qual Life Res 2015; 24:1587-96. [PMID: 25557496 DOI: 10.1007/s11136-014-0908-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/23/2014] [Indexed: 11/28/2022]
Abstract
PURPOSE To assess the validity of the Patient Activation Measure (PAM13) of patient activation in persons with neurological conditions. METHODS "The Everyday Experience of Living with and Managing a Neurological Condition" (The LINC study) surveyed 948 adults with neurological conditions residing in Canada in 2011 and 2012. Using data for 722 respondents who met coding requirements for the PAM-13, we examined the properties of the measure using principle components analysis, inter-item correlations and Cronbach's alpha to assess unidimensionality and internal consistency. Rasch modeling was used to assess item performance and scaling. Construct validity was assessed by calculating associations between the PAM and known correlates. RESULTS PAM-13 provides a suitably reliable and valid instrument for research in patients with neurological conditions, but scaling problems may yield measurement error and biases for those with low levels of activation. This is of particular importance when used in clinical settings or for individual client care. Our study also suggests that measurement of activation may benefit from tailoring items and scaling to specific diagnostic groups such as people with neurological conditions, thus allowing the PAM-13 to recognize unique attributes and management challenges in those conditions. CONCLUSIONS The PAM-13 is an internally reliable and valid tool for research purposes. The use of categorical activation "level" in clinical settings should be done with caution.
Collapse
Affiliation(s)
- Tanya L Packer
- School of Occupational Therapy, Dalhousie University, Forrest Building, Rm 161, 5869 University Av., P.O. Box 15000, Halifax, NS, B3H 4R2, Canada,
| | | | | | | | | | | |
Collapse
|
22
|
Abstract
OBJECTIVES To describe patterns in the qualitative literature regarding the everyday experience of living with a neurological condition; to identify areas of depth as well as gaps in the existing knowledge base. METHODS An extensive search of the literature yielded 474 articles meeting the inclusion criteria. Data extraction, based on scrutiny of both abstract and full text article included country of origin, diagnosis, stated aim, methodological framework/design, participants, and data collection method(s). Studies were categorized into 27 topics within four broad foci. RESULTS Four broad foci describe the field: impact and management, daily activities and occupations, impact on family, and the healthcare experience. Overall the research is unevenly distributed by diagnosis; some are well represented while others are the subject of little research. Even diagnoses well represented in quantity can be limited in breadth. DISCUSSION Possible explanations for the patterns of emphasis include: a focus on issues and problems, highlighted points of contact between patients and healthcare providers, and ability of participants to voice their views. The literature is also characterized by limited across diagnoses research or that comparing the experience of people with different diagnoses. There is a need for more research in particular diagnoses; more varied data collection methods and acknowledgement of ethnicity, gender, discrimination, and social inequalities.
Collapse
Affiliation(s)
- Åsa Audulv
- Department of Nursing, Mid Sweden University, Sundsvall, Sweden School of Occupational Therapy, Dalhousie University, Halifax, Canada
| | - Tanya Packer
- School of Occupational Therapy, Dalhousie University, Halifax, Canada
| | - Joan Versnel
- School of Occupational Therapy, Dalhousie University, Halifax, Canada
| |
Collapse
|
23
|
Audulv Å. The over time development of chronic illness self-management patterns: a longitudinal qualitative study. BMC Public Health 2013; 13:452. [PMID: 23647658 PMCID: PMC3649883 DOI: 10.1186/1471-2458-13-452] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2012] [Accepted: 04/30/2013] [Indexed: 11/17/2022] Open
Abstract
Background There currently exists a vast amount of literature concerning chronic illness self-management, however the developmental patterns and sustainability of self-management over time remain largely unknown. This paper aims to describe the patterns by which different chronic illness self-management behaviors develop and are maintained over time. Method Twenty-one individuals newly diagnosed with chronic illnesses (e.g., diabetes, rheumatism, ischemic heart disease, multiple sclerosis, chronic renal disease, inflammatory bowel disease) were repeatedly interviewed over two-and-a-half years. The interviews were conducted in Sweden from 2006 to 2008. A total of 81 narrative interviews were analyzed with an interpretive description approach. Results The participants’ self-management behaviors could be described in four different developmental patterns: consistent, episodic, on demand, and transitional. The developmental patterns were related to specific self-management behaviors. Most participants took long-term medications in a consistent pattern, whereas exercise was often performed according to an episodic pattern. Participants managed health crises (e.g., angina, pain episodes) according to an on demand pattern and everyday changes due to illness (e.g., adaptation of work and household activities) according to a transitional pattern. All of the participants used more than one self-management pattern. Conclusion The findings show that self-management does not develop as one uniform pattern. Instead different self-management behaviors are enacted in different patterns. Therefore, it is likely that self-management activities require support strategies tailored to each behavior’s developmental pattern.
Collapse
Affiliation(s)
- Åsa Audulv
- Department of Health Sciences, Mid Sweden University, SE-851 70 Sundsvall, Sweden.
| |
Collapse
|
24
|
|