Which self-management strategies do health care professionals recommend to their cancer patients? An experimental investigation of patient age and treatment phase

Systematic reviews of self-management programs for osteoarthritis suggest minimal evidence of benefit and indicate substantial heterogeneity in interventions. The purpose of this scoping review was to describe the nature of self-management interventions provided to patients with osteoarthritis focusing on the inclusion and type of education and social support components. We searched PsycINFO, EMBASE, MEDLINE, and Cochrane Library databases from 1990 to 2016 to identify studies addressing community-based management strategies for osteoarthritis that included aspects of disease-specific education and ongoing social support. Results are presented as a narrative synthesis to facilitate integration of diverse evidence. Data were extracted from 23 studies that met our inclusion and exclusion criteria, describing complex, multicomponent interventions for osteoarthritis. All studies included education components, and 18 of these were osteoarthritis-specific. Social support was most often offered through peers and health care professionals, but also through exercise trainers/instructors and researchers, and lasted between 5 and 52 weeks. We charted positive social interaction offered by peers in group settings and emotional/informational support offered by health care professionals. Overall, descriptions of self-management provided limited documentation of the rationale or content of the programs. This suggests that more precise definitions of the theoretical underpinnings, components, and mechanisms would be useful for greater insight into best practices for osteoarthritis self-management programs.

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Barriers and Facilitators to the Adoption of Mobile Health Among Health Care Professionals From the United Kingdom: Discrete Choice Experiment

JMIR mhealth and uhealth ◽

10.2196/17704 ◽

2020 ◽

Vol 8 (7) ◽

pp. e17704 ◽

Cited By ~ 2

Author(s):

Simon Leigh ◽

Liz Ashall-Payne ◽

Tim Andrews

Keyword(s):

Health Care ◽

Discrete Choice ◽

Mobile Health ◽

Health Care Professionals ◽

Choice Experiment ◽

Patient Age ◽

Health Apps ◽

The United Kingdom ◽

Patient Âgé ◽

Subgroup Analyses

Background Despite the increasing availability of mobile health services, clinical engagement remains minimal. Objective This study aims to identify and weight barriers to and drivers of health app use among health care professionals (HCPs) from the United Kingdom. Methods A discrete choice experiment was conducted with 222 HCPs using a web-based survey between March 2019 and June 2019. Participants were recruited to take part via social media and asked to choose their preferred option of 2 hypothetical health apps to prescribe to a hypothetical patient or to prescribe neither. Choices were characterized by differing levels of patient age, cost, published evidence bases, whether they had a National Health Service (NHS) stamp of approval, personal familiarity with the technology, and whether they were recommended by a fellow HCP. The results were analyzed using a mixed logit model, with subgroup analyses to account for heterogeneity. Results We received 230 responses, a total of 96.5% (n=222/230) of respondents understood the survey task and passed the test of rationality. The median age was between 36 and 45 years, and 62.6% (n=139/222) of the health care providers responding to the survey had previously recommended the use of health apps to patients. Health apps were most likely to be prescribed to patients if they had an NHS stamp of approval or if they were recommended by another HCP (both P<.001). Published studies detailing clinical effectiveness were important (P<.001), but it would take five published studies to have the same impact on prescribing behavior as an NHS stamp of approval and two studies to be as convincing as having used the technology personally. Increasing patient age and costs resulted in significant reductions in digital health prescribing (P<.001), none more so than among allied health professionals. Willingness-to-pay for health apps increased by £124.61 (US $151.14) if an NHS stamp of approval was present and by £29.20 (US $35.42) for each published study. Overall, 8.1% (n=18/222) of respondents were reluctant to use health apps, always choosing the I would prescribe neither option, particularly among older HCPs, nurses, and those who do not use health apps personally. Subgroup analyses revealed significant differences in preferences among HCPs of differing ages and clinical backgrounds. Conclusions An NHS stamp of approval, published studies, and recommendations from fellow HCPs are significant facilitators of digital prescribing, whereas increasing costs and patient age are significant barriers to engagement. These findings suggest that demonstrating assurances of health apps and supporting both the dissemination and peer-to-peer recommendation of evidence-based technologies are critical if the NHS is to achieve its long-term digital transformation ambitions.

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Exploring Strategies for Using Social Media to Self-Manage Health Care When Living With and Beyond Breast Cancer: In-Depth Qualitative Study (Preprint)

10.2196/preprints.16902 ◽

2019 ◽

Author(s):

Cathy Ure ◽

Anna Mary Cooper-Ryan ◽

Jenna Condie ◽

Adam Galpin

Keyword(s):

Breast Cancer ◽

Health Care ◽

Social Media ◽

Health Care Professionals ◽

Cancer Survival ◽

Management Strategies ◽

Survival Rates ◽

Self Management ◽

Health Providers ◽

Psychosocial Needs

BACKGROUND As breast cancer survival rates improve and structural health resources are increasingly being stretched, health providers require people living with and beyond breast cancer (LwBBC) to self-manage aspects of their care. OBJECTIVE This study aimed to explore how women use and experience social media to self-manage their psychosocial needs and support self-management across the breast cancer continuum. METHODS The experiences of 21 women (age range 27-64 years) were explored using an in-depth qualitative approach. The women varied in the duration of their experiences of LwBBC, which facilitated insights into how they evolve and change their self-management strategies over time. Semistructured interviews were analyzed inductively using a thematic analysis, a polytextual analysis, and voice-centered relational methods. RESULTS The use of multiple social media platforms, such as YouTube, Facebook, WhatsApp, and Twitter, enabled women to self-manage aspects of their care by satisfying needs for timely, relevant, and appropriate support, by navigating identities disrupted by diagnosis and treatment and by allowing them to (re)gain a sense of control. Women described extending their everyday use of multiple platforms to self-manage their care. However, women experienced social media as both empowering and dislocating, as their engagement was impacted by their everyday experiences of LwBBC. CONCLUSIONS Health care professionals (HCPs) need to be more aware, and open to the possibilities, of women using multiple social media resources as self-management tools. It is important for HCPs to initiate value-free discussions and create the space necessary for women to share how social media resources support a tailored and timely self-managed approach to their unique psychosocial needs.

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Self-management of chronic conditions in a rural and remote context

Australian Journal of Primary Health ◽

10.1071/py13084 ◽

2015 ◽

Vol 21 (1) ◽

pp. 90 ◽

Cited By ~ 6

Author(s):

Adem Sav ◽

Michelle A. King ◽

Fiona Kelly ◽

Sara S. McMillan ◽

Elizabeth Kendall ◽

...

Keyword(s):

Health Care ◽

Health Care Professionals ◽

Urban Areas ◽

Chronic Conditions ◽

Health Care Services ◽

Management Strategies ◽

Lifestyle Changes ◽

Self Management ◽

Rural And Remote ◽

North West

Living in a rural or remote environment presents unique challenges for people with chronic conditions, mainly those created by limited health-care services and the physical and emotional isolation. Yet, research on how people self-manage their chronic conditions in such locations is limited. This study aims to contribute to research and clinical practice by describing the ways in which a diverse group of rural and remote people with a range of chronic conditions, and their unpaid carers, self-manage their conditions. Using semi-structured in-depth interviews, data was collected from a sample of 32 participants, residing in one of two regions of Australia: Mount Isa/North West region of Queensland and the Northern Rivers area of New South Wales. Our findings suggest that although self-managing in a rural and remote context requires many of the lifestyle changes necessary in urban areas, the uniqueness of the rural lifestyle and the limited availability of health care results in, at times, creative forms of self-management. Health-care professionals and policy makers need to be cognisant of the ways in which rural and remote residents modify self-management strategies to suit their needs, and help them develop self-management plans tailored to the realities of their rural environment.

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Barriers and Facilitators to the Adoption of Mobile Health Among Health Care Professionals From the United Kingdom: Discrete Choice Experiment (Preprint)

10.2196/preprints.17704 ◽

2020 ◽

Author(s):

Simon Leigh ◽

Liz Ashall-Payne ◽

Tim Andrews

Keyword(s):

Health Care ◽

Discrete Choice ◽

Mobile Health ◽

Health Care Professionals ◽

Choice Experiment ◽

Patient Age ◽

Health Apps ◽

The United Kingdom ◽

Patient Âgé ◽

Subgroup Analyses

BACKGROUND Despite the increasing availability of mobile health services, clinical engagement remains minimal. OBJECTIVE This study aims to identify and weight barriers to and drivers of health app use among health care professionals (HCPs) from the United Kingdom. METHODS A discrete choice experiment was conducted with 222 HCPs using a web-based survey between March 2019 and June 2019. Participants were recruited to take part via social media and asked to choose their preferred option of 2 hypothetical health apps to prescribe to a hypothetical patient or to prescribe neither. Choices were characterized by differing levels of patient age, cost, published evidence bases, whether they had a National Health Service (NHS) stamp of approval, personal familiarity with the technology, and whether they were recommended by a fellow HCP. The results were analyzed using a mixed logit model, with subgroup analyses to account for heterogeneity. RESULTS We received 230 responses, a total of 96.5% (n=222/230) of respondents understood the survey task and passed the test of rationality. The median age was between 36 and 45 years, and 62.6% (n=139/222) of the health care providers responding to the survey had previously recommended the use of health apps to patients. Health apps were most likely to be prescribed to patients if they had an NHS stamp of approval or if they were recommended by another HCP (both P<.001). Published studies detailing clinical effectiveness were important (P<.001), but it would take five published studies to have the same impact on prescribing behavior as an NHS stamp of approval and two studies to be as convincing as having used the technology personally. Increasing patient age and costs resulted in significant reductions in digital health prescribing (P<.001), none more so than among allied health professionals. Willingness-to-pay for health apps increased by £124.61 (US $151.14) if an NHS stamp of approval was present and by £29.20 (US $35.42) for each published study. Overall, 8.1% (n=18/222) of respondents were reluctant to use health apps, always choosing the I would prescribe neither option, particularly among older HCPs, nurses, and those who do not use health apps personally. Subgroup analyses revealed significant differences in preferences among HCPs of differing ages and clinical backgrounds. CONCLUSIONS An NHS stamp of approval, published studies, and recommendations from fellow HCPs are significant facilitators of digital prescribing, whereas increasing costs and patient age are significant barriers to engagement. These findings suggest that demonstrating assurances of health apps and supporting both the dissemination and peer-to-peer recommendation of evidence-based technologies are critical if the NHS is to achieve its long-term digital transformation ambitions.

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Usefulness and Relevance of an eHealth Tool in Supporting the Self-Management of Chronic Obstructive Pulmonary Disease: Explorative Qualitative Study of a Cocreative Process (Preprint)

10.2196/preprints.10801 ◽

2018 ◽

Author(s):

Malin Tistad ◽

Sara Lundell ◽

Maria Wiklund ◽

André Nyberg ◽

Åsa Holmner ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Primary Care ◽

Health Care ◽

Pulmonary Disease ◽

Health Care Professionals ◽

Qualitative Content Analysis ◽

Management Strategies ◽

Self Management ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease

BACKGROUND New strategies are urgently needed to support self-management for people with chronic obstructive pulmonary disease (COPD) in primary care. The use of electronic health (eHealth) solutions is promising. However, there is a lack of knowledge about how such eHealth tools should be designed in order to be perceived as relevant and useful and meet the needs and expectations of the health professionals as well as people with COPD and their relatives. OBJECTIVE The objective of this study was to explore the aspects of an eHealth tool design and content that make it relevant and useful for supporting COPD-related self-management strategies from the perspective of health care professionals, people with COPD and their relatives, and external researchers. METHODS Data were collected during the development of an eHealth tool. A cocreation process was carried out with participants from two primary care units in northern Sweden and external researchers. Individual interviews were performed with health care professionals (n=13) as well as people with COPD (n=6) and their relatives (n=2), and focus group discussions (n=9) were held with all groups of participants. Data were analyzed using qualitative content analysis. RESULTS The overarching theme, reinforcing existing support structures, reflects participant views that the eHealth tool needs to be directly applicable and create a sense of commitment in users. Moreover, participants felt that the tool needs to fit with existing routines and contexts and preferably should not challenge existing hierarchies between health care professionals and people with COPD. Important content for health care professionals and people with COPD included knowledge about self-management strategies. Videos were regarded as the most effective method for communicating such knowledge. CONCLUSIONS The cocreation in the development process enables participant perspectives and priorities to be built into the eHealth tool. This is assumed to contribute to a tool that is useful and relevant and, therefore, adopted into clinical practice and everyday life. Findings from this study can inform the development of eHealth tools for people with COPD in other contexts, as well as the development of eHealth tools for self-management support of other chronic diseases.

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Diabetes self-management : strategies to support patients and health care professionals

10.26481/dis.20110218eh ◽

2011 ◽

Author(s):

E. Heinrich

Keyword(s):

Health Care ◽

Health Care Professionals ◽

Management Strategies ◽

Self Management

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IMPORTANCE OF SELF – MANAGEMENT OF PATIENTS WITH CARDIOVASCULAR DISEASE ON HEALTH-RELATED QUALITY OF LIFE

10.35988/sm-hs.2020.149 ◽

2020 ◽

Vol 30 (6) ◽

pp. 99-106

Author(s):

Vilma Rastenienė ◽

Aurelija Blaževičienė

Keyword(s):

Quality Of Life ◽

Cardiovascular Disease ◽

Health Care ◽

Health Care Professionals ◽

Healthy Lifestyle ◽

Good Practice ◽

Management Strategies ◽

Self Management ◽

Related Quality

The aim of the paper was to find out what is known about how do people effectively manage their illness, heart and cardiovascular diseases, themselves in the advanced stages of their disease. Material and Metods. An integrative review. Results. Promotion of self-managment in patients with a viable health care strategy in order to maintain health and prevent exacerbations. Optimal treatment of care, patients‘ self-managment promotion reduces the financial costs of treating patients. Increasing the patient‘s ability to achieve a healthy lifestyle, the application of medical recommendations to recognize the symptoms and signs of consultations with health care professionals can reduce repeated hospitalization rates. For health care professionals self-managment education promotion is a great strategy to improve patients‘ quality of life. Conclusions. Self management strategies for people with heart and cardiovascular disease should be related to helping them cope with pain and debilitating symptoms, coping emotionally and adjusting psychosocially to their illness, and alleviating distress associated with symptoms that can not easily be improved. Examples of good practice should be formally evaluated.

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Using experiences of mobile application from the perspective of patients with diabetes mellitus: A qualitative meta-synthesis (Preprint)

10.2196/preprints.11476 ◽

2018 ◽

Author(s):

Xiaoyan Lv ◽

Yingjuan Cao ◽

Jinghua Xia ◽

Ran Tan ◽

Polun Chang

Keyword(s):

Diabetes Mellitus ◽

Health Care ◽

Health Care Professionals ◽

Mobile Application ◽

Management Strategies ◽

Self Management ◽

Cochrane Library ◽

Diabetic Patients ◽

Negative Effects ◽

Patients With Diabetes

BACKGROUND Mobile application has become a new tool for management of chronic disease like diabetes mellitus (DM). Up to date, most of the studies related to mobile application focus on the effectiveness of self-management, rarely take perceptions and experiences of users into account. OBJECTIVE To conduct a meta- synthesis of qualitative researches which associated with mobile application using experiences among diabetic patients in order to better understand those factors which facilitate or hinder patients’ embracement, and to provide recommendations for future mobile application design and disease management strategies. METHODS Literatures focused on experiences and perceptions of users in diabetes application were searched in PubMed, Web of Science and Cochrane Library between inception and June 2018. The Jonna Briggs Institute (JBI) Critical Appraisal Tool for qualitative studies was utilized to evaluate the quality of the selected studies. The searching results were synthesized by employing Integrating Methods. RESULTS Four studies were included for analysis, 17 findings were subsequently integrated into 6 categories and finally 2 synthesized results were defined, including the use of mobile application for diabetes can improve patients’ self-management and confidence in disease control, obtain more support from health care professionals, and reduce negative emotions; Problems and negative effects in use. CONCLUSIONS Mobile application is a helpful tool to initiate and maintain self-management among diabetic patients and more improvements are necessary for the sake of easy use and effectiveness. Further high-quality qualitative study is needed to better understand requirements and using experience of diabetics, health care professionals or other stakeholders.

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Exploring Strategies for Using Social Media to Self-Manage Health Care When Living With and Beyond Breast Cancer: In-Depth Qualitative Study

Journal of Medical Internet Research ◽

10.2196/16902 ◽

2020 ◽

Vol 22 (5) ◽

pp. e16902 ◽

Cited By ~ 1

Author(s):

Cathy Ure ◽

Anna Mary Cooper-Ryan ◽

Jenna Condie ◽

Adam Galpin

Keyword(s):

Breast Cancer ◽

Health Care ◽

Social Media ◽

Health Care Professionals ◽

Cancer Survival ◽

Management Strategies ◽

Survival Rates ◽

Self Management ◽

Health Providers ◽

Psychosocial Needs

Background As breast cancer survival rates improve and structural health resources are increasingly being stretched, health providers require people living with and beyond breast cancer (LwBBC) to self-manage aspects of their care. Objective This study aimed to explore how women use and experience social media to self-manage their psychosocial needs and support self-management across the breast cancer continuum. Methods The experiences of 21 women (age range 27-64 years) were explored using an in-depth qualitative approach. The women varied in the duration of their experiences of LwBBC, which facilitated insights into how they evolve and change their self-management strategies over time. Semistructured interviews were analyzed inductively using a thematic analysis, a polytextual analysis, and voice-centered relational methods. Results The use of multiple social media platforms, such as YouTube, Facebook, WhatsApp, and Twitter, enabled women to self-manage aspects of their care by satisfying needs for timely, relevant, and appropriate support, by navigating identities disrupted by diagnosis and treatment and by allowing them to (re)gain a sense of control. Women described extending their everyday use of multiple platforms to self-manage their care. However, women experienced social media as both empowering and dislocating, as their engagement was impacted by their everyday experiences of LwBBC. Conclusions Health care professionals (HCPs) need to be more aware, and open to the possibilities, of women using multiple social media resources as self-management tools. It is important for HCPs to initiate value-free discussions and create the space necessary for women to share how social media resources support a tailored and timely self-managed approach to their unique psychosocial needs.

Download Full-text