Patients and healthcare workers experience with a mobile application for self-management of diabetes in Qatar: A qualitative study

BackgroundTechnology such as wearable technology and self-management applications could improve the care of patients with chronic obstructive pulmonary disease (COPD) by real-time continuous monitoring, early detection of COPD and improved self-management. However, patients have not been willing to use technology when it is too difficult to use, interferes with their daily lives or threatens their identity, independence and self-care.MethodsWe conducted a qualitative study to determine what patients with COPD would like to see in a wearable device and a mobile application to help manage their condition. Semi-structured interviews were conducted, recorded and transcribed. Thematic analysis was used to identify themes and concepts.ResultsWe interviewed 14 people with COPD with an average age of 69 years. Participants perceived that the technology could improve their ability to manage their condition both in daily life and during exacerbations by connecting how they feel and by knowing their oxygen saturation, heart rate and activity. The technology may help them address feelings of fear and panic associated with exacerbations and may provide reassurance and connectedness. Some people with COPD wanted their healthcare providers to have access to their data, while others were concerned about inundating them with too much information. Of note, people wanted to maintain control of the information; to make connections with the data, but also in order to be alerted when a possible exacerbation occurs.ConclusionPatients perceived significant potential for wearables and apps to help manage their condition.

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A patient-centered mobile intervention to promote self-management and improve patient outcomes in chronic heart failure: The ManageHF4Life trial (Preprint)

10.2196/preprints.26185 ◽

2020 ◽

Author(s):

Michael P. Dorsch ◽

Karen B. Farris ◽

Brigid E. Rowell ◽

Scott L. Hummel ◽

Todd M. Koelling

Keyword(s):

Heart Failure ◽

Mobile Application ◽

Controlled Trial ◽

Intervention Group ◽

Self Care ◽

Self Management ◽

Control Group ◽

Patient Centered ◽

Self Monitoring ◽

Heart Failure Questionnaire

BACKGROUND Successful management of heart failure (HF) involves guideline based medical therapy as well as self-care behavior. As a result, the management of HF is moving toward a proactive real-time technological model of assisting patients with monitoring and self-management. OBJECTIVE Evaluate the effectiveness of a mobile application intervention that enhances self-monitoring on health-related quality of life, self-management, and reduces HF readmissions. METHODS A single-center randomized controlled trial was performed. Patients greater than 45 years of age and admitted for acute decompensated HF or recently discharged in the past 4 weeks were included. The intervention group used a mobile application (App). The intervention prompted daily self-monitoring and promoted self-management. The control group (No App) received usual care. The primary outcome was the change in Minnesota Living with Heart Failure Questionnaire (MLHFQ) from baseline to 6 and 12 weeks. Secondary outcomes were the Self-Care Heart Failure Index (SCHFI) questionnaire and recurrent HF admissions. RESULTS Eighty-three patients were enrolled and completed all baseline assessments. Baseline characteristics were similar between groups with the exception of HF etiology. The App group had a reduced MLHFQ at 6 weeks (37.5 ± 3.5 vs. 48.2 ± 3.7, P=0.039) but not at 12 weeks (44.2 ± 4 vs. 45.9 ± 4, P=0.778) compared to No App. There was no effect of the App on the SCHFI at 6 or 12 weeks. The time to first HF admission was not statistically different between the App versus No App groups (HR 0.89, 95% CI 0.39-2.02, P=0.781) over 12 weeks. CONCLUSIONS The mobile application intervention improved MLHFQ at 6 weeks, but did not sustain its effects at 12 weeks. No effect was seen on HF self-care. Further research is needed to enhance engagement in the application for a longer period of time and to determine if the application can reduce HF admissions in a larger study. CLINICALTRIAL NCT03149510

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Young adults’ perceptions of living with atopic dermatitis in relation to the concept of self-management: a qualitative study

BMJ Open ◽

10.1136/bmjopen-2020-044777 ◽

2021 ◽

Vol 11 (6) ◽

pp. e044777

Author(s):

Susanne Lundin ◽

Marina Jonsson ◽

Carl-Fredrik Wahlgren ◽

Emma Johansson ◽

Anna Bergstrom ◽

...

Keyword(s):

Young Adults ◽

Atopic Dermatitis ◽

Qualitative Study ◽

Healthcare Providers ◽

Transition Process ◽

Population Based ◽

Self Management ◽

School Age ◽

Perceived Availability ◽

Semistructured Interviews

ObjectivesLearning to take control of one’s health is an important part of the transition from adolescence to adulthood. This study aimed to explore young adults’ perceptions of living with atopic dermatitis (AD) in relation to the concept of self-management.DesignA qualitative study with an inductive approach was performed through semistructured interviews (n=15). The interviews were recorded, transcribed verbatim and analysed with systematic text condensation.ParticipantsYoung adults (mean age 23,4 years) with persistent AD in a longitudinal population-based birth cohort. To capture experience of living with persistent AD (preschool/school-age onset) of different severity (mild to severe/very severe), a purposive selection was performed. In total, 15 young adults were included. Persistent AD (preschool/school-age onset) was defined as dry skin in combination with itchy rash of typical localisation in the 12 months preceding the 16-year and the 24-year follow-ups. Severity was self-assessed using the Patient Oriented Eczema Measure.ResultsDespite having experience of AD since childhood, the respondents expressed uncertainty about treatment and how it affected their bodies. Their uncertainties and feelings affected how they used topical corticosteroids. The respondents emphasised that they perceived availability of healthcare and knowledge about treatment of AD among healthcare providers to be limited. The participants did not state any experiences of support to self-management from healthcare, which affect young adults’ possibilities to take full control of their AD care.ConclusionsYoung adults with preschool/school-age onset of AD are unsure how to treat and manage the disease. One explanation may be insufficient transition process.

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The experiences of cooperation among healthcare workers who participated in COVID‐19 aid mission in China: A qualitative study

Journal of Clinical Nursing ◽

10.1111/jocn.15774 ◽

2021 ◽

Author(s):

Anni Wang ◽

Lei Liu ◽

Jianguo Zhu ◽

Xue Chen ◽

Siyuan Tang ◽

...

Keyword(s):

Qualitative Study ◽

Healthcare Workers

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Understanding peer mentorship in supporting self‐management of hip and knee osteoarthritis: A qualitative study of mentees' perspectives

Musculoskeletal Care ◽

10.1002/msc.1580 ◽

2021 ◽

Author(s):

Elizabeth C. Lavender ◽

Anna M. Anderson ◽

Esther Dusabe‐Richards ◽

Deborah Antcliff ◽

Sarah R. Kingsbury ◽

...

Keyword(s):

Qualitative Study ◽

Knee Osteoarthritis ◽

Self Management ◽

Peer Mentorship

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Patients’ and healthcare professionals’ beliefs, perceptions and needs towards chronic kidney disease self-management in China: a qualitative study

BMJ Open ◽

10.1136/bmjopen-2020-044059 ◽

2021 ◽

Vol 11 (3) ◽

pp. e044059

Author(s):

Hongxia Shen ◽

Rianne M J J van der Kleij ◽

Paul J M van der Boog ◽

Wenjiao Wang ◽

Xiaoyue Song ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Qualitative Study ◽

Healthcare Professionals ◽

Illness Perceptions ◽

Chinese Patients ◽

Self Management ◽

Tertiary Referral Hospital ◽

Chinese Context ◽

Management Interventions

ObjectivesTo support the adaptation and translation of an evidence-based chronic kidney disease (CKD) self-management intervention to the Chinese context, we examined the beliefs, perceptions and needs of Chinese patients with CKD and healthcare professionals (HCPs) towards CKD self-management.DesignA basic interpretive, cross-sectional qualitative study comprising semistructured interviews and observations.SettingOne major tertiary referral hospital in Henan province, China.Participants11 adults with a diagnosis of CKD with CKD stages G1–G5 and 10 HCPs who worked in the Department of Nephrology.ResultsFour themes emerged: (1) CKD illness perceptions, (2) understanding of and motivation towards CKD self-management, (3) current CKD practice and (4) barriers, (anticipated) facilitators and needs towards CKD self-management. Most patients and HCPs solely mentioned medical management of CKD, and self-management was largely unknown or misinterpreted as adherence to medical treatment. Also, the majority of patients only mentioned performing disease-specific acts of control and not, for instance, behaviour for coping with emotional problems. A paternalistic patient–HCP relationship was often present. Finally, the barriers, facilitators and needs towards CKD self-management were frequently related to knowledge and environmental context and resources.ConclusionsThe limited understanding of CKD self-management, as observed, underlines the need for educational efforts on the use and benefits of self-management before intervention implementation. Also, specific characteristics and needs within the Chinese context need to guide the development or tailoring of CKD self-management interventions. Emphasis should be placed on role management and emotional coping skills, while self-management components should be tailored by addressing the existing paternalistic patient–HCP relationship. The use of electronic health innovations can be an essential facilitator for implementation.

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A qualitative study of home care client and caregiver experiences with a complex cardio-respiratory management model

BMC Geriatrics ◽

10.1186/s12877-021-02251-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Connie Schumacher ◽

Darly Dash ◽

Fabrice Mowbray ◽

Lindsay Klea ◽

Andrew Costa

Keyword(s):

Health Service ◽

Qualitative Study ◽

Home Care ◽

Therapeutic Relationship ◽

Service Use ◽

Management Model ◽

Health Service Use ◽

Self Management ◽

Home Based ◽

Respiratory Management

Abstract Background Home care clients are typically older and have some degree of medical, physical, cognitive or social conditions that require formal or informal support to promote healthy aging in the community. Home care clients contribute a significant proportion of health service use, including emergency department visits. The DIVERT-CARE trial introduced a cardio-respiratory management model to improve client motivation, symptoms and rates of unwarranted health service use. Our objective was to explore the perceptions and experiences of individuals who participated in the DIVERT-CARE self-management support and education intervention. Methods A qualitative study was nested within a pragmatic randomized control trial and conducted following a 15-week multi-component cardio-respiratory intervention. A phenomenological descriptive design was employed using thematic analysis. Post-intervention, clients and their caregivers were invited to participate in a semi-structured telephone interview. Interview questions were designed to elicit the experience with the intervention components. Results A total of 29 interviews were completed from June 2018 to March 2020 from participants in Ontario, Newfoundland, and British Columbia. Three themes were identified; self-care trajectory and burden of responsibility, learning and behaviour change, and feeling connected pre-emptively to care providers, the information and medical advice, and connection through the therapeutic relationship. Conclusions Home care clients experience unique challenges in managing cardio-respiratory related chronic disease. Home-based interventions fostered a therapeutic relationship of connectedness while equipping clients with necessary knowledge and skills. These results inform recommendations for community nursing, and home-based self-management supports for older community-residing individuals.

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A qualitative study of self‐management experiences in people with non‐alcoholic fatty liver disease

Nursing Open ◽

10.1002/nop2.1025 ◽

2021 ◽

Author(s):

Yeonsoo Jang ◽

Ji Yea Lee ◽

Seung Up Kim ◽

Beomkyung Kim

Keyword(s):

Liver Disease ◽

Qualitative Study ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Self Management ◽

Alcoholic Fatty Liver ◽

Alcoholic Fatty Liver Disease

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To Volunteer or Not? Perspectives towards Pre-Registered Nursing Students Volunteering Frontline during COVID-19 Pandemic to Ease Healthcare Workforce: A Qualitative Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18126668 ◽

2021 ◽

Vol 18 (12) ◽

pp. 6668

Author(s):

Betsy Seah ◽

Ben Ho ◽

Sok Ying Liaw ◽

Emily Neo Kim Ang ◽

Siew Tiang Lau

Keyword(s):

Nursing Students ◽

Qualitative Study ◽

Professional Identity ◽

Healthcare Workers ◽

Healthcare Services ◽

Strategic Partnerships ◽

Healthcare Workforce ◽

Student Volunteer ◽

Operational Processes

COVID-19 has caused a shortage of healthcare workers and has strained healthcare systems globally. Pre-registered healthcare students with training have a duty of care and can support the healthcare workforce. This study explored factors influencing the willingness of final-year nursing students to volunteer during the COVID-19 pandemic, the role of professional identity in volunteering as healthcare workers, and strategies to improve future volunteering uptakes and processes. A qualitative study using focus-group discussions was conducted. Final-year nursing students who volunteered, students who did not volunteer, and lecturers who supervised student volunteers were recruited. Interviews were conducted online, video-recorded, and transcribed verbatim. A thematic analysis was used. The themes were “wavering thoughts on volunteering”, “bringing out ‘the nurse’ in students through volunteering” and “gearing up to volunteer”. Findings suggested the need to look beyond the simplicity of altruism to the role of professional identity, operational, and motivational factors to explain nursing students’ decision to volunteer and their volunteer behavior. Providing accommodation, monetary and academic-related incentives, supporting the transitionary phase from students to “professional volunteers”, promoting cohesive and positive staff–student volunteer relationships, and establishing a volunteer management team are strategies identified to improve volunteering uptake and operational processes. Our findings advocate strategic partnerships between hospitals/communities and academic institutions in providing various healthcare services during pandemics.

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Experience of taking care of children exposed to HIV: a trajectory of expectations

Revista Latino-Americana de Enfermagem ◽

10.1590/0104-1169.3607.2489 ◽

2014 ◽

Vol 22 (5) ◽

pp. 848-856 ◽

Cited By ~ 4

Author(s):

Willyane de Andrade Alvarenga ◽

Giselle Dupas

Keyword(s):

Antiretroviral Therapy ◽

Qualitative Study ◽

Incomplete Information ◽

Vertical Transmission ◽

Healthcare Workers ◽

Child Interaction ◽

Lack Of Information ◽

Mother And Child ◽

Specialized Service

OBJECTIVE: to learn about the experience of caregivers/mothers providing care to infants exposed to HIV through vertical transmission.METHODS: this qualitative study used Symbolic Interactionism as the theoretical framework. A total of 39 caregivers of children exposed to HIV in follow-up at a specialized service were interviewed. Data were analyzed through inductive content analysis.RESULTS: four categories were identified that report on the lonely experience of handling the child's antiretroviral therapy, mainly due to a lack of information or incomplete information; being attentive to required care, such as the use of prophylaxis for pneumonia, vaccines, and other practices restricted to the mother-child interaction; the desire to omit the HIV out of fear of prejudice and fear of the disease, considering future prospects.CONCLUSION: the HIV and the threat this infection may affect the child cause apprehension and feelings such as fear, guilt and anxiety in the caregivers. Healthcare workers need to work together with mothers so they are able to cope with demands and distress. Only then will the treatment to avoid vertical transmission be efficient and will mother and child be supported during the process, despite apprehension with the outcome.

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