scholarly journals Impact of health policy based on the self-management program on Cesarean section rate at a tertiary hospital in Taiwan

2013 ◽  
Vol 112 (2) ◽  
pp. 93-98 ◽  
Author(s):  
Ching-Ming Liu ◽  
Yu-Jr Lin ◽  
Yu-Yun Su ◽  
Shuenn-Dyh Chang ◽  
Po-Jen Cheng
Keyword(s):  
Health Policy ◽  
Cesarean Section ◽  
Tertiary Hospital ◽  
Management Program ◽  
The Self ◽  
Cesarean Section Rate ◽  
Self Management

scholarly journals Multidisciplinary Treatment for Headache in the Canadian Healthcare Setting

2008 ◽  
Vol 35 (1) ◽  
pp. 46-56 ◽  
Author(s):  
Khara M. Sauro ◽  
Werner J. Becker
Keyword(s):  
Multidisciplinary Treatment ◽  
Healthcare Setting ◽  
Management Program ◽  
Patient Perceptions ◽  
The Self ◽  
Self Management ◽  
Patient Treatment ◽  
Treatment Programs ◽  
Public Healthcare ◽  
Management Workshop

Background/Objectives:Multidisciplinary treatment programs are seen as an effective way to treat patients with chronic illness. The purpose of this study was to describe a multidisciplinary headache program which was developed in the Canadian public healthcare setting, and to report on patient perceptions of the program and patient treatment outcomes.Methods:The Calgary Headache Assessment and Management Program (CHAMP) was developed with initial funding from Alberta Health, and continued with function from the Calgary Health Region. Patient perceptions of the program were obtained with questionnaires. Outcome measures for a cohort of patients who completed the Self-Management Workshop were obtained using standard headache related disability measures.Results:Patient perceptions of the education session, the Lifestyle Assessment, and the Self-Management Workshop were very positive. Headache Disability Inventory scores fell from 56.2 to 46.3 from baseline to three months post Self-Management Workshop (p<.001). Corresponding scores for the HIT-6 were 63.6 and 58.2 (p <.001).Conclusions:Multidisciplinary headache treatment programs can be developed in the Canadian public healthcare system. The program described here was well accepted by many patients and perceived to be useful by them. Headache related disability as measured by standard measures was significantly reduced after participation in the program.

scholarly journals Standardising the Lay: Logics of Change in Programs of Disease Self-management

2012 ◽  
Vol 4 (3) ◽  
pp. 425-442 ◽  
Author(s):  
Annegrete Juul Nielsen ◽  
Lone Grøn
Keyword(s):  
Chronic Disease ◽  
Role Models ◽  
Chronic Condition ◽  
Expert Knowledge ◽  
Management Program ◽  
The Self ◽  
Self Management ◽  
Social Settings ◽  
Patient Centric ◽  
Forms Of Knowledge

The health political discourse on self-care is dominated by the view that the selfmanaging patient represents a more democratic and patient-centric perspective, as he or she is believed to renegotiate the terms on which patient participation in health care has hitherto taken place. The self-managing patient is intended as a challenge to traditional medical authority by introducing lay methods of knowing disease. Rather than a meeting between authoritative professionals and vulnerable patients, the self-managing patient seeks to open up new spaces for a meeting between experts. The present paper questions these assumptions through an ethnographic exploration of a patient-led self-management program called the Chronic Disease Self-Management Program. The program is concerned with what its developers call the social and mental aspects of living with a chronic disease and uses trained patients as role models and program leaders. Drawing inspiration from Annemarie Mol’s term ’logic’, we explore the rationale of ’situations of selfmanagement’ and identify what we call a ’logic of change’, which involves very specific ideas on how life with a chronic condition should be dealt with and directs attention towards particular manageable aspects of life with a chronic condition. This logic of change entails, we argue, a clash not between ’medical’ and ’lay’ forms of knowledge but between different logics or perceptions of how transformation can be achieved: through open-ended and ongoing reflection and experimentation in social settings or through standardised trajectories of change. Returning to the literature on lay forms of knowledge and illness perspectives, we question whether programs such as the Chronic Disease Self-Management Program – despite its apparent patient-centric perspective – reproduces classical hierarchical relations between lay and expert knowledge, albeit in new forms.

scholarly journals 2294 Do patient comorbidities impact the effectiveness of a COPD self-management program?

2018 ◽  
Vol 2 (S1) ◽  
pp. 41-41
Author(s):  
Emilia Galli Thurber ◽  
Hanan Aboumatar
Keyword(s):  
Quality Of Life ◽  
Patient Outcomes ◽  
The United States ◽  
Management Program ◽  
Emergency Department Visits ◽  
The Self ◽  
Self Management ◽  
Management Intervention ◽  
Comorbidity Burden

OBJECTIVES/SPECIFIC AIMS: Chronic obstructive pulmonary disease (COPD) is a leading cause of both hospitalizations and readmissions in the United States, and about 1 in 5 hospitalized patients with COPD will be readmitted within 30 days. COPD-focused self-management programs are frequently used to help patients better manage their symptoms and prevent hospitalization. However, while the majority of patients with COPD have at least one comorbidity, most trials of COPD self-management programs either excluded patients with significant comorbidities or did not analyze the impact of comorbidities on patient outcomes. Using data from the BREATHE trial of a COPD self-management program, this study aims to determine if patient post-intervention outcomes differ based on the intensity and type of patient comorbidities. METHODS/STUDY POPULATION: In total, 240 patients hospitalized for COPD were randomly assigned to either a comprehensive self-management intervention or usual transitional care. Primary outcomes for this trial were the number of COPD-related hospitalizations and emergency department visits at 6 months and changes in COPD-specific quality of life. To determine whether patient comorbidities modify the effect of the self-management intervention on readmission and quality of life outcomes, we will compare patient outcomes across groups stratified by comorbidity burden (Charlson Comorbidity Index) and type (baseline diagnosis of congestive heart failure, diabetes, and depression). In addition, we will use regression analysis with interaction terms to test for interaction between comorbidity burden/type and intervention assignment. RESULTS/ANTICIPATED RESULTS: We hypothesize that the effect of the self-management intervention will differ in patients with greater comorbidity burden due to competing medical demands for patients with multimorbidity. DISCUSSION/SIGNIFICANCE OF IMPACT: The results of this study will help clinicians better target disease-specific self-management programs to the groups of patients with COPD who are likely to receive the greatest benefit from this type of intervention.

scholarly journals Impact of the chronic disease self-management program (CDSMP) on self-perceived frailty condition: the EU-EFFICHRONIC project

2021 ◽  
Vol 12 ◽  
pp. 204062232110567
Author(s):  
Sabrina Zora ◽  
Carlo Custodero ◽  
Yves-Marie Pers ◽  
Verushka Valsecchi ◽  
Alberto Cella ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Chronic Diseases ◽  
Cognitive Performance ◽  
Nutritional Assessment ◽  
Short Form ◽  
Prognostic Index ◽  
Mini Nutritional Assessment ◽  
Management Program ◽  
The Self ◽  
Self Management

Introduction: The Chronic Disease Self-Management Program (CDSMP) improves self-efficacy and health outcomes in people with chronic diseases. In the context of the EFFICHRONIC project, we evaluated the efficacy of CDSMP in relieving frailty, as assessed by the self-administered version of Multidimensional Prognostic Index (SELFY-MPI), identifying also potential predictors of better response over 6-month follow-up. Methods: The SELFY-MPI explores mobility, basal and instrumental activities of daily living (Barthel mobility, ADL, IADL), cognition (Test Your Memory-TYM Test), nutrition (Mini Nutritional Assessment-Short Form-MNA-SF), comorbidities, medications, and socio-economic conditions (social-familiar evaluation scale-SFES). Participants were stratified in three groups according to the 6-month change of SELFY-MPI: those who improved after CDSMP (Δ SELFY-MPI < 0), those who remained unchanged (Δ SELFY-MPI = 0), and those who worsened (Δ SELFY-MPI > 0). Multivariable logistic regression was modeled to identify predictors of SELFY-MPI improvement. Results: Among 270 participants (mean age = 61.45 years, range = 26–93 years; females = 78.1%) a benefit from CDSMP intervention, in terms of decrease in the SELFY-MPI score, was observed in 32.6% of subjects. SELFY-MPI improvement was found in participants with higher number of comorbidities (1–2 chronic diseases: adjusted odd ratio (aOR)=2.38, 95% confidence interval (CI) =1.01, 5.58; ⩾ 3 chronic diseases: aOR = 3.34, 95% CI = 1.25, 8.90 vs no chronic disease), poorer cognitive performance (TYM ⩽ 42: aOR = 2.41, 95% CI = 1.12, 5.19 vs TYM > 42) or higher risk of malnutrition (MNA-SF ⩽ 11: aOR = 6.11, 95% CI = 3.15, 11.83 vs MNA-SF > 11). Conclusion: These findings suggest that the CDSMP intervention contributes to decreasing the self-perceived severity of frailty (SELFY-MPI score) in more vulnerable participants with several chronic diseases and lower cognitive performance and nutritional status.

scholarly journals The Effect of a Self-Management Program Combined with Social Support on the Self-Management and Healthy Eating Behaviors among Patients with Cardiovascular Disease

2021 ◽  
Vol 18 (4) ◽  
Author(s):  
Pachanut NUNTHAITAWEEKUL ◽  
Junpen PANSUP
Keyword(s):  
Social Support ◽  
Cardiovascular Disease ◽  
Eating Behavior ◽  
Healthy Eating ◽  
Eating Behaviors ◽  
Management Program ◽  
The Self ◽  
Self Management ◽  
Healthy Eating Behavior ◽  
Healthy Eating Behaviors

Unhealthy eating behaviors are one of the major causes of Coronary vascular disease (CVD). The self-management program combined with social support (CIP) was implemented to improve the patients’ self-management ability and maintain their eating behaviors to a healthier standard. The purpose of this study was to compare the scores of self-management and healthy eating behaviors of patients with CVD in the experimental CIP group before and after participation in the CIP. It also compared self-management and healthy eating behavior scores between patients with CVD who entered the CIP with the usual nursing care group. This study was a quasi-experimental approach with 2 groups of pre-and post-tests. The sample size of 50 cases, 25 in each group, was considered for the study. Questionnaires were used to assess the patient’s self-management and healthy eating behavior scores. Descriptive statistics, dependent t-test, and independent t-test were used for the data analysis. The findings revealed that the experimental group showed a significantly (p < 0.05) increased average self-management (46.2 ± 5.6 to 51.1 ± 5.9) and healthy eating behaviors (39.3 ± 5.5 to 48.4 ± 4.0) scores after the program than before. They also had a significantly (p < 0.05) higher self-management and healthy eating behavior scores than the control group (51.1 ± 5.9 vs. 48.9 ± 6.0 and 48.4 ± 4.0 vs. 39.8 ± 7.5, respectively). This program increased the patients’ self-management scores, and consequentially their healthy eating behaviors score also improved.   Keywords: The self-management program, social support, Cardiovascular disease, self-management, healthy eating behaviors

A Brief Report on the Evaluation of a Pain Self-Management Program for Older Adults

2012 ◽  
Vol 26 (2) ◽  
pp. 157-168 ◽  
Author(s):  
Clair Barefoot ◽  
Thomas Hadjistavropoulos ◽  
R. Nicholas Carleton ◽  
James Henry
Keyword(s):  
Older Adults ◽  
Chronic Pain ◽  
Pain Management ◽  
Behavioral Therapy ◽  
Management Program ◽  
The Self ◽  
Self Management ◽  
Control Group ◽  
Self Help ◽  
Professional Intervention

Chronic pain is often resistant to traditional medical management and other types of professional intervention. As such, several investigators have conducted studies of pain self-management programs. These self-management programs, however, were often led by therapists and shared much in common with traditional cognitive behavioral therapy (CBT); the efficacy of which, despite some inconsistencies, is largely supported in the literature. Although, like CBT, many therapist led programs involve a component of self-management in the form of “homework assignments,” it is important to evaluate the effectiveness of pain self-management, which is not therapist led. Within the context of controlled investigation, we evaluated a pain self-management program that involved use of a comprehensive self-help pain management book for older adults. Contrary to expectation, we did not identify any differences in the outcomes observed in the self-help patient group as compared to the control group (i.e., participants who did not receive the pain management book until after the study was completed) despite a great deal of satisfaction with the manualized program that was expressed by the participants. The implications of these findings are discussed.

scholarly journals Self-management: A comprehensive approach to improve quality of life among people living with HIV in Indonesia

2021 ◽  
Author(s):  
Achmad Fauzi ◽  
Nofa Anggraini ◽  
Novy Fatkhurohman
Keyword(s):  
Quality Of Life ◽  
Comparison Group ◽  
Management Program ◽  
The Self ◽  
World Health ◽  
Self Management ◽  
People Living With Hiv ◽  
Post Test ◽  
Living With Hiv

Background: People living with HIV (PLWH) today have to deal with a chronic condition that requires efficient self-management due to increased longevity. Self-management interventions have been shown to improve physical and psychological symptoms as well as clinical results in chronic diseases. However, few studies have investigated the effect of self-management on quality of life (QOL) among PLWH in Indonesia. Objective: To examine the effect of a self-management program on QOL among PLWH in Indonesia. Methods: This was a quasi-experiment design with a pre-post-test study with a comparison group in a general hospital in Jakarta. Of the 114 recruited PLWH, 57 were assigned to the intervention group and 57 to the comparison group. The self-management group attended a four-week program workshop. The intervention consisted of five sessions: need assessment and goal setting, maintaining a healthy lifestyle, educational participation to increase communication and self-esteem, and evaluation. The comparison group received standard educational material throughout the leaflet regarding HIV prevention. The post-test assessment was conducted immediately after intervention (T1) and two months (T2) after the intervention in both groups. QoL was measured using the World Health Organization Quality of Life (WHOQOL)-HIV brief Bahasa version. The estimations were obtained using fixed-effect regressions. The differences between T0, T1, and T2 for the intervention and comparison groups were evaluated and compared using the DI Differences method (DID). Results: The self-management program improved outcomes relative to the control at T1 across four outcomes: 1) overall QOL score increased 8.7% (95% CI 0.021–0.149), 2) physical domain saw a modest increased 8.8% (95% CI 0.017–0.125), 3) psychological domain increased 23.5 % (95% CI 0.085–0.689), environmental domain saw a modest increase of 18.7% (95% CI 0.053–0.371). At T2, the total QOL score and the physical, psychological, and environmental dimensions significantly improved compared to the comparison group. Conclusion: The self-management program appears to improve the QOL of the life of PLWH. Nurses are advised to provide PLWH with self-management training. Future research on self-management intervention would need to be refined further to ensure that each community achieves consistent intervention outcomes. Funding: This study was funded by STIKes Abdi Nusantara, Indonesia.

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