Nationwide implementation of the self-management program “Living well with COPD”: Process and effectiveness evaluation using a mixed-methods approach

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.

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

Culture Unbound Journal of Current Cultural Research ◽

10.3384/cu.2000.1525.124425 ◽

2012 ◽

Vol 4 (3) ◽

pp. 425-442 ◽

Cited By ~ 9

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.

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

Journal of Clinical and Translational Science ◽

10.1017/cts.2018.163 ◽

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.

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A Mixed Methods Approach to Understanding Curricular Impact of a Capstone Course on the Self-Efficacy of Fourth-Year Medical Students

Cureus ◽

10.7759/cureus.9537 ◽

2020 ◽

Author(s):

Kimberley G Jacobs ◽

John Kugler ◽

Jeffrey Chi ◽

Elizabeth Stuart ◽

Sylvia Bereknyei Merrell ◽

...

Keyword(s):

Mixed Methods ◽

Medical Students ◽

Self Efficacy ◽

The Self ◽

Capstone Course ◽

Mixed Methods Approach ◽

Fourth Year Medical Students

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Living Well with a Disability, a Self-Management Program

MMWR Supplements ◽

10.15585/mmwr.su6501a10 ◽

2016 ◽

Vol 65 (01) ◽

pp. 61-67 ◽

Cited By ~ 7

Author(s):

Craig Ravesloot ◽

Tom Seekins ◽

Meg Traci ◽

Tracy Boehm ◽

Glen White ◽

...

Keyword(s):

Management Program ◽

Self Management ◽

Living Well

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Mobile Health Features Supporting Self-Management Behavior in Patients With Chronic Arthritis: Mixed-Methods Approach on Patient Preferences (Preprint)

10.2196/preprints.12535 ◽

2018 ◽

Author(s):

Jonas Geuens ◽

Luc Geurts ◽

Thijs W Swinnen ◽

Rene Westhovens ◽

Vero Vanden Abeele

Keyword(s):

Mixed Methods ◽

Mobile Health ◽

Disease Status ◽

Chronic Arthritis ◽

Adult Patients ◽

Self Management ◽

Structured Interviews ◽

Management Behavior ◽

Mixed Methods Approach ◽

Related Data

BACKGROUND Patients with chronic arthritis (CA) ideally apply self-management behaviors between consultations. This enduring, tedious task of keeping track of disease-related parameters, adhering to medication schemes, and engaging in physical therapy may be supported by using a mobile health (mHealth) app. However, further research is needed to determine which self-management features are valued most by adult patients with CA patients. OBJECTIVE The aim of this study was to determine the preference of features for an mHealth app to support self-management behavior in patients with CA. In addition, we aimed to explore the motives behind these ratings. METHODS A mixed-methods approach was used to gather information from 31 adult patients (14 females), aged 23 to 71 years (mean 51 [SD 12.16]), with CA. Structured interviews were conducted to gather data pertaining to preferences of app features. Interviews were analyzed qualitatively, whereas ratings for each of the 28 features studied were analyzed quantitatively. RESULTS In general, patients with CA favored the use of features pertaining to supporting active and direct disease management, (eg, medication intake and detecting and alarming of bad posture), helping them to keep a close watch on their disease status and inform their health care professional (eg, providing a means to log and report disease-related data) and receiving personalized information (eg, offering tailored information based on the patient’s health data). Patients strongly disliked features that provide a means of social interaction or provide incentivization for disease-related actions (eg, being able to compare yourself with other patients, cooperating toward a common goal, and receiving encouragement from friends and/or family). Driving these evaluations is the finding that every patient with CA hurts in his/her own way, the way the disease unfolds over time and manifests itself in the patient and social environment is different for every patient, and patients with CA are well aware of this. CONCLUSIONS We have offered an insight into how patients with CA favor mHealth features for self-management apps. The results of this research can inform the design and development of prospective self-management apps for patients with CA.

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

Therapeutic Advances in Chronic Disease ◽

10.1177/20406223211056722 ◽

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.

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

Walailak Journal of Science and Technology (WJST) ◽

10.48048/wjst.2021.9614 ◽

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

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