scholarly journals Augmenting the Clinical Data Sources for Enigmatic Diseases: A Cross-Sectional Study of Self-Tracking Data and Clinical Documentation in Endometriosis

2020 ◽  
Vol 11 (05) ◽  
pp. 769-784
Author(s):  
Ipek Ensari ◽  
Adrienne Pichon ◽  
Sharon Lipsky-Gorman ◽  
Suzanne Bakken ◽  
Noémie Elhadad
Keyword(s):  
Additional Data ◽  
Intraclass Correlation ◽  
Management Strategies ◽  
The Self ◽  
Self Management ◽  
Cross Sectional ◽  
Two Samples ◽  
Data Source ◽  
Daily Function ◽  
Over Time

Abstract Background Self-tracking through mobile health technology can augment the electronic health record (EHR) as an additional data source by providing direct patient input. This can be particularly useful in the context of enigmatic diseases and further promote patient engagement. Objectives This study aimed to investigate the additional information that can be gained through direct patient input on poorly understood diseases, beyond what is already documented in the EHR. Methods This was an observational study including two samples with a clinically confirmed endometriosis diagnosis. We analyzed data from 6,925 women with endometriosis using a research app for tracking endometriosis to assess prevalence of self-reported pain problems, between- and within-person variability in pain over time, endometriosis-affected tasks of daily function, and self-management strategies. We analyzed data from 4,389 patients identified through a large metropolitan hospital EHR to compare pain problems with the self-tracking app and to identify unique data elements that can be contributed via patient self-tracking. Results Pelvic pain was the most prevalent problem in the self-tracking sample (57.3%), followed by gastrointestinal-related (55.9%) and lower back (49.2%) pain. Unique problems that were captured by self-tracking included pain in ovaries (43.7%) and uterus (37.2%). Pain experience was highly variable both across and within participants over time. Within-person variation accounted for 58% of the total variance in pain scores, and was large in magnitude, based on the ratio of within- to between-person variability (0.92) and the intraclass correlation (0.42). Work was the most affected daily function task (49%), and there was significant within- and between-person variability in self-management effectiveness. Prevalence rates in the EHR were significantly lower, with abdominal pain being the most prevalent (36.5%). Conclusion For enigmatic diseases, patient self-tracking as an additional data source complementary to EHR can enable learning from the patient to more accurately and comprehensively evaluate patient health history and status.

scholarly journals Patient, clinician and independent observer perspectives of shared decision making in adult orthodontics

2021 ◽  
pp. 146531252110075
Author(s):  
Asma Keshtgar ◽  
Susan J Cunningham ◽  
Elinor Jones ◽  
Fiona S Ryan
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Intraclass Correlation ◽  
The Self ◽  
Shared Decision ◽  
Cross Sectional ◽  
Independent Observer ◽  
The Mean ◽  
Patient’S Perception ◽  
Validated Instrument

Objectives: To investigate and compare the extent of shared decision making (SDM) in orthodontics from the perspective of patients, clinicians and independent observers. Design: A cross-sectional, observational study. Setting: NHS teaching hospital. Participants: A total of 31 adult patients and their treating clinicians were included in the study. Methods: The extent of SDM in new patient orthodontic consultations was measured using three versions of a validated instrument: the self-administered patient dyadic-OPTION scale; the self-administered clinician dyadic-OPTION scale; and an independent observer-rated OPTION12 scale. Patients and clinicians completed the 12-item dyadic-OPTION questionnaire independently at the end of the consultation to rate their perceived levels of SDM. The consultations were also audio-recorded and two calibrated raters independently rated the extent of SDM in these consultations using the OPTION12 scale. Results: There was excellent inter-rater reliability between the two independent raters using the OPTION12 scale (intraclass correlation coefficient (ICC) = 0.909). The mean patient, clinician and independent observer OPTION scores for SDM were 90.4% (SD 9.1%, range 70.8% to 100%), 76.2% (SD 8.95%, range 62.5% to 95.8%) and 42.6% (SD 17.4%, range 13.5% to 68.8%), respectively. There was no significant correlation between the OPTION scores for the three groups (ICC = −0.323). Conclusions: The results showed that generally high levels of SDM were perceived by patients and clinicians but lower levels of SDM were scored by the independent observers. However, it could be argued that the patient’s perception of SDM is the most important measure as it is their care that is affected by their involvement.

Self-Management Status in Patients with Diabetes and Disease Control Indicators in Lamerd City, Iran

2020 ◽  
Vol 9 (2) ◽  
Author(s):  
Fereidoun Jahangir ◽  
Esmaeil Kavi ◽  
Behnam Masmouei ◽  
Mohammad-Rafi Bazrafshan ◽  
Hamed Delam ◽  
...  
Keyword(s):  
Waist Circumference ◽  
Disease Control ◽  
Correlation Coefficient ◽  
Pearson Correlation ◽  
T Test ◽  
The Self ◽  
Self Management ◽  
Pearson Correlation Coefficient ◽  
Cross Sectional ◽  
The Mean

Background: Diabetes is a global epidemic with serious complication and there is a clear need for paying special attention to self-management as the cornerstone to optimal control of the disease. Objectives: This study aimed to assess the self-management status and its correlation to disease control indicators in people with diabetes. Methods: In a descriptive cross-sectional study, 220 patients were selected from the list of the referred patients available in Lamerd public health network from December 2014 to June 2015. In the first step, data about demographic information and disease control were collected from the patients’ records. In the second step, the self-management status of each patient was assessed by the Diabetes Self-Management Questionnaire developed by Schmitt et al. To analyze the data, independent sample t-test and Pearson correlation coefficient were used. Results: The mean age of the male and female participants was 56.43 ± 13.50 and 56.46 ± 10.49 years old, respectively. The mean duration of the disease was 6.67 ± 4.72 years for men and 7.07 ± 5.30 years for women. Twenty-one (25.9%) men and 60 (43.7%) women had a history of smoking. The results of the Pearson correlation coefficient showed that there was an inverse and statistically significant relationship between diabetes self-management status and weight, body mass index (BMI), waist circumference, glucose tolerance test (GTT), LDL, and cholesterol. The results of the t-test did not show significant differences between the level of HbA1C (HbA1C7) and self-management scores of the patients (P > 0.05). Conclusions: Patients with better self-management status were in a better disease control condition with respect to weight, BMI, waist circumference, GTT, LDL, and cholesterol levels. Special attention to the control and management of LDL, cholesterol, HbA1C, BMI, and blood pressure levels is recommended in planning for these patients.

scholarly journals Self-management strategies of graduate employees to enhance work engagement

2021 ◽  
Vol 47 ◽  
Author(s):  
Nelesh Dhanpat ◽  
Dorothy L. Danguru ◽  
Oyisa Fetile ◽  
Kholeka Kekana ◽  
Kholosa N. Mathetha ◽  
...  
Keyword(s):  
Employee Engagement ◽  
Work Engagement ◽  
Management Strategies ◽  
Theory And Practice ◽  
The Self ◽  
Self Management ◽  
Research Approach ◽  
Structured Interviews ◽  
Managerial Implications ◽  
Value Add

Orientation: The hiring of graduates is valuable to organisations. It is necessary to understand the self-management behaviours they display and the behaviours required to keep them engaged.Research purpose: The purpose of this study was to explore how self-management strategies enhance work engagement of recent graduates who find themselves in a new environment of the world of work.Motivation for the study: Employee engagement is of both academic and practitioner interest. With organisations hiring graduates, it is valuable to understand the self-management behaviours needed to remain engaged.Research approach/design and method: A qualitative research approach was employed through an interpretivist research paradigm. A purposive sample of 12 graduate employees (median age = 24) in various fields of work were interviewed (women = 11, men = 1; black = 11, coloured = 1). The graduates participated in semi-structured interviews. A thematic analysis was conducted and five themes emerged.Main findings: Through an inductive approach, the five themes that emerged concerning self-management strategies used by graduates to enhance their work engagement are goal setting, self-cueing, self-observation, self-reward and self-punishment and work engagement practices.Practical/managerial implications: Self-management strategies help to sustain an engaged workforce. Organisations that make use of graduate recruitment will largely benefit from the findings.Contribution/value-add: There is limited research on the topic pertaining to graduate employees. Graduates remain relevant in the organisation, and hence, the study makes a contribution to theory and practice. A model is presented with recommendations for graduates and the organisation, which, when implemented, have the potential to enhance work engagement.

Career attitudes and employability: analysis of mediation via career strategies

2019 ◽  
Vol 42 (2) ◽  
pp. 417-436
Author(s):  
Gina Gaio Santos ◽  
Ana Paula Ferreira ◽  
José Carlos Pinho
Keyword(s):  
Direct Effect ◽  
Negative Impact ◽  
Management Strategies ◽  
Self Management ◽  
Equation Modeling ◽  
Cross Sectional ◽  
Content Type ◽  
Career Attitudes ◽  
Boundaryless Career

Purpose The purpose of this paper is to evaluate the impact of career attitudes (traditional career vs boundaryless career) on perceived employability (internal vs external employability). In addition, the authors examine whether career self-management strategies act as mediators of these relationships. Due to high unemployment rates in the last two decades, it is important to assess the extent to which young graduates’ career attitudes affect perceived internal and external employability, along with the role of career self-management strategies as an employability enhancement tool. Design/methodology/approach As part of a cross-sectional research design, the authors administered a survey questionnaire to a sample of 131 graduates (i.e. master’s students) with at least one year of work experience. The empirical data were analyzed with partial least squares structural equation modeling, which combines confirmatory factor analysis, multiple linear regression and path analysis. Findings The results reveal that there is a positive and significant impact (direct effect) of a traditional career attitude (TCA) on internal employability, while there is no significant negative impact of a TCA on external employability. Additionally, the results show that there is a negative impact (direct effect) of a boundaryless career attitude (BCA) on internal employability, while no significant positive impact is found of a BCA on external employability. This study also confirms the mediation effect (full mediation) of career positioning strategies on the BCA-external employability relationship, and a partial mediation of career influence strategies on the TCA-internal employability relationship. Research limitations/implications Limitations of this study relate to the sample size and the use of a convenience sampling technique. Hence, some caution is needed regarding results’ generalization. In addition, this research uses a cross-sectional design, thus the authors cannot assess longitudinal causal relationships between variables. Future research should be replicated with different types of respondents and in different cultural contexts. Practical implications The results suggest that organizations would benefit more from employees that hold a TCA than those that hold a BCA, especially if they are interested in fostering the internal employability of their workforce. At the individual level, the results identify optimal career self-management strategies (internal vs external employability) for young graduates. Originality/value This study offers new empirical evidence of the predictive value of perceived internal vs external employability and the mediating role of career self-management strategies in explaining employability. Young graduates perceive a TCA as more advantageous than a BCA for both internal and external employability. This is an unexpected but interesting finding, since the bulk of the literature on contemporary career attitudes overemphasizes the advantages of a BCA, while disregarding potential disadvantages for both individuals and organizations.

Convergence of Quality Management Approaches

2014 ◽  
pp. 84-105
Author(s):  
Magdalena Platis
Keyword(s):  
Higher Education ◽  
Development Process ◽  
Management Strategies ◽  
Education Institution ◽  
The Self ◽  
Whole Body ◽  
Self Management ◽  
Self Evaluation ◽  
Self Development ◽  
Management Approaches

In all evaluations of universities, either of programs, schools, or the institution as a whole body, the starting point is the self-evaluation report. Its importance is crucial since all the recommendations and conclusions are based on its content. The purpose of this chapter is to reveal the importance of the self-development process as part of the self-management strategies that need to be implemented in higher education universities, in the context of the quality assessment procedures. In the contemporary context, the process of university development has to be understood as a self-development process, taking into consideration all the reforms and changes generated since the the Bologna Declaration (1999). Therefore, it is important to reveal the characteristics of the process of self-development for the higher education institution, to identify most relevant methods of management development, and to explain how self-management strategies can be supported for universities to become better off. In addition, the concept of quality convergence is expressed on the basis of the self-development process.

The Use of Mobile Apps to Improve Diabetes Self-Management: A Cross-Sectional Study (Preprint)

2021 ◽  
Author(s):  
Satoshi Inagaki ◽  
Kenji Kato ◽  
Kozue Abe ◽  
Takeshi Kawamoto ◽  
Hiroaki Takahashi ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Diabetes Management ◽  
The Self ◽  
Walking Distance ◽  
Self Management ◽  
Care Providers ◽  
Management Behavior ◽  
Cross Sectional ◽  
Significant Difference ◽  
Management Behaviors

BACKGROUND Background: Healthcare apps on smartphones are used to retrieve health information and manage health. A number of healthcare apps have been employed to support diabetes self-management, and evidence has accumulated on the outcomes of interventions using individual apps. However, only a small percentage of all healthcare apps have a proven effect on people with diabetes, and it is unclear which apps should be recommended in non-English-speaking countries. Verifying that the healthcare apps used by people with diabetes are useful for diabetes management behaviors will help healthcare providers know which apps to recommend. OBJECTIVE Objective: The purpose of this study was to clarify whether and how the use of healthcare apps affects the self-management behavior of people with diabetes. METHODS Methods: A cross-sectional questionnaire was given to patients with type 2 diabetes who were pre-registered with an Internet research company. The items on the questionnaire involved the use of smartphone healthcare apps, diabetes self-management behaviors (Japan Summary of Diabetes Self-Care Activities [J-SDSCA]), motivations for diabetes self-management (autonomous motivation and controlled motivation), and feelings of competence in self-management (Perceived Competence for Diabetes Scale). To examine whether a healthcare app had an effect on the self-management behavior score, a multiple regression analysis was conducted with the J-SDSCA score as the objective variable. RESULTS Results: Of the 253 participants, 61 (24.1%) indicated that they were currently using a healthcare app. Those using a healthcare app had a significantly higher J-SDSCA score than those not using one (beta =.15, 95% CI 0.60–3.54, P <.001). Regarding the frequency of exercise, the use of apps for steps and walking distance led to a significant difference (beta =.22, 95% CI 0.59–1.90, P <.001). For general diet, the use of any healthcare app had no significant effect (P =.22). CONCLUSIONS Conclusions: The use of healthcare apps was beneficial for diabetes self-management. Given that even non-specialized apps can improve diabetes self-management behaviors, health care providers should encourage patients to use apps that are tailored to their preferences and that are easy to use long-term. The use of healthcare apps was particularly associated with increased exercise regimen efforts. Recommending the use of healthcare apps, especially apps that include pedometers, could be useful when patients have problems with exercise.

Self-management activities in diabetes care: a systematic review

2013 ◽  
Vol 37 (4) ◽  
pp. 513 ◽  
Author(s):  
Meaghan E. Coyle ◽  
Karen Francis ◽  
Ysanne Chapman
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Blood Glucose ◽  
Management Practices ◽  
Management Strategies ◽  
Self Management ◽  
Foot Care ◽  
Change Over Time ◽  
Glucose Testing ◽  
Over Time

Objective To identify the range of self-management activities people diagnosed with diabetes engage in to manage their disease, the frequency of use, and whether self-management practices change over time. Methods A systematic review of the literature was undertaken. Thirty-two studies identified through electronic databases met the inclusion criteria and were included in the review. Results The study found that people living with diabetes undertake regular self-management activities and that compliance with medication regimes is high. Adherence, however, varied with respect to blood glucose testing, diet, physical activity and foot care. Levels of physical activity were not found to change over time. Evidence suggests that some people with diabetes modify their self-management practices in response to factors such as holidays. Conclusions The review suggests that the majority of people with diabetes self-manage, although there is variation in adherence to key self-management activities. How self-management practices change over time and whether this impacts on health outcomes is an area for future research. What is known about the topic? Self-management is key to diabetes control; however, many papers have described adherence as variable. Although there is a growing body of knowledge on adherence to self-management strategies, the question of whether self-management practices change over time has not been explored. What does this paper add? This review found that adherence to medication regimes was highest of all self-management strategies, whereas considerable variation exists for self-monitoring of blood glucose, dietary changes, physical activity and foot care. The findings suggest that adherence varies under special circumstances; however, the question of whether self-management practices change over time remains unanswered. What are the implications for practitioners? Continued efforts are necessary to promote awareness of the importance of diabetes self-management and adherence to regular self-care.

scholarly journals Self-management and its associated factors among people living with diabetes in Blantyre, Malawi: a cross-sectional study

2021 ◽  
Vol 2 ◽  
pp. 161
Author(s):  
Chimwemwe Kwanjo Banda ◽  
Belinda T. Gombachika ◽  
Moffat J. Nyirenda ◽  
Adamson Sinjani Muula
Keyword(s):  
Logistic Regression ◽  
Self Efficacy ◽  
Social Cognitive ◽  
Management Practices ◽  
Cross Sectional Study ◽  
The Self ◽  
Self Management ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated

Background: Self-management is key to the control of glycaemia and prevention of complications in people with diabetes. Many people with diabetes in Malawi have poorly controlled glucose and they experience diabetes-related complications. This study aimed to assess diabetes self-management behaviours and to identify factors associated with it among people with diabetes at Queen Elizabeth Central Hospital, Blantyre, Malawi. Methods: This cross-sectional study recruited 510 adults attending a diabetes clinic at a teaching referral hospital in southern Malawi. The social cognitive theory was applied to identify factors associated with following all recommended self-management behaviours. Data on participants’ demographics, clinical history, diabetes knowledge, self-efficacy, outcome expectations, social support, environmental barriers and diabetes self-management were collected. Univariate and multivariate logistic regression analyses were conducted to identify factors associated with following all self-management behaviours. Results: The mean age of participants was 53.6 (SD 13.3) years. The majority (82%) were females. Self-reported medication adherence within the last seven days was 88.6%; 77% reported being physically active for at least 30 minutes on more than three days in the previous seven days; 69% reported checking their feet every day and inspecting inside their shoes; 58% reported following a healthy diet regularly. Only 33% reported following all the self-management behaviours regularly.  Multiple logistic regression analysis showed that self-efficacy was the only social cognitive factor associated with following all the self-management practices (p < 0.001). Conclusions: Participants in our study were not consistently achieving all self-management practices with dietary practices being the least adhered to behaviour by many. To improve self-management practices of people with diabetes, current health education programs should not only aim at improving diabetes related knowledge but also self-efficacy. Adopting interventions that promote self-efficacy in diabetes patients such as exposure to role models, peer education, providing positive feedback, and counselling is recommended.

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