Feasibility of the PHYZ X 2U program: a mobile and cloud-based outreach service to improve chronic disease outcomes in underserviced rural communities

2019 ◽  
Vol 25 (6) ◽  
pp. 539
Author(s):  
Serene S. Paul ◽  
Tania Gardner ◽  
Angela Hubbard ◽  
Justin Johnson ◽  
Colleen G. Canning ◽  
...  

Chronic disease is prevalent in rural communities, but access to health care is limited. Allied health intervention, incorporating behaviour change and exercise, may improve health outcomes. PHYZ X 2U is a new service delivery model incorporating face-to-face consultations via a mobile clinic and remote health coaching, delivered by physiotherapy and exercise physiology clinicians and university students on clinical placement, to provide exercise programs to people living with chronic disease in rural New South Wales, Australia. This pilot study evaluated the feasibility and acceptability of PHYZ X 2U by evaluating participants’ goal attainment, exercise, quality of life and behaviour change following participation in the 12-week program, and amount of health coaching received. Sixty-two participants with one or more chronic diseases set a total of 123 goals. Thirty-nine (63%) participants completed the program, with 59% of these achieving their goals and 43% progressing in their attitudes and behaviour towards exercise. Weekly exercise increased by 1h following program participation (P=0.02), but quality of life remained unchanged (P=0.24). Participants who completed the program received more health coaching than those lost to follow up. PHYZ X 2U can increase access to allied health for people with chronic disease living in rural and remote areas. Refining the service to maximise program adherence and optimally manage a broad range of chronic diseases is required.

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Teresa Santos ◽  
Margarida Gaspar de Matos ◽  
Adilson Marques ◽  
Celeste Simões ◽  
Isabel Leal ◽  
...  

Living with a chronic disease (CD) in adolescence involves new multifaceted challenges. This study aims to conduct a psychosocial characterization of a group of adolescents with chronic diseases in a hospital setting and to compare such dimensions for the total group and for different diseases. A cross-sectional study included 135 adolescents with chronic diseases (51.9% boys; 48.1% girls), having an average age of 14±1.5 years (SD=1.5) and attending a paediatric outpatient department in a hospital setting. Statistically significant differences were found among the different chronic diseases for the variables self-regulation (adolescents with diabetes had significantly higher competencies) and multiple psychosomatic symptoms (adolescents with neurologic diseases reported significantly more complaints). Boys presented both better health-related quality of life and psychosomatic health when compared to girls. No statistically significant differences were observed for health-related quality of life, psychosomatic health, resilience, and social support. These findings bring important suggestions especially while planning interventions, which must take into account the promotion of a healthy psychosocial development, through an inclusive perspective (covering different chronic diseases), that take into consideration specific and gendered approaches. Such suggestions might help healthcare professionals to better plan interventions in order to increase their effectiveness.


2000 ◽  
Vol 56 (4) ◽  
pp. 10-16 ◽  
Author(s):  
C. J. Eales ◽  
A. V. Stewart ◽  
T. D. Noakes

The major objective of medical care is to preserve life. If patients cannot be cured and are left with residual chronic diseases then the aim is to provide them with the means to lead a life of quality within the confines of their disease. Rehabilitation in chronic disease means restoring or creating a life of acceptable quality. This is achieved by restoring the patient to optimal physiological and psychological health compatible with the extent of the disease and in doing so improve the quality of life. Improved quality of life is the best indicator of successful rehabilitation. Patients with chronic diseases are increasingly expected to become partners when decisions are made regarding their therapy and therefor their evaluation of the outcome is of great importance. There are a number of shortcomings with quality of life evaluations and the most important one is that it does not seem to be adequately defined. Another major problem is that this evaluation usually focuses on aspects of physical function and few studies include subjective indicators. It is generally felt that the opinion of the spouse or caregiver should be included.


Author(s):  
Emilio Casariego ◽  
Ana Cebrián-Cuenca ◽  
José Llisterri ◽  
Rafael Micó-Pérez ◽  
Domingo Orozco-Beltran ◽  
...  

Background: Chronic diseases are currently the main cause of morbidity and mortality and represent a major challenge to healthcare systems. The objective of this study is to know Spanish public opinion about chronic disease and how it affects their daily lives. Methods: Through a telephone or online survey of 24 questions, data was gathered on the characteristics of the respondents and their knowledge and experiences of chronic diseases. Results: Of the 2522 survey respondents, 325 had a chronic disease and were carers, 1088 had a chronic disease and were not carers, 140 did not have a chronic disease but were carers, and 969 did not have chronic disease and were not carers. The degree of knowledge on these diseases was good or very good for 69.4%, 56.0%, 62.2%, and 46.7%, respectively, for each group. All the groups agreed that chronic diseases mainly affect mood, quality of life and having to make sacrifices. Conclusions: Knowledge about chronic diseases is relatively good, although it can be improved among the Spanish population, especially among patients who report having a chronic disease and play the role of carers. However, it is important to continue maintaining the level of information and training concerning these diseases.


Author(s):  
Mohammed Safeer V S ◽  
Dr M Umesh

According to various studies conducted on HRQoL it was found that patient counselling provided by a pharmacist play an appreciable role in improving the HRQoL of the patients. Patient counselling plays a pivotal role in improving patient understanding about the disease and medications. Patient counselling can be provided through various mediums such as face-to-face counselling, patient information leaflets. The HRQoL of the patients can be assessed using various questionnaires available. The aim of the study is to assess influence of pharmacist provided counselling on improving the Health related quality of life (HRQoL) in patients with chronic diseases. Over a period of nine months, a prospective interventional study was held in the department of General Medicine JSS Hospital, Mysuru. Ethics committee approval was obtained for this study. Patients that fulfilled the requirements were included in the research and were educated about the disease, medications, importance of medication adherence and lifestyle modifications. All the necessary data have been gathered and recorded. The HRQoL was determined before and after educating using HRQoL (SF-20) questionnaire respectively. Paired student t-test had been used to compare the pre and post HRQoL scores. Out of 227 subjects admitted in the study, 66(29%) had Diabetes Mellitus, 55(24%) had been diagnosed with hypertension, 52(23%) had been diagnosed with stroke and 54(24%) were diagnosed with bronchial asthma. All the study participants with different chronic disease were given with the HRQoL questionnaire before education (baseline) and after education (follow up). There was a significant increase in the patients’ HRQoL scores after education as p-value which has been calculated was <0.001. Educating or counselling the patients regarding disease, medication and medication adherence helps in improving the Health related quality of life (HRQoL) in chronic disease patients.


Purpose: The Chronic Disease Management Program (Prolanis) implemented at Puskesmas with the concept of cost effective and efficient health services in the National Health Insurance (JKN). Prolanis intended for participants who suffer from chronic diseases to achieve optimal Quality of Life (QoL). Therefore, aims this study to assess the effectiveness of Prolanis services in improving the quality of life of JKN participants in Banyuasin District. Methodology: This study using a cross sectional design, data was taken in 2018. Population is people who suffer from chronic diseases (type 2 Diabetes Mellitus and Hypertension). Sample was pre-elderly dan elderly as Puskesmas visitors in Banyuasin District was chosen by proportional random sampling (n=250 people). Data collection used the WHOQOL-BREF questionnaire through direct interviews with respondents. Data analysis using bivariate and multivariate analysis. Main Findings: The respondents were most underage of 60 years (participants of 63.4% and non-participants of 74.1%). Most of respondents had moderate exercise habits (participants of 59.9% and non-participants of 51.9%), among others: walking, jogging, cycling, or other sports. Body Mass Index in normal category (participants of 62.0% and non-participants of 64.8%). It’s known that Prolanis participants (61.3%) and non-participants (53.7%) have majority perception of a good QoL. Respondents who are willing to become Prolanis participants are around 142 people (56.8%). Application: The Puskesmas can improve socialization and motivation for participants to use Prolanis services, and to increase the frequency of gymnastic club activities continuously so that there are many time choices. Novelty: Participants who used Prolanis services more often, will have a higher QoL score. Respondents who visited Prolanis services 3-4 times had a tendency to be 1.3 times more likely to have a good perception of QoL (RR:1.33; CI95%:0.71–2.49).


2019 ◽  
Vol 40 (1) ◽  
pp. 127-146 ◽  
Author(s):  
John P. Allegrante ◽  
Martin T. Wells ◽  
Janey C. Peterson

A majority of the US adult population has one or more chronic conditions that require medical intervention and long-term self-management. Such conditions are among the 10 leading causes of mortality; an estimated 86% of the nation's $2.7 trillion in annual health care expenditures goes toward their treatment and management. Patient self-management of chronic diseases is increasingly essential to improve health behaviors, health outcomes, and quality of life and, in some cases, has demonstrated effectiveness for reducing health care utilization and the societal cost burden of chronic conditions. This review synthesizes the current state of the science of chronic disease self-management interventions and the evidence for their effectiveness, especially when applied with a systematic application of theories or models that account for a wide range of influences on behavior. Our analysis of selected outcomes from randomized controlled trials of chronic disease self-management interventions contained in 10 Cochrane systematic reviews provides additional evidence to demonstrate that self-management can improve quality of life and reduce utilization across several conditions.


2021 ◽  
pp. 030802262110344
Author(s):  
Emma Kemmis ◽  
Samantha Ashby ◽  
Lesley MacDonald-Wicks

Introduction The aim was to explore occupational participation and quality of life (QoL) for power mobility device users with chronic disease. Methods Arksey and O’Malley’s framework for scoping reviews was used. Six data bases were searched using keywords: wheelchair, scooter, QoL and participation. Data were extracted with coding and thematic analysis performed. Results Forty-one articles met the inclusion criteria. An overarching theme of enhanced QoL was identified with subthemes of (i) independence, (ii) enabling participation in instrumental activities of daily living, (iii) enhanced social participation and leisure, (iv) environmental barriers to occupational participation, (vi) power mobility device (PMD) performance concerns impacting occupational participation and (vii) overcoming risk of harm through PMD training. Conclusion The scoping review identified a heterogeneity of study designs and outcome measures, which makes comparison between studies difficult. For people with chronic diseases, PMDs improve independence in occupational participation, particularly in IADL, social participation and leisure. Unfortunately, improved QoL was often inferred, without the use of an outcome measure. Areas which impacted occupational participation for PMD users were environmental barriers and a lack of PMD training. Further research is needed to understand the impact of a PMD on QoL and occupational participation for those with chronic disease.


2021 ◽  
Vol 10 (12) ◽  
pp. 894-898
Author(s):  
Barsha Pathak Gadapani ◽  
Rukman M. Manapurath

BACKGROUND Quality of life (QOL) measures have become a vital and frequently essential fragments to appraise health-care outcomes and is a powerful tool to determine the impact of healthcare as well as personal care for the population who are surviving with chronic diseases especially when ultimate cure for that specific disease is not conceived. METHODS This is a cross-sectional study where consecutive random sampling was utilised to select 258 diabetics from the general outpatient department (OPD) of a tertiary care center and QOL was evaluated among the diabetics and diabetics with osteoarthritis (OA) using modified Flanagan’s QOL scale. RESULTS The mean QOL among diabetics was 88.28 (± 2.62), mean QOL among diabetics with OA (hand) was 87.26 (± 2.22), mean QOL among diabetics with OA (knee) was 85.37 (± 2.14), mean QOL among diabetics with OA (knee and hand) was 83 (± 2.33), mean QOL among diabetics with OA with radiological changes was 80.77 (± 2.9). CONCLUSIONS The presence of more than one chronic disease significantly deteriorates the QOL. The domains of QOL are further affected when the chronic disease progresses further. KEY WORDS Quality of Life (QOL), Diabetes, Osteoarthritis, Chronic Diseases


Author(s):  
Teodora Dimcheva ◽  
Gergana Foreva ◽  
Radost Аsenova ◽  
Nonka Маteva ◽  
Todor Stoev ◽  
...  

The management of chronic diseases shall be considered a priority in the work of the global international institutions, which are related to health policies. In the search for effective and efficient solutions for the treatment of chronic diseases, scientists are developing different programs. In Bulgaria the continuous monitoring of chronically ill people is defined with the term dispensarization. The objective of the research is to analyze the place and the role of patients in the monitoring of their chronic diseases and how the concept of quality of life relates to this process.Method The research in focus groups is planned within a research project on the monitoring of chronic diseases. Five group discussions were held. The number of participants in all focus groups was sixty.Results The two discussed directions - the active role of the patient and the focus on the results are weak links in the current organization of the care for the chronically ill people. The topic of creating and adopting an Act of the patient was also presented, in which to be paid attention to the evaluation of the quality of life. In general was brought the need for a clear delineation of the roles and the competencies of everyone involved in the monitoring process of chronic diseases. The chronic disease cannot be defined only as a medical problem, as there are economic and social, including political consequences.Conclusions The management of the chronic disease requires coordination of doctor-patient interaction, a model of partnership and trust in the relations, self-management of the condition by the patients and their inclusion in the health team. The most important step to achieve this goal is the education of the patients, increasing their knowledge and motivation, psycho-emotional support, instilling hope and faith in the capacity of the patients.


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