scholarly journals Applying the resources and supports in self-management framework to examine ophthalmologist-patient communication and glaucoma medication adherence

2015 ◽  
Vol 30 (5) ◽  
pp. 693-705 ◽  
Author(s):  
B. Sleath ◽  
D. M. Carpenter ◽  
S. J. Blalock ◽  
R. Sayner ◽  
K. W. Muir ◽  
...  
Ophthalmology ◽  
2015 ◽  
Vol 122 (4) ◽  
pp. 748-754 ◽  
Author(s):  
Betsy Sleath ◽  
Susan J. Blalock ◽  
Delesha M. Carpenter ◽  
Robyn Sayner ◽  
Kelly W. Muir ◽  
...  

2017 ◽  
Vol 16 (1) ◽  
Author(s):  
Yuliati Hasanah

Abstract Self management is a strategy in which the cognitive behavioral approach in the application, subject to the expected full attendance during the intervention process. NAP is an HIV patient and had undergone antiretroviral therapy. Saturation, fatigue experienced by NAP during the ARV therapy, so found some times subject medical leave provisions. Healthy behavior in a sick person (in this case a person suffering from HIV) one of which is adherent to treatment that must be endured. This research aims to gain result the applying of self management techniques against medication adherence of NAP patient with HIV in the Balai Rehabilitasi Sosial Pamardi PutraYogyakarta. This study focuses on the application of self-management techniques that include self-monitoring, self reinforcement and self evaluation of medication adherence that includes aspects of belief, accept and act on the subject. Researchers used quantitative approach by using the method of single subject design N = 1 model A-B-A now where the measurements and observations made in each phase. The subject in this study as many as one person with initials NAP. The purpose of this study is to look at the effect of applying the self management technique against NAP’s medication adherence. The results of this study indicate that the application of self-management techniques have a positive effect in improving NAP’s medication adherence with skor of 2SD smaller than skor of the mean phase difference A2 and A1. Stages through the application of this technique is extracting and determining value, set goals, formulate an action plan, the implementation of self-monitoring, self reinforcement and self evaluation. Based on the analysis of the results of the study concluded that the motivation, participation and discipline will determine the effectiveness of the intervention. Support of family members is also important to support the commitment of the subjects in this therapy.Keywords: behavior modification, HIV, medication adherence, self-management AbstrakManusia dapat memutuskan dan menentukan dirinya sendiri. Berdasarkan asumsi tersebut teknik self management merupakan salah satu teknik modifikasi perilaku yang memfokuskan pada regulasi diri. Self management merupakan salah satu strategi dalam pendekatan perilaku kognitif dimana dalam penerapannya, subjek diharapkan kehadiran penuh selama proses intervensi. NAP adalah seorang penderita HIV dan telah menjalani terapi ARV. Kejenuhan, kelelahan dialami NAP selama mengikuti terapi ARV, sehingga ditemukan beberapa kali subjek meninggalkan ketentuan-ketentuan medis. Perilaku sehat pada orang sakit (dalam kasus ini seseorang yang menderita HIV) salah satunya adalah patuh terhadap pengobatan yang harus dijalani. Penelitian ini bertujuan untuk memperoleh hasil dari penerapan teknik self management terhadap kepatuhan berobat subjek NAP sebagai penderita HIV di Balai Rehabilitasi Sosial Pamardi Putra Yogyakarta. Penelitian ini menitikberatkan pada penerapan teknik self management yang mencakup self monitoring, self reinforcement dan self evaluation terhadap kepatuhan berobat yang mencakup aspek mempercayai (belief), menerima (accept) dan tindakan (act) pada subjek. Peneliti menggunakan pendekatan kuantitatif dengan menggunakan metode single subject design N=1 dengan model A-B-A dinama pengukuran dan pengamatan dilakukan di setiap fase. Subjek dalam penelitian ini sebanyak satu orang dengan inisial NAP. Tujuan penelitian ini adalah untuk melihat pengaruh penerapan teknik self management terhadap kepatuhan berobat subjek NAP. Hasil penelitian ini menunjukkan bahwa penerapan teknik self management mempunyai pengaruh positif dalam meningkatkan kepatuhan berobat subjek NAP dengan nilai 2SD lebih kecil dari selisih mean fase A2 dan A1. Tahapan yang dilalui dalam penerapan teknik ini adalah penggalian dan penentuan value, menetapkan goals, merumuskan rencana tindakan, pelaksanaan self monitoring, self reinforcement dan self evaluation. Berdasarkan analisa hasil penelitian disimpulkan bahwa motivasi, peran serta dan kedisiplinan akan menentukan efektifitas intervensi. Dukungan anggota keluarga juga penting untuk mendukung komitmen subjek dalam terapi ini.Kata kunci:  HIV, kepatuhan berobat, modifikasi perilaku, self management


2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
C Yang ◽  
Z Hui ◽  
S Zhu ◽  
X Wang ◽  
G Tang ◽  
...  

Abstract Introduction Medication self-management support has been recognised as an essential element in primary health care to promote medication adherence and health outcomes for older people with chronic conditions. A patient-centred intervention empowering patients and supporting medication self-management activities could benefit older people. This pilot study tested a newly developed medication self-management intervention for improving medication adherence among older people with multimorbidity. Method This was a two-arm randomised controlled trial. Older people with multimorbidity were recruited from a community healthcare centre in Changsha, China. Participants were randomly allocated to either a control group receiving usual care (n = 14), or to an intervention group receiving three face-to-face medication self-management sessions and two follow-up phone calls over six weeks, targeting behavioural determinants of adherence from the Information-Motivation-Behavioural skills model (n = 14). Feasibility was assessed through recruitment and retention rates, outcome measures collection, and intervention implementation. Follow-up data were measured at six weeks after baseline using patient-reported outcomes including medication adherence, medication self-management capabilities, treatment experiences, and quality of life. Preliminary effectiveness of the intervention was explored using generalised estimating equations. Results Of the 72 approached participants, 28 (38.89%) were eligible for study participation. In the intervention group, 13 participants (92.86%) completed follow-up and 10 (71.42%) completed all intervention sessions. Ten participants (71.42%) in the control group completed follow-up. The intervention was found to be acceptable by participants and the intervention nurse. Comparing with the control group, participants in the intervention group showed significant improvements in medication adherence (β = 0.26, 95%CI 0.12, 0.40, P < 0.001), medication knowledge (β = 4.43, 95%CI 1.11, 7.75, P = 0.009), and perceived necessity of medications (β = −2.84, 95%CI -5.67, −0.01, P = 0.049) at follow-up. Conclusions The nurse-led medication self-management intervention is feasible and acceptable among older people with multimorbidity. Preliminary results showed that the intervention may improve patients’ medication knowledge and beliefs and thus lead to improved adherence.


2013 ◽  
Vol 90 (8) ◽  
pp. 883-897 ◽  
Author(s):  
Laura E. Dreer ◽  
Christopher A. Girkin ◽  
Lisa Campbell ◽  
Andy Wood ◽  
Liyan Gao ◽  
...  

2021 ◽  
Author(s):  
Geneva Kay Jonathan ◽  
Cynthia A Dopke ◽  
Tania Michaels ◽  
Clair R Martin ◽  
Chloe Ryan ◽  
...  

BACKGROUND Bipolar disorder is a severe mental illness characterized by recurrent episodes of depressed, elevated and mixed mood states. Pharmacological management combined with adjunctive psychotherapy can decrease symptoms, lower relapse rates and improve quality of life; however, access to psychotherapy is limited. Mental health technologies such as smartphone applications are being studied as a means to increase access to and enhance the effectiveness of adjunctive psychotherapies for bipolar disorder. These studies have demonstrated that individuals with bipolar disorder find this intervention format acceptable, but our understanding of how people utilize and integrate these tools into their behavior change and maintenance processes remains limited. OBJECTIVE The objective of this study was to explore how individuals with bipolar disorder perceive and utilize a smartphone intervention for health behavior change and maintenance. METHODS Individuals with bipolar disorder participated in a pilot study of LiveWell, a smartphone-based self-management intervention. At the end of the study, all participants completed in-depth qualitative exit interviews. The behavior change framework developed to organize the intervention design was used to deductively code behavioral targets and determinants involved in target engagement and inductive coding was used to identify themes not captured by this framework. RESULTS In terms of behavioral targets, participants emphasized the importance of managing mood episode related signs and symptoms. They also discussed the importance of maintaining regular routines, sleep duration, and medication adherence. In addition, participants emphasized that receiving support from a coach as well as seeking and receiving assistance from family, friends and providers was important for managing behavioral targets and staying well. In terms of determinants, participants stressed the important role of monitoring for their behavior change and maintenance efforts. Participants indicated that monitoring facilitated self-awareness and reflection which they felt was valuable for staying well. Some participants also felt that the intervention facilitated learning information necessary for managing bipolar disorder but others felt that the information provided was too basic. CONCLUSIONS In addition to addressing acceptability, satisfaction, and engagement, person-based design of mental health technologies can be used to understand how people experience the impact of these technologies on their behavior change and maintenance efforts. This understanding may then be used to guide ongoing intervention development. In this study, participants discussed their perceptions that managing signs and symptoms and maintaining regular routines, sleep duration, and medication adherence were important for staying well and that monitoring played an important role in these efforts. These perceptions aligned with the intervention's primary behavioral targets and use of a monitoring tool as a core intervention feature. However, participants also highlighted how the intervention encouraged involving family and friends in their change efforts. While content addressing building and engaging supports was included in the intervention, this was not a primary intervention target. Participant feedback thus indicates that developing additional content and tools to address building and engaging social support may be an important avenue for improving LiveWell. Our findings suggest that using a comprehensive behavior change framework to understand participant perceptions of their behavior change and maintenance efforts may help facilitate ongoing intervention development. CLINICALTRIAL NCT02405117


10.2196/17776 ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. e17776 ◽  
Author(s):  
Ran Li ◽  
Ning Liang ◽  
Fanlong Bu ◽  
Therese Hesketh

Background Effective treatment of hypertension requires careful self-management. With the ongoing development of mobile technologies and the scarcity of health care resources, mobile health (mHealth)–based self-management has become a useful treatment for hypertension, and its effectiveness has been assessed in many trials. However, there is a paucity of comprehensive summaries of the studies using both qualitative and quantitative methods. Objective This systematic review aimed to measure the effectiveness of mHealth in improving the self-management of hypertension for adults. The outcome measures were blood pressure (BP), BP control, medication adherence, self-management behavior, and costs. Methods A systematic search was conducted using 5 electronic databases. The snowballing method was used to scan the reference lists of relevant studies. Only peer-reviewed randomized controlled trials (RCTs) published between January 2010 and September 2019 were included. Data extraction and quality assessment were performed by 3 researchers independently, adhering to the validation guideline and checklist. Both a meta-analysis and a narrative synthesis were carried out. Results A total of 24 studies with 8933 participants were included. Of these, 23 studies reported the clinical outcome of BP, 12 of these provided systolic blood pressure (SBP) and diastolic blood pressure (DBP) data, and 16 articles focused on change in self-management behavior and medication adherence. All 24 studies were included in the narrative synthesis. According to the meta-analysis, a greater reduction in both SBP and DBP was observed in the mHealth intervention groups compared with control groups, −3.78 mm Hg (P<.001; 95% CI −4.67 to −2.89) and −1.57 mm Hg (P<.001; 95% CI −2.28 to −0.86), respectively. Subgroup analyses showed consistent reductions in SBP and DBP across different frequencies of reminders, interactive patterns, intervention functions, and study duration subgroups. A total of 16 studies reported better medication adherence and behavioral change in the intervention groups, while 8 showed no significant change. Six studies included an economic evaluation, which drew inconsistent conclusions. However, potentially long-term financial benefits were mentioned in all economic evaluations. All studies were assessed to be at high risk of bias. Conclusions This review found that mHealth self-management interventions were effective in BP control. The outcomes of this review showed improvements in self-management behavior and medication adherence. The most successful mHealth intervention combined the feature of tailored messages, interactive communication, and multifaceted functions. Further research with longer duration and cultural adaptation is necessary. With increasing disease burden from hypertension globally, mHealth offers a potentially effective method for self-management and control of BP. mHealth can be easily integrated into existing health care systems. Trial Registration PROSPERO CRD42019152062; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=152062


2018 ◽  
Vol 6 (2) ◽  
pp. 82
Author(s):  
Ni Kadek Sutini ◽  
Ni Wayan Septarini ◽  
I Made Ady Wirawan ◽  
Anak Agung Sagung Sawitri

Background and purpose: Hypertension is a major risk factor for stroke. Despite efforts to control hypertension with pharmacological and non-pharmacological therapies, the prevalence of and death from stroke is reported to be increasing. This study aims to determine the association of hypertension self-management with the incidence of stroke in patients with hypertension.Methods: A case-control study was conducted involving 44 patients suffering from hypertension and who had suffered a stroke as a case, as well as 44 patients with hypertension and no stroke as a control. Data on self-management of diet, physical activity, stress mitigation efforts, alcohol consumption, and medication adherence were collected using self administered questionnaire. Data on the diagnosis of hypertension, stroke and history of comorbidities were obtained from the patient's medical records. Multivariatee analysis using logistic regression was employed to assess the association between hypertension self-management with the incidence of stroke in patients with hypertension.Results: Characteristics of cases and controls did not differ in education, marital and socioeconomic status, but differed in age and employment. Multivariate analysis showed that there were three components of hypertension self-management associated with the incidence of stroke, namely poor adherence to medication (AOR=7.28; 95%CI: 2.19-24.17), poor self-management of stress (AOR=5.45; 95%CI: 1.56-18.99), and poor management of self-regulated diet (AOR=5.28; 95%CI: 1.31-21.32).Conclusions: Medication adherence, diet and stress management are the three main components of self-management that are associated with stroke events among hypertension patients. Efforts to increase medication adherence, diet and stress management should be enhanced.


2020 ◽  
Author(s):  
Yanbing Zeng ◽  
Chenxi Lin ◽  
Fan Chen ◽  
Ya Fang

Abstract Background: A low HRQOL can be a risk factor for future cardiovascular events in patients with hypertension. Therefore, HRQOL should receive attention and be improved in the treatment of hypertension. The purpose of this study was to investigate if the association between treatment groups and Health-Related Quality of Life (HRQOL) of hypertension mediated by self-management, and to determine which factors of hypertension self-management influenced HRQOL. Methods: Hypertensive patients were selected by multi-stage stratified samping from “1+1+N” Physicians intervention (PI) group and the conventional management (CM) group in 5 communities of Xiamen, China. Patients were cross-sectionally assessed by validated self-reports using self-management Behavior Rating Scale and Quality of Life Instruments for Hypertension. A structural equation modeling (SEM) and a path analytic model were used to assess if the association between treatment groups and HRQOL was mediated by self-management. Results: A total of 1207 patients were included, of whom 48.55% were in the PI group. The average score of the HRQOL scale was 86.68, and the average score of the PI group was higher than the CM group (87.35 vs 86.04, respectively). Similar findings were observed for the self-management scale, in which the average score of the PI group was higher than the CM group (76.32 vs 72.00, respectively). Patients in the PI group had higher levels of self-management compared to the CM group except for management of emotion. SEM showed that the association between treatment groups and HRQOL was significantly mediated by self-management (a*b, 95% confidence intervals CI: 0.02,0.07) and that the single mediator (self-management) model explained 76.67% of the intervention effect. In the multivariable mediation model, the association between treatment groups and HRQOL was significantly mediated by management of medication adherence, sport and diet.Conclusions: The findings presented good evidence supporting that treatment groups are linked to HRQOL of hypertension via self-management. Specifically, management of medication adherence, sport, diet, and emotion are important for improving HRQOL.


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