Self-management factors associated with quality of life among women with endometriosis: a cross-sectional Australian survey

2020 ◽  
Author(s):  
Rebecca O’Hara ◽  
Heather Rowe ◽  
Jane Fisher
Keyword(s):  
Quality Of Life ◽  
Chronic Disease ◽  
Disease Management ◽  
Self Efficacy ◽  
Chronic Disease Management ◽  
Self Management ◽  
Cross Sectional ◽  
Female Population ◽  
Management Factors

Abstract STUDY QUESTION What self-management factors are associated with quality of life among women with endometriosis? SUMMARY ANSWER Greater self-efficacy was associated with improved physical and mental quality of life. WHAT IS KNOWN ALREADY Women with endometriosis have an impaired quality of life compared to the general female population. However, most studies have investigated quality of life in a hospital or clinic setting rather than a community setting and the association between self-management factors and quality of life have not, to date, been investigated. STUDY DESIGN, SIZE, DURATION A cross-sectional, population-based online survey was performed, which was advertised through women’s, community and endometriosis-specific groups. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 620 women completed the survey for this study. Mental and physical quality of life was assessed using the standardized SF36v2 questionnaire. Self-management factors included self-efficacy, partners in health (active involvement in managing the condition) and performance of self-care activities. Treatment approaches included the use of hormonal treatment, pain medications and complementary therapies and whether the participant had a chronic disease management plan. Hierarchical regression analyses were used to examine whether self-management and treatment factors were associated with quality of life. MAIN RESULTS AND THE ROLE OF CHANCE Both physical and mental quality of life were significantly lower among women with endometriosis compared to the mean scores of the general Australian female population (P < 0.001). Physical quality of life was positively associated with income sufficiency (P < 0.001) and greater self-efficacy (P < 0.001), but negatively associated with age (P < 0.001), pain severity (P < 0.001), use of prescription medications (P < 0.001), having a chronic disease management plan (P < 0.05) and number of self-care activities (P < 0.05). Mental quality of life was positively associated with being older (P < 0.001), partnered (P < 0.001), having a university education (P < 0.05), increasing self-efficacy (P < 0.001) and higher partners in health scores (P < 0.001). LIMITATIONS, REASONS FOR CAUTION Results are derived from a cross-sectional study and can only be interpreted as associations not as causal relationships. The sample was more educated, more likely to speak English and be born in Australia than the general Australian female population of the same age, which may influence the generalizability of these results. WIDER IMPLICATIONS OF THE FINDINGS This study investigated a knowledge gap by investigating quality of life of women with endometriosis in a large community sample. Self-efficacy was significantly associated with both physical and mental quality of life. Supporting women with endometriosis to improve self-efficacy through a structured chronic disease management programme may lead to improvements in this aspect of wellbeing. STUDY FUNDING/COMPETING INTEREST(S) R.O. undertook this research as part of her PhD at Monash University, which was supported by an Australian Government Research Training Program Stipend. J.F. is the Finkel Professor of Global Public Health, which was supported by the Finkel Family Foundation. There are no conflicts of interest to declare. TRIAL REGISTRATION NUMBER NA.

Outcomes and opportunities: a nurse-led model of chronic disease management in Australian general practice

2013 ◽  
Vol 19 (2) ◽  
pp. 150 ◽  
Author(s):  
Diann S. Eley ◽  
Elizabeth Patterson ◽  
Jacqui Young ◽  
Paul P. Fahey ◽  
Chris B. Del Mar ◽  
...  
Keyword(s):  
Quality Of Life ◽  
General Practice ◽  
Chronic Disease ◽  
Disease Management ◽  
Chronic Disease Management ◽  
Models Of Care ◽  
Practice Nurses ◽  
Australian General Practice ◽  
General Practices

The Australian government’s commitment to health service reform has placed general practice at the centre of its agenda to manage chronic disease. Concerns about the capacity of GPs to meet the growing chronic disease burden has stimulated the implementation and testing of new models of care that better utilise practice nurses (PN). This paper reports on a mixed-methods study nested within a larger study that trialled the feasibility and acceptability of a new model of nurse-led chronic disease management in three general practices. Patients over 18 years of age with type 2 diabetes, hypertension or stable ischaemic heart disease were randomised into PN-led or usual GP-led care. Primary outcomes were self-reported quality of life and perceptions of the model’s feasibility and acceptability from the perspective of patients and GPs. Over the 12-month study quality of life decreased but the trend between groups was not statistically different. Qualitative data indicate that the PN-led model was acceptable and feasible to GPs and patients. It is possible to extend the scope of PN care to lead the routine clinical management of patients’ stable chronic diseases. All GPs identified significant advantages to the model and elected to continue with the PN-led care after our study concluded.

scholarly journals SAT0652-HPR CHRONIC DISEASE MANAGEMENT AND HEALTH TECHNOLOGY READINESS OF PATIENTS WITH SYSTEMIC SCLEROSIS IN SWITZERLAND – A CROSS-SECTIONAL STUDY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1285.1-1285
Author(s):  
A. Kocher ◽  
M. Simon ◽  
C. Chizzolini ◽  
O. Distler ◽  
A. A. Dwyer ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Systemic Sclerosis ◽  
Disease Management ◽  
Chronic Disease Management ◽  
Health Technology ◽  
Self Management ◽  
Technology Readiness ◽  
Management Support ◽  
Research Support ◽  
Cross Sectional

Background:People living with systemic sclerosis (SSc) often lack access to coordinated, specialized care and self-management support from qualified healthcare professionals. Such gaps lead to significant unmet health needs and inability to get preventive services. The Chronic Care Model (CCM) has been used to guide disease management across a wide range of chronic conditions. The CCM often uses e-health technologies to address self-management problems, connect patients with clinicians and reduce patient travel requirements.Objectives:To evaluate current SSc care practice patterns and elicit patient health technology readiness to define relevant aspects and resources needed to improve SSc chronic disease management.Methods:We employed a cross-sectional survey using the 20-item Patient Assessment of Chronic Illness Care (PACIC) instrument to assess how aspects of SSc care align with key components of the CCM.1Six items drawn from the ‘5A’ (ask, advise, agree, assist, and arrange) model of behavioural counselling were included (all 26 items scored on 5-point scale, 1=never to 5=always). Acceptance of health technology was evaluated by adapting and combining questionnaires from Vanhoof2and Halwas3. German and French speaking SSc patients (>18 years) were recruited from university/cantonal hospitals and the Swiss scleroderma patients’ association. Participants completed anonymous paper/online questionnaires. Data were analysed descriptively.Results:Of 101 SSc patients, most were female (76%), spoke German (78%) and had a median age of 60 years (IQR: 50-68). Median disease duration was 8 years (IQR: 5-15), spanning a range of severity (31% limited SSc, 36% diffuse SSc, 3% overlap syndrome). One-quarter (25%) did not know their disease subset.The mean overall PACIC score was relatively low (2.91±0.95) indicating that care was ‘never’ to ‘generally not’ aligned with the CCM. Lowest mean subscale scores related to Follow-up/ Coordination (2.64±1.02), Goal setting (2.68±1.07) and Problem-solving/Contextual Counselling (2.94±1.22). The single items ‘Given a copy of my treatment plan’ (1.99±1.38) and ‘Encouraged to attend programs in the community’ (1.89±1.16) were given the lowest ratings. The ‘5A’ summary score was 2.84±0.97.In terms of technology readiness, 43% completed the survey online. Most participants owned a smartphone (81%), laptop (63%) and/or desktop computer (46%). The overwhelming majority of patients (91%) reported using the Internet in the last year – primarily for communication (e.g. emails, text messages). Participants indicated relatively little experience with e-health applications and participating in SSc online forums or self-help groups.Conclusion:To improve chronic disease management of SSc patients in Switzerland, current care practices warrant reengineering taking CCM components into account. Specific unmet needs relate to self-management support, help patients set individualized goals, and coordinate continuous care. Web-based technologies incorporating user-centred design principles may be a reasonable option for improving care.References:[1]Glasgow, RE, et al. Development and validation of the Patient Assessment of Chronic Illness Care (PACIC).Med Care2005; 43(5): 436-44[2]Vanhoof, JM, et al. Technology Experience of Solid Organ Transplant Patients and Their Overall Willingness to Use Interactive Health Technology. J Nurs Scholarsh2018; 50(2): 151-62[3]Halwas, N, et al. eHealth literacy, Internet and eHealth service usage: a survey among cancer patients and their relatives. J Cancer Res Clin Oncol2017; 143(11): 2291-99Disclosure of Interests:Agnes Kocher Grant/research support from: Sandoz to support the development of an eLearning module for patients with rheumatic diseases., Michael Simon: None declared, Carlo Chizzolini Consultant of: Boehringer Ingelheim, Roche, Oliver Distler Grant/research support from: Grants/Research support from Actelion, Bayer, Boehringer Ingelheim, Competitive Drug Development International Ltd. and Mitsubishi Tanabe; he also holds the issued Patent on mir-29 for the treatment of systemic sclerosis (US8247389, EP2331143)., Consultant of: Consultancy fees from Actelion, Acceleron Pharma, AnaMar, Bayer, Baecon Discovery, Blade Therapeutics, Boehringer, CSL Behring, Catenion, ChemomAb, Curzion Pharmaceuticals, Ergonex, Galapagos NV, GSK, Glenmark Pharmaceuticals, Inventiva, Italfarmaco, iQvia, medac, Medscape, Mitsubishi Tanabe Pharma, MSD, Roche, Sanofi and UCB, Speakers bureau: Speaker fees from Actelion, Bayer, Boehringer Ingelheim, Medscape, Pfizer and Roche, Andrew A. Dwyer: None declared, Peter Villiger Consultant of: MSD, Abbvie, Roche, Pfizer, Sanofi, Speakers bureau: Roche, MSD, Pfizer, Ulrich Walker Grant/research support from: Ulrich Walker has received an unrestricted research grant from Abbvie, Consultant of: Ulrich Walker has act as a consultant for Abbvie, Actelion, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, MSD, Novartis, Pfizer, Phadia, Roche, Sandoz, Sanofi, and ThermoFisher, Paid instructor for: Abbvie, Novartis, and Roche, Speakers bureau: Abbvie, Actelion, Bristol-Myers Squibb, Celgene, MSD, Novartis, Pfizer, Phadia, Roche, Sandoz, and ThermoFisher, Dunja Nicca: None declared

scholarly journals The relationship between self efficacy, general self disease management strategies in coping with pain and quality of life in migraine patients: Testing a theoretical methodMigrenli hastalarda öz yeterlik, ağrıyla başa çıkmada kendi genel yönetim stratejileri ve yaşam kalitesi arasındaki ilişkinin incelenmesi: Teorik bir modelin test edilmesi

2017 ◽  
Vol 14 (4) ◽  
pp. 3389
Author(s):  
İlknur Özkan ◽  
Nermin Olgun
Keyword(s):  
Quality Of Life ◽  
Chronic Disease ◽  
Disease Management ◽  
Self Efficacy ◽  
Latent Variables ◽  
Management Strategies ◽  
Self Report ◽  
Quality Of Life Scale ◽  
Item Scale

This study was designed to test a causality-based model in the context of relationships based on social cognitive theory and the literature for the purpose of examining how self-efficacy directly affects the quality of life of migraine patients through self- disease management skills. The sample of the study consisted of 343 migraine patients selected from a neurology outpatient clinic. The data were collected with self-report method using Self-Disease Management Strategies Scale in Migraine Patients developed by the researcher, the interview form, Quality of Life Scale in Migraine Patients and Self-Efficacy for Managing Chronic Disease 6-Item Scale, SEMCD developed by Stanford Patient Education Research Center. In order to test construct validity of scales, explanatory factor analysis and varimax axis rotation basic component analysis were applied. Cronbach's alpha values were calculated by analyzing the internal consistency for all the items in the scales and each subscale of the scale. The model proposed in the study was tested by using Structural Equation Model (SEM)-path analysis with latent variables in lisrel program. In SEM application, direct effect of self-efficacy on quality of life and indirect effect on self-disease management strategies were found to be statistically significant.  Based on these results, self-efficacy can be thought to be a determinant of self-efficacy, quality of life of the patient and the patient’s skills of using self-disease management strategies. In order to improve the quality of life of migraine patients, their self-efficacy on disease management should be assessed and nursing practices should be planned to increase their confidence in the ability of preventing and managing migraine attacks.Extended English abstract is in the end of PDF (TURKISH) file. ÖzetBu araştırma, öz yeterliğin migrenli hastaların yaşam kalitesini doğrudan ve kendi kendine hastalık yönetimi becerileri aracılığı yoluyla ne kadar etkilediğini incelemek amacıyla, sosyal bilişsel teoriden temel alarak ve literatüre dayalı ilişkiler bağlamında nedensellik temelli bir modeli test etmek amacıyla planlanmıştır. Araştırmanın örneklemini bir nöroloji polikliniğinden seçilen 343 migren hastası oluşturmuştur. Veriler, görüşme formu, araştırmacı tarafından geliştirilen Migrenli Hastalarda Kendi Kendine Hastalık Yönetim Stratejileri Ölçeği, Migrenli Hastalarda Yaşam Kalitesi Ölçeği ve Standford Hasta Eğitim Araştırma Merkezi tarafından geliştirilen[WK1] [Mh2]  Kronik Hastalıkları Yönetimde Öz Yeterlik Ölçeği (Self-Efficacy for Managing Chronic Disease 6-Item Scale, SEMCD) kullanılarak öz bildirim yöntemi ile toplanmıştır. Ölçeklerin yapı geçerliliğini test etmek için açıklayıcı faktör analizi ve varimaks’ eksen döndürme temel bileşenler analizi uygulanmıştır. Ölçeklerde yer alan maddelerin tamamı ve ölçeğin her bir alt boyutu için, iç tutarlık analizi yapılarak, Cronbach Alfa değerleri hesaplanmıştır. Araştırmada ileri sürülen model, lisrel programında Yapısal Eşitlik Modeli (YEM)-örtük değişkenlerle yol analizi yapılarak test edilmiştir. YEM uygulamasında öz yeterliğin yaşam kalitesi üzerine doğrudan etkisi ve kendi kendine hastalık yönetim stratejileri üzerinden dolaylı etkisi istatiksel olarak anlamlı bulunmuştur. Bu sonuçlara dayanarak; öz yeterlik, hastanın yaşam kalitesini, kendi kendine hastalık yönetim stratejilerini kullanma becerisinin bir belirleyicisi olarak düşünülebilir. Migrenli hastaların yaşam kalitesini artırmak için migrenli hastaların hastalık yönetimi konusundaki öz yeterlikleri değerlendirilmeli, hemşirelik uygulamaları hastaların migren atağını önleme ve yönetme becerileri konusundaki kendilerine olan güvenini artıracak şekilde planlanmalıdır.// // // //

scholarly journals Effectiveness of Chronic Disease Management Program in Improving the Quality of Life under National Health Insurance

2019 ◽  
Vol 8 (2S9) ◽  
pp. 245-250
Keyword(s):  
Quality Of Life ◽  
Health Insurance ◽  
Chronic Disease ◽  
Disease Management ◽  
Chronic Diseases ◽  
National Health Insurance ◽  
Disease Management Program ◽  
Chronic Disease Management ◽  
Management Program

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).

scholarly journals Capitated versus fee-for-service reimbursement and quality of care for chronic disease: a US cross-sectional analysis

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Sri Lekha Tummalapalli ◽  
Michelle M. Estrella ◽  
Deanna P. Jannat-Khah ◽  
Salomeh Keyhani ◽  
Said Ibrahim
Keyword(s):  
Quality Of Care ◽  
Chronic Disease ◽  
Disease Management ◽  
Chronic Disease Management ◽  
Cross Sectional ◽  
Practice Characteristics ◽  
Sectional Analysis ◽  
Payment Models ◽  
Statin Use

Abstract Background Upcoming alternative payment models Primary Care First (PCF) and Kidney Care Choices (KCC) incorporate capitated payments for chronic disease management. Prior research on the effect of capitated payments on chronic disease management has shown mixed results. We assessed the patient, physician, and practice characteristics of practices with capitation as the majority of revenue, and evaluated the association of capitated reimbursement with quality of chronic disease care. Methods We performed a cross-sectional analysis of visits in the United States’ National Ambulatory Medical Care Survey (NAMCS) for patients with hypertension, diabetes, or chronic kidney disease (CKD). Our predictor was practice reimbursement type, classified as 1) majority capitation, 2) majority FFS, or 3) other reimbursement mix. Outcomes were quality indicators of hypertension control, diabetes control, angiotensin-converting enzyme inhibitor or angiotensin receptor blocker (ACEi/ARB) use, and statin use. Results About 9% of visits were to practices with majority capitation revenue. Capitated practices, compared with FFS and other practices, had lower visit frequency (3.7 vs. 5.2 vs. 5.2, p = 0.006), were more likely to be located in the West Census Region (55% vs. 18% vs. 17%, p < 0.001), less likely to be solo practice (21% vs. 37% vs. 35%, p = 0.005), more likely to be owned by an insurance company, health plan or HMO (24% vs. 13% vs. 13%, p = 0.033), and more likely to have private insurance (43% vs. 25% vs. 19%, p = 0.004) and managed care payments (69% vs. 23% vs. 26%, p < 0.001) as the majority of revenue. The prevalence of controlled hypertension, controlled diabetes, ACEi/ARB use, and statin use was suboptimal across practice reimbursement types. Capitated reimbursement was not associated with differences in hypertension, diabetes, or CKD quality indicators, in multivariable models adjusting for patient, physician, and practice characteristics. Conclusions Practices with majority capitation revenue differed substantially from FFS and other practices in patient, physician, and practice characteristics, but were not associated with consistent quality differences. Our findings establish baseline estimates of chronic disease quality of care performance by practice reimbursement composition, informing chronic disease care delivery within upcoming payment models.

scholarly journals Elderly Quality of Life and Its Predictors in Chronic Disease Management Program: Indonesian Version of WHOQOL-BREF and WHOQOL-OLD

2020 ◽  
Vol 52 (1) ◽  
pp. 28-34
Author(s):  
Melly Lionthina ◽  
Guswan Wiwaha ◽  
Sharon Gondodiputro ◽  
Hadyana Sukandar ◽  
Insi Farida Desy Arya ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Disease ◽  
Disease Management ◽  
Disease Management Program ◽  
Chronic Disease Management ◽  
Management Program
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