Talking the same language on patient empowerment: Development and content validation of a taxonomy of self‐management interventions for chronic conditions

Objective The aim of this study was to investigate the effectiveness of occupational therapist-/physiotherapist-guided fatigue self-management for individuals with chronic conditions. Methods Eight databases, including MEDLINE and EMBASE, were searched until September 2019 to identify relevant studies. Randomised controlled trials and quasi-experimental studies of self-management interventions specifically developed or delivered by occupational therapists/physiotherapists to improve fatigue symptoms of individuals with chronic conditions were included. A narrative synthesis and meta-analysis were conducted to determine the effectiveness of fatigue self-management. Results Thirty-eight studies were included, and fatigue self-management approaches led by occupational therapists/physiotherapists were divided into six categories based on the intervention focus: exercise, energy conservation, multimodal programmes, activity pacing, cognitive-behavioural therapy, and comprehensive fatigue management. While all exercise programmes reported significant improvement in fatigue, other categories showed both significant improvement and no improvement in fatigue. Meta-analysis yielded a standardised mean difference of the overall 13 studies: 0.42 (95% confidence interval:−0.62 to − 0.21); standardised mean difference of the seven exercise studies was −0.55 (95% confidence interval: −0.78 to −0.31). Discussion Physical exercises inspired by the self-management principles may have positive impacts on fatigue symptoms, quality of life, and other functional abilities.

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SELF-MANAGEMENT INTERVENTIONS IN DIALYSIS FACILITIES

Innovation in Aging ◽

10.1093/geroni/igz038.267 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S69-S69

Author(s):

Tiffany R Washington ◽

Chivon Mingo ◽

Matthew L Smith

Keyword(s):

Chronic Conditions ◽

Management Program ◽

Self Management ◽

Dialysis Patients ◽

Management Intervention ◽

Management Interventions ◽

Implementation Studies ◽

Dialysis Facilities ◽

The Relationship ◽

Management Behaviors

Abstract There have been few attempts to implement self-management interventions in dialysis facilities. This paper presentation describes four studies that constitute the formative work necessary to inform implementation. Studies one and two examined the relationship between psychosocial factors and kidney disease self-management, finding depression and cognitive decline to undermine self-management behaviors. Study three examined how dialysis patients define and think about self-management and their interest in participating in a self-management program. Among them, 78% affirmed they would participate in a self-management program if it were offered in their facility. Finally, when examining organizational readiness to implement a self-management intervention in dialysis facilities, staff perceived it to be consistent with facility values, and agreed they were well-positioned to implement the program. Taken together, these findings suggest a self-management intervention would be beneficial and supported, but would require thoughtful implementation considerations. These studies have implications for developmental self-management research with other chronic conditions.

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Self-Management Interventions to Improve Activities of Daily Living and Rest and Sleep for Adults With Chronic Conditions: A Systematic Review

American Journal of Occupational Therapy ◽

10.5014/ajot.2021.046946 ◽

2021 ◽

Vol 75 (4) ◽

pp. 7504190010p1

Author(s):

Stacy Smallfield ◽

Lea Fang ◽

Darby Kyler

Keyword(s):

Systematic Review ◽

Activities Of Daily Living ◽

Chronic Conditions ◽

Daily Living ◽

Self Management ◽

Management Interventions

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PROMOTING SUCCESSFUL CHRONIC DISEASE SELF-MANAGEMENT THROUGH COMMUNITY-BASED INTERVENTIONS

Innovation in Aging ◽

10.1093/geroni/igz038.266 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S68-S69

Author(s):

Tiffany R Washington ◽

Laura N Gitlin ◽

Matthew L Smith

Keyword(s):

Older Adults ◽

Chronic Disease ◽

Chronic Conditions ◽

Health Management ◽

Negative Impact ◽

Self Management ◽

Community Based Interventions ◽

Community Based ◽

Factors Affecting ◽

Management Interventions

Abstract Persistent chronic conditions are among the top leading causes of death in the U.S. The majority of older adults live with two or more chronic conditions. When poorly managed, chronic conditions can result in negative psychosocial and health outcomes such as low quality of life, diminished mood, workforce withdrawal, high healthcare utilization, and disability. Fortunately, chronic disease self-management interventions show promise in reducing the negative impact of chronic conditions on health status. This symposium will highlight formative work and recent findings of community-based interventions that promote successful self-management. To start, presenter one will describe findings from four studies that constitute the formative work necessary to inform implementation of self-management interventions in community and healthcare settings. Next, presenter two will report findings from an effectiveness trial of a technology-based intervention to support hypertension self-management. Then, presenter three will describe findings on the feasibility of a Health Passport tool to promote self-health management among individuals with physical limitations. Finally, presenter four will describe factors affecting attendance among African Americans with arthritis who participated in a national dissemination of Chronic Disease Self-Management Education programs. Collectively, these presentations will provide practical evidence and science-based recommendations for ways to increase successful chronic disease self-management and ultimately improve population health among older adults.

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Development of a Smartphone Application for the Treatment of Chronic pain in Older adults based on the Daily life experience of Pain Ecological monitoring and management app for chronic pain in older adults - EMMA: Protocol for the EMMA design and feasibility study (Preprint)

10.2196/preprints.26930 ◽

2021 ◽

Author(s):

Katharina Ledermann

Keyword(s):

Older Adults ◽

Chronic Pain ◽

Older People ◽

Chronic Conditions ◽

Daily Life ◽

Ecological Monitoring ◽

Cognitive Behavioral ◽

Self Management ◽

Trial Period ◽

Management Interventions

BACKGROUND Chronic pain is a complex problem for many older adults that affects both physical functioning and psychological well-being. Mobile health (mHealth) technologies have shown promise in supporting older persons in managing chronic conditions. Cognitive behavior therapy (CBT) is recommended for older people with chronic pain. However, online treatment programs for chronic pain are not aimed at the needs of older people and offer standard therapies without providing tailored treatment for this population. OBJECTIVE To address this problem, we will develop a psychological internet-based intervention based on ecological monitoring of daily life experiences with chronic pain, called EMMA to support self-management of chronic pain in older adults. METHODS The key clinical and engagement features of the intervention were established through the integration of evidence-based material from cognitive behavioral therapy for the treatment of chronic pain in older adults. The development process uses a CoDesign approach and actively involves the end-users in the design process by incorporating feedback from focus groups with older adults in order to inform a user centered intervention design. For the CoDesign process, we will include 10 older adults without chronic pain that will discuss the requirements in workshops in order to ensure suitability for older adults. In order to test the feasibility and acceptability of the intervention, we will include a sample of 30 older adults with chronic pain that will test all features of the intervention for a period of eight consecutive weeks. After the trial period, validated instruments to assess usability and acceptability, as well as influence on pain levels and associated physical and psychological symptoms will be filled out by the participants. Participants will be invited to take part in a semi-structured telephone interview after the trial period to explore their experiences using the app. Required changes to assure usability and acceptability will afterwards directly implemented in the application. RESULTS EMMA brings together a strong body of evidence using cognitive behavioral and self-management theory with contemporary mHealth principles, allowing for a cost-effective intervention irrespective of place and time to target chronic pain in older adults. CONCLUSIONS Given the ubiquity of mHealth interventions for chronic conditions, the results of this study may serve to inform the development of tailored pain self-management interventions.

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