scholarly journals Self-management approaches for osteoarthritis in the hand: a 2×2 factorial randomised trial

2013 ◽  
Vol 74 (1) ◽  
pp. 108-118 ◽  
Author(s):  
Krysia Dziedzic ◽  
Elaine Nicholls ◽  
Susan Hill ◽  
Alison Hammond ◽  
June Handy ◽  
...  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Lindsay Welch ◽  
Rosanna Orlando ◽  
Sharon X. Lin ◽  
Ivaylo Vassilev ◽  
Anne Rogers

2019 ◽  
Vol 25 (4) ◽  
pp. 359 ◽  
Author(s):  
Chelsea Baird ◽  
Marta H. Woolford ◽  
Carmel Young ◽  
Margaret Winbolt ◽  
Joseph Ibrahim

Effective self-management is the cornerstone of chronic disease self-management. However, self-management of chronic disease in patients with comorbid dementia is particularly challenging. It is vital that clinicians, patients and carers work collaboratively to tailor self-management programs to each patient with dementia. This study aimed to identify barriers and facilitators of successful self-management in the context of cognitive impairment in order to optimise the capacity for self-management for persons with dementia (PWD). A qualitative study based on semistructured interviews was conducted in Victoria, Australia. Interviews were conducted with 12 people (employed in the ambulatory and dementia care sectors), representing six health services. Participants identified a healthcare system that is complex, not dementia friendly and not accommodating the needs of PWD who have comorbidities. Individual and systemic barriers contributed to ineffective self-management. Chronic disease support programs do not routinely undertake cognitive assessment or have guidelines for modified management approaches for those with cognitive impairment. Support needs to be long-term and requires a specialised skillset that recognises not only chronic disease management, but also the effect of cognition on self-management. Although formal guidelines are needed, care also needs to be tailored to individual cognitive abilities and deficits.


2016 ◽  
Vol 17 (04) ◽  
pp. 351-360 ◽  
Author(s):  
Peter Keogh ◽  
Peter Weatherburn ◽  
David Reid

AimTo explore the experiences of people with HIV (PWHIV) using general practitioner (GP) services in order to identify barriers to use.BackgroundTraditionally, GPs have little involvement in the care of PWHIV. However, as HIV becomes a chronic condition and the population of PWHIV ages, there is a need to increase this involvement. Despite high levels of GP registration, the majority of PWHIV in London report that their GP is not involved in their HIV care.MethodsThis paper presents qualitative findings from a mixed method study of PWHIV’s experiences of clinical services. Survey respondents were purposively sampled to recruit 51 PWHIV who took part in eight focus groups. Participants were asked about their experience of using GP services.FindingsThree factors emerged which mediated experiences of GP care.Competence: respondents were concerned about the potential for misdiagnosis of symptoms, lack of awareness of the health needs of PWHIV and experiences of prescribing, which could lead to drug interactions.Continuity: not being able to get appointments quickly enough, not being able to see the same doctor twice and not being able to keep the same GP when one changed address were experienced as impediments to use.Communication: lack of communication between GPs and HIV specialists led to what participants called ‘patient ping-pong’ where they found themselves acting as a go-between for different clinical specialists trying to make sense of their care.ConclusionMeaningful contact between HIV specialists and GPs is likely to allay concerns about competency as treatment and care decisions can be taken collaboratively between the GP, HIV specialist and patient. A key component of acceptable GP care for PWHIV is likely to be the application of long-term condition management approaches, which includes empowered patient self-management.


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