scholarly journals Perspectives of healthcare providers on the nutritional management of patients on haemodialysis in Australia: an interview study

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e020023 ◽  
Author(s):  
Jessica Stevenson ◽  
Allison Tong ◽  
Katrina L Campbell ◽  
Jonathan C Craig ◽  
Vincent W Lee
Keyword(s):  
Clinical Status ◽  
Management Strategies ◽  
Healthcare Providers ◽  
Dietary Behaviour ◽  
Self Management ◽  
Multidisciplinary Teams ◽  
Nutritional Management ◽  
Nutritional Care ◽  
Management Interventions ◽  
Collaborative Structures

ObjectiveTo describe the perspectives of healthcare providers on the nutritional management of patients on haemodialysis, which may inform strategies for improving patient-centred nutritional care.DesignFace-to-face semistructured interviews were conducted until data saturation, and thematic analysis based on principles of grounded theory.Setting21 haemodialysis centres across Australia.Participants42 haemodialysis clinicians (nephrologists and nephrology trainees (15), nurses (12) and dietitians (15)) were purposively sampled to obtain a range of demographic characteristics and clinical experiences.ResultsSix themes were identified: responding to changing clinical status (individualising strategies to patient needs, prioritising acute events, adapting guidelines), integrating patient circumstances (assimilating life priorities, access and affordability), delineating specialty roles in collaborative structures (shared and cohesive care, pivotal role of dietary expertise, facilitating access to nutritional care, perpetuating conflicting advice and patient confusion, devaluing nutritional specialty), empowerment for behaviour change (enabling comprehension of complexities, building autonomy and ownership, developing self-efficacy through engagement, tailoring self-management strategies), initiating and sustaining motivation (encountering motivational hurdles, empathy for confronting life changes, fostering non-judgemental relationships, emphasising symptomatic and tangible benefits, harnessing support networks), and organisational and staffing barriers (staffing shortfalls, readdressing system inefficiencies).ConclusionsOrganisational support with collaborative multidisciplinary teams and individualised patient care were seen as necessary for developing positive patient–clinician relationships, delivering consistent nutrition advice, and building and sustaining patient motivation to enable change in dietary behaviour. Improving service delivery and developing and delivering targeted, multifaceted self-management interventions may enhance current nutritional management of patients on haemodialysis.

Theoretical and contextual considerations for self-management strategies of children and adolescents with chronic diseases: An integrative review

2021 ◽  
pp. 136749352110136
Author(s):  
Logan J Camp-Spivey ◽  
Ayaba Logan ◽  
Michelle Nichols
Keyword(s):  
Children And Adolescents ◽  
Chronic Diseases ◽  
Management Strategies ◽  
Healthcare Providers ◽  
Integrative Review ◽  
Self Management ◽  
Intervention Delivery ◽  
Management Interventions ◽  
Technological Platforms ◽  
Management Behaviors

The primary aim of this integrative review was to critically evaluate and synthesize published, peer-reviewed research to better understand self-management strategies of children and adolescents with chronic diseases. This review was guided by Whittemore and Knafl’s methodological framework. The Pediatric Self-management Model provided the theoretical framework for understanding how self-management behaviors operate within the domains of individual, family, community, and healthcare systems. In June 2019, the electronic databases of EBSCOhost, PubMed, and Scopus, along with reference lists of applicable studies, were searched for appropriate publications. The initial searches yielded 920 citations. Of these, 11 studies met inclusion criteria. A key finding was that involving children and adolescents in the design and delivery phases of interventions was most effective in improving self-management when the interventions did not outweigh cognitive ability or maturity level. In addition, incorporating self-efficacy promotion into self-management interventions may lead to greater sense of responsibility and improved health outcomes. In terms of intervention delivery of self-management strategies, the use of technological platforms and devices was revealed as a promising avenue for youth. A final implication was the importance of family members, peers, and healthcare providers in supporting children and adolescents in adopting self-management behaviors.

scholarly journals Effectiveness of self-management interventions in inflammatory arthritis: a systematic review informing the 2021 EULAR recommendations for the implementation of self-management strategies in patients with inflammatory arthritis

RMD Open ◽  
2021 ◽  
Vol 7 (2) ◽  
pp. e001647
Author(s):  
Andréa Marques ◽  
Eduardo Santos ◽  
Elena Nikiphorou ◽  
Ailsa Bosworth ◽  
Loreto Carmona
Keyword(s):  
Systematic Review ◽  
Full Text ◽  
Inflammatory Arthritis ◽  
Data Extraction ◽  
Management Strategies ◽  
Psychosocial Interventions ◽  
Behavioural Therapy ◽  
Self Management ◽  
Cochrane Library ◽  
Management Interventions

ObjectiveTo perform a systematic review (SR) on the effectiveness of self-management interventions, in order to inform the European League Against Rheumatism Recommendations for its implementation in patients with inflammatory arthritis (IA).MethodsThe SR was conducted according to the Cochrane Handbook and included adults (≥18 years) with IA. The search strategy was run in Medline through PubMed, Embase, Cochrane Library, CINAHL Plus with Full Text, and PEDro. The assessment of risk of bias, data extraction and synthesis were performed by two reviewers independently. A narrative Summary of Findings was provided according to the Grading of Recommendations, Assessment, Development and Evaluation.ResultsFrom a total 1577 references, 57 were selected for a full-text review, and 32 studies fulfilled the inclusion criteria (19 randomised controlled trials (RCTs) and 13 SRs). The most studied self-management components were specific interactive disease education in ten RCTs, problem solving in nine RCTs, cognitive–behavioural therapy in eight RCTs, goal setting in six RCTs, patient education in five RCTs and response training in two RCTs. The most studied interventions were multicomponent or single exercise/physical activity in six SRs, psychosocial interventions in five SRs and education in two SRs. Overall, all these specific components and interventions of self-management have beneficial effects on IAs-related outcomes.ConclusionsThe findings confirm the beneficial effect of the self-management interventions in IA and the importance of their implementation. Further research should focus on the understanding that self-management is a complex intervention to allow the isolation of the effectiveness of its different components.

scholarly journals Education and Social Support as Key Factors in Osteoarthritis Management Programs: A Scoping Review

Arthritis ◽  
2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Shabana Amanda Ali ◽  
Kristina M. Kokorelias ◽  
Joy C. MacDermid ◽  
Marita Kloseck
Keyword(s):  
Social Support ◽  
Health Care ◽  
Scoping Review ◽  
Health Care Professionals ◽  
Management Strategies ◽  
Self Management ◽  
Cochrane Library ◽  
Group Settings ◽  
Management Interventions ◽  
Positive Social Interaction

Systematic reviews of self-management programs for osteoarthritis suggest minimal evidence of benefit and indicate substantial heterogeneity in interventions. The purpose of this scoping review was to describe the nature of self-management interventions provided to patients with osteoarthritis focusing on the inclusion and type of education and social support components. We searched PsycINFO, EMBASE, MEDLINE, and Cochrane Library databases from 1990 to 2016 to identify studies addressing community-based management strategies for osteoarthritis that included aspects of disease-specific education and ongoing social support. Results are presented as a narrative synthesis to facilitate integration of diverse evidence. Data were extracted from 23 studies that met our inclusion and exclusion criteria, describing complex, multicomponent interventions for osteoarthritis. All studies included education components, and 18 of these were osteoarthritis-specific. Social support was most often offered through peers and health care professionals, but also through exercise trainers/instructors and researchers, and lasted between 5 and 52 weeks. We charted positive social interaction offered by peers in group settings and emotional/informational support offered by health care professionals. Overall, descriptions of self-management provided limited documentation of the rationale or content of the programs. This suggests that more precise definitions of the theoretical underpinnings, components, and mechanisms would be useful for greater insight into best practices for osteoarthritis self-management programs.

scholarly journals Living with severe asthma: the role of perceived competence and goal achievement

2019 ◽  
pp. 174239531988410
Author(s):  
Daniela Eassey ◽  
Helen K Reddel ◽  
Kath Ryan ◽  
Lorraine Smith
Keyword(s):  
Severe Asthma ◽  
Healthcare Providers ◽  
Perceived Competence ◽  
Goal Achievement ◽  
Self Management ◽  
Future Research ◽  
Face To Face ◽  
Management Interventions ◽  
Semistructured Interviews

Objective The overall aim of this study was to examine, among individuals living with severe asthma, the role of perceived competence in achieving their goals. Methods Qualitative research methods were used to conduct in-depth semistructured interviews. Interviews were video and/or audio recorded, transcribed and analyzed inductively and deductively, informed by the self-determination theory construct of perceived competence. Thirty-six face-to-face interviews, lasting 1.5–4 h, were conducted across Australia. Results Feeling competent to achieve asthma goals played a role in participants’ ability to achieve broader goals. Their desire to achieve their broader goals was strongly driven by their perceived ability to master managing their condition, which at times required more than medical strategies. Two main themes were discerned from the analysis: (1) learning how to look after yourself: self-care is important and (2) reaching an agreement with severe asthma: being at one with the illness. Discussion This study highlighted the influence of perceived competence on self-management and goal achievement in severe asthma. Healthcare providers could explore patients’ perceived competence to set and achieve goals, as a self-management strategy. Future research should consider these findings when developing and implementing patient-driven, self-management interventions for those living with severe asthma.

Self-Management of Tinnitus

2017 ◽  
pp. 420-439
Keyword(s):  
Coping Skills ◽  
Negative Impact ◽  
Management Strategies ◽  
Healthcare Providers ◽  
Chronic Health Condition ◽  
Health Condition ◽  
Self Management ◽  
Psychosocial Effects ◽  
Acoustic Stimuli ◽  
Significant Negative Impact

Tinnitus (i.e., ringing, hissing, or buzzing in the ears) occurs without external acoustic stimuli and can be constant or intermittent. While individuals with tinnitus may be told that nothing can be done about tinnitus, multiple tinnitus management strategies exist that can help to reduce individuals’ focus on and distress due to tinnitus and to increase their coping skills. Given that at the present time there is no cure for most forms of tinnitus, it must be self-managed as a chronic health condition. This chapter discusses multiple approaches that healthcare providers can utilize to assist individuals in navigating the range of functional and psychosocial effects triggered by tinnitus, in order to help decrease the potential for it having a significant negative impact on their lives.

Exploring and Prioritization of Mobile-Based Self-Management Strategies for HIV Care

2019 ◽  
Vol 19 (3) ◽  
pp. 288-296
Author(s):  
Esmaeil Mehraeen ◽  
Reza Safdari ◽  
SeyedAhmad SeyedAlinaghi ◽  
Niloofar Mohammadzadeh
Keyword(s):  
Quality Of Life ◽  
Management Strategies ◽  
Healthcare Services ◽  
Point Of View ◽  
Hiv Care ◽  
Self Management ◽  
Second Phase ◽  
People Living With Hiv ◽  
Management Interventions

Background: Appropriate mobile-based self-management strategies can be as new approaches to decelerate the HIV infection progression and improve the quality of life. This study aims at (i) identifying in the literature mobile-based self-management strategies for HIV care and (ii) prioritizing those from the point of view of infectious diseases specialists. This study provides some clues to design useful mobile-based self-management tools for HIV patients, from the point of view of practitioners. Methods: This mixed methods study was done in two main phases. In the first phase, a review was conducted in: PubMed, Web of Science, Science Direct, Scopus, and Ovid. In this manner, related studies published between 2010 and 2017 and in the English language were reviewed. In the second phase, identified mobile-based self-management strategies were scored and prioritized by 23 participants. Frequency distribution and mean reports were calculated using SPSS statistical software. Results: By detailed reviewing of 24 related articles, the HIV mobile-based self-management strategies were identified in 47 categories and subcategories. According to the findings, "enhance the quality of life" was the main self-management strategy addressed by reviewed studies. However, "antiretroviral therapy and medication adherence" was reported at a higher rate to be a more helpful strategy than "enhance the quality of life". Conclusion: In this study, helpful HIV mobile-based self-management strategies were identified that can be used to guide self-management interventions which have the potential to improve the healthcare services for people living with HIV.

Patients’, carers’ and providers’ experiences and requirements for support in self-management of multiple sclerosis: a qualitative study

2013 ◽  
Vol 1 (2) ◽  
pp. 457 ◽  
Author(s):  
Francesca Deibel ◽  
Michelle Edwards ◽  
Adrian Edwards
Keyword(s):  
Multiple Sclerosis ◽  
Qualitative Study ◽  
Focus Groups ◽  
Management Strategies ◽  
Strong Relationship ◽  
Information Provision ◽  
Self Management ◽  
Management Skills ◽  
Long Term Conditions ◽  
Management Interventions

Background: Self-management is a process increasingly promoted for the management of long term conditions, both for ethical reasons of enhancing autonomy and for likely cost-effectiveness, but the nature and scope of self-management strategies are currently highly variable.Objective: To identify patients’, carers’ and clinicians’ current experiences of self-management in multiple sclerosis (MS) and their recommendations for the development of a future MS-specific self-management interventionMethods: Qualitative study using focus groups and semi-structured one-to-one interviews with a purposive sample. Three focus groups were held with 25 patients with moderate to advanced multiple sclerosis and 4 carers. Ten clinicians were interviewed. Data underwent thematic analysis.Results: Participants perceived multiple aspects of MS to be amenable to self-management, but identified a current lack of service provision to support their abilities to self-manage. Participants felt that to address both the physical and psychosocial challenges posed by MS required better information provision, a strong relationship with healthcare professionals and a toolkit of self-management skills. Participants expressed concern at the lack of consideration currently given to carers, which should be addressed in future provision.Conclusion: The diverse experiences of patients living with MS warrant a multidisciplinary, flexible and proactive approach to improve their self-management capabilities, acknowledging both patients’ and carers’ unmet needs. The findings can be used to guide the development of future self-management interventions specific to individuals with multiple sclerosis.

scholarly journals Self-management strategies to consider to combat endometriosis symptoms during the COVID-19 pandemic

2020 ◽  
Vol 2020 (2) ◽  
Author(s):  
Mathew Leonardi ◽  
Andrew W Horne ◽  
Katy Vincent ◽  
Justin Sinclair ◽  
Kerry A Sherman ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pain Relief ◽  
Expert Opinion ◽  
Management Strategies ◽  
Healthcare Providers ◽  
Psychological Effects ◽  
Self Management ◽  
Educational Resource ◽  
Underlying Condition

ABSTRACT The care of patients with endometriosis has been complicated by the coronavirus disease 2019 (COVID-19) pandemic. Medical and allied healthcare appointments and surgeries are being temporarily postponed. Mandatory self-isolation has created new obstacles for individuals with endometriosis seeking pain relief and improvement in their quality of life. Anxieties may be heightened by concerns over whether endometriosis may be an underlying condition that could predispose to severe COVID-19 infection and what constitutes an appropriate indication for presentation for urgent treatment in the epidemic. Furthermore, the restrictions imposed due to COVID-19 can impose negative psychological effects, which patients with endometriosis may be more prone to already. In combination with medical therapies, or as an alternative, we encourage patients to consider self-management strategies to combat endometriosis symptoms during the COVID-19 pandemic. These self-management strategies are divided into problem-focused and emotion-focused strategies, with the former aiming to change the environment to alleviate pain, and the latter address the psychology of living with endometriosis. We put forward this guidance, which is based on evidence and expert opinion, for healthcare providers to utilize during their consultations with patients via telephone or video. Patients may also independently use this article as an educational resource. The strategies discussed are not exclusively restricted to consideration during the COVID-19 pandemic. Most have been researched before this period of time and all will continue to be a part of the biopsychological approach to endometriosis long after COVID-19 restrictions are lifted.

scholarly journals Self-Management Interventions to Prevent the Secondary Condition of Pain in People with Disability Due to Mobility Limitations

2016 ◽  
Vol 5 ◽  
pp. RPO.S12339 ◽  
Author(s):  
Katherine Froehlich-Grobe ◽  
Simon J. Driver ◽  
Katherine D. Sanches
Keyword(s):  
Health Care Providers ◽  
Scoping Review ◽  
Management Strategies ◽  
Self Management ◽  
Secondary Outcome ◽  
Care Providers ◽  
Mobility Limitations ◽  
Review Of The Literature ◽  
Mobility Impairment ◽  
Management Interventions

Introduction This focused review examines the use and effectiveness of self-management strategies in preventing or managing pain, which is among the most common secondary conditions faced by individuals with a mobility disability. Methods This focused review was part of a two-phase comprehensive scoping review. Phase I was a comprehensive scoping review of the literature targeting multiple outcomes of self-management interventions for those with mobility impairment, and Phase II was a focused review of the literature on self-management interventions that target pain as a primary or secondary outcome. Two authors searched CINAHL, PubMed, and PsyclNFO for papers published from January 1988 through August 2014 using specified search terms. Following the scoping review, the authors independently screened and selected the studies and reviewed the eligible studies, and the first author extracted data from the included studies. Results The scoping review yielded 40 studies that addressed pain self-management interventions for those living with mobility impairment. These 40 accumulated papers revealed a heterogeneous evidence base in terms of setting (clinic, community, and online), target populations, intervention duration (3 weeks to 24 months), and mode (health-care providers and lay leaders). Most of the reviewed studies reported that the self-management intervention led to significant reduction of pain over time, suggesting that self-management may be a promising approach for addressing pain experienced by people who live with mobility limitations. Discussion This review also reveals moderate-to-high bias across studies, and findings indicate that future research should enhance the methodological quality to provide stronger evidence about the effectiveness of self-management strategies for reducing pain among those with mobility impairments.

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