scholarly journals Young adults’ perceptions of living with atopic dermatitis in relation to the concept of self-management: a qualitative study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e044777
Author(s):  
Susanne Lundin ◽  
Marina Jonsson ◽  
Carl-Fredrik Wahlgren ◽  
Emma Johansson ◽  
Anna Bergstrom ◽  
...  
Keyword(s):  
Young Adults ◽  
Atopic Dermatitis ◽  
Qualitative Study ◽  
Healthcare Providers ◽  
Transition Process ◽  
Population Based ◽  
Self Management ◽  
School Age ◽  
Perceived Availability ◽  
Semistructured Interviews

ObjectivesLearning to take control of one’s health is an important part of the transition from adolescence to adulthood. This study aimed to explore young adults’ perceptions of living with atopic dermatitis (AD) in relation to the concept of self-management.DesignA qualitative study with an inductive approach was performed through semistructured interviews (n=15). The interviews were recorded, transcribed verbatim and analysed with systematic text condensation.ParticipantsYoung adults (mean age 23,4 years) with persistent AD in a longitudinal population-based birth cohort. To capture experience of living with persistent AD (preschool/school-age onset) of different severity (mild to severe/very severe), a purposive selection was performed. In total, 15 young adults were included. Persistent AD (preschool/school-age onset) was defined as dry skin in combination with itchy rash of typical localisation in the 12 months preceding the 16-year and the 24-year follow-ups. Severity was self-assessed using the Patient Oriented Eczema Measure.ResultsDespite having experience of AD since childhood, the respondents expressed uncertainty about treatment and how it affected their bodies. Their uncertainties and feelings affected how they used topical corticosteroids. The respondents emphasised that they perceived availability of healthcare and knowledge about treatment of AD among healthcare providers to be limited. The participants did not state any experiences of support to self-management from healthcare, which affect young adults’ possibilities to take full control of their AD care.ConclusionsYoung adults with preschool/school-age onset of AD are unsure how to treat and manage the disease. One explanation may be insufficient transition process.

Chronic disease management and dementia: a qualitative study of knowledge and needs of staff

2019 ◽  
Vol 25 (4) ◽  
pp. 359 ◽  
Author(s):  
Chelsea Baird ◽  
Marta H. Woolford ◽  
Carmel Young ◽  
Margaret Winbolt ◽  
Joseph Ibrahim
Keyword(s):  
Cognitive Impairment ◽  
Chronic Disease ◽  
Disease Management ◽  
Qualitative Study ◽  
Cognitive Abilities ◽  
Chronic Disease Management ◽  
Self Management ◽  
Semistructured Interviews ◽  
Management Approaches

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.

scholarly journals Facilitators and Barriers of Managing Patients with Multiple Chronic Conditions in the Community: A Qualitative Study

2019 ◽  
Author(s):  
Kah Mun Foo ◽  
Meena Sundram ◽  
Helena Legido-Quigley
Keyword(s):  
Qualitative Study ◽  
Waiting Time ◽  
Chronic Conditions ◽  
Resource Constraints ◽  
Healthcare Providers ◽  
Policy Formulation ◽  
Care Quality ◽  
Self Management ◽  
Multiple Chronic Conditions ◽  
Facilitators And Barriers

Abstract Background About one-third of all adults worldwide were diagnosed with multiple chronic conditions (MCCs). Literature had found several challenges of providers and patients coping with managing MCCs in the community, and yet limited research studies that consider their viewpoints in combination. A qualitative study involving healthcare providers and users was thus conducted to examine facilitators and barriers of managing patients with MCCs in the community in Singapore. Methods This involves 26 semi-structured interviews with 10 physicians, 2 caregivers and 14 patients seeking treatment in the polyclinics that provides subsidised primary care services. Topic guides were developed with reference from literature review, Chronic Care Model (CCM) and Framework for patient-centred access to healthcare. Results Despite perceived affordable charges and availability of support system, some patients still encountered financial difficulties in managing care. These include inadequacy of the nation-wide medical savings scheme to cover outpatient treatment and medications. Half of the healthcare users did not know where to seek help. While patients could access comprehensive services in polyclinics, those that did not turn up might not receive timely care. Furthermore, patients reported long consultation waiting time. Physicians were able to propose and drive quality improvement projects to improve care quality. However, there were challenges of delivering safe and quality care with limited consultation duration due to the need to manage waiting time, inadequate communication with specialists to coordinate care, and resource constraints in managing complex patients. Although providers could equip patients with self-management and lifestyle related guidelines, patients’ actions are influenced by multiple factors including work nature, beliefs and environment. Conclusions There were barriers on care access, delivery and self-management as reported. It is crucial to adopt whole-of-society approach involving individuals, community, institutions and policymakers to improve and support MCCs management. This study has also highlighted the importance to consider different viewpoints of healthcare providers and users in policy formulation and community care planning.

scholarly journals Do young adults see value in advance directives?

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 850-850
Author(s):  
Yuchi Young ◽  
Arianna Stone ◽  
Taylor Perre ◽  
Kuo-Piao Chung ◽  
Ya-Mei Chen
Keyword(s):  
New York ◽  
Young Adults ◽  
End Of Life ◽  
End Of Life Care ◽  
New York State ◽  
Healthcare Providers ◽  
Population Based ◽  
Life Care ◽  
Study Results ◽  
Attitude Toward Ads

Abstract Many Americans avoid end-of-life care planning; only 26% have completed an advance directive (AD). An AD promotes end-of-life care with dignity allowing individuals to make end-of-life treatment and care decisions before they are unable to do so. Previous studies related to ADs are focused on older adults with serious illness or people with functional/mental disability. The objective of this survey is to better understand young adults' knowledge of and attitude toward ADs and their preferences for ADs related to treatment and care options. Methods. Participants include graduate students (n=25) attending a state university in New York State (NYS). Data were collected using two ADs (Five Wishes; Medical Orders for Life-Sustaining Treatment (MOLST)) and one survey questionnaire. Summary statistics and multivariate models will be used to address the study aims. Results. Preliminary results show the average age was 23 years, 72% were female, 48% White, and 44% Black. The majority of young adults hadn’t completed an AD; however, their attitude toward ADs was positive; the majority believe it is important to have an AD prepared at their current age; and they believe young adults would willing to fill out ADs. Young adults can make difficult treatment and care decisions when the situation requires it. Conclusion. The study findings can be useful to policy makers, healthcare providers and other stakeholders in promoting population-based healthcare decision-making. Limitation. Participants were recruited from one university in NYS; thus, the study results may be generalized to a population sharing similar characteristics.

Sleep Disturbance and Self-management in Adults With Subarachnoid Hemorrhage: A Qualitative Study

2021 ◽  
pp. 105477382110640
Author(s):  
Eeeseung Byun ◽  
Susan M. McCurry ◽  
Boeun Kim ◽  
Suyoung Kwon ◽  
Hilaire J. Thompson
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Qualitative Study ◽  
Sleep Disturbances ◽  
Management Practices ◽  
Healthcare Providers ◽  
Self Management ◽  
Sleep Health ◽  
Convenience Sample ◽  
Falling Asleep ◽  
Sleep Management

Subarachnoid hemorrhage (SAH) survivors often experience sleep disturbances. Little is known about sleep-management practices used to improve their sleep. The purpose of this qualitative study was to explore interest in and engagement with self-management practices to promote sleep health in SAH survivors. We conducted a cross-sectional qualitative study using semi-structured interviews with a convenience sample of 30 SAH survivors recruited from a university hospital. We conducted content analysis of interview transcripts. Three themes and 15 subcategories were identified: (1) sleep disturbances (difficulties falling asleep, wake after sleep onset, daytime sleepiness, too much or insufficient sleep, and poor sleep quality); (2) sleep-management practices (exercise, regular sleep schedule, relaxation, keeping busy and staying active, changing beverage intake, taking supplements, taking medications, recharging energy, and barriers to sleep management); and (3) consulting with healthcare providers (discussing sleep problems with healthcare providers). Self-management strategies focusing on health-promoting behaviors may improve SAH survivors’ sleep health.

Looking Back at Adolescent Depression: A Qualitative Study

2008 ◽  
Vol 30 (1) ◽  
pp. 49-68 ◽  
Author(s):  
John McCarthy ◽  
Edward Downes ◽  
Christine Sherman
Keyword(s):  
Mental Health ◽  
Young Adults ◽  
Major Depressive Disorder ◽  
Qualitative Study ◽  
Adolescent Depression ◽  
Mental Health Counselors ◽  
Major Depressive ◽  
Semistructured Interviews ◽  
Professional Helpers ◽  
Looking Back

Adolescent depression is a serious disorder marked by a prevalence rate of approximately 5% along with significant rates of relapse and mortality (Brent & Birmaher, 2002). This qualitative study involved semistructured interviews of nine young adults who were diagnosed with and treated for major depressive disorder between the ages of 15 and 18. Five themes emerged from the interviews: (a) talking to a counselor about their depression was helpful; (b) participants obtained relief in their counseling and expressed respect for their professional helpers; (c) parental (and adult) partnerships are important; (d) friends of the adolescent clients were usually helpful to them; and (e) the adolescents possessed a realistic optimism concerning a possible subsequent depressive episode. Implications for mental health counselors are also discussed.

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.

scholarly journals Perspectives of deprived patients on diabetes self-management programmes delivered by the local primary care team: a qualitative study on facilitators and barriers for participation, in France

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Emmanuel Allory ◽  
Hélène Lucas ◽  
Arnaud Maury ◽  
Ronan Garlantezec ◽  
Candan Kendir ◽  
...  
Keyword(s):  
Primary Care ◽  
Qualitative Study ◽  
Primary Care Practice ◽  
Healthcare Providers ◽  
Primary Care Providers ◽  
Self Management ◽  
Care Practice ◽  
Geographical Proximity ◽  
Facilitators And Barriers ◽  
Improve Access

Abstract Background Diabetes self-management education (DSME) is an effective intervention for patients with type 2 diabetes mellitus (T2DM); nevertheless, patient participation in this type of programme is low. Implementation of DSME programmes in primary care practices by the local multi-professional team is a potential strategy to improve access to DSME for T2DM patients. The aim of this study was to identify perceived facilitators and barriers by patients to participation in local DSME delivered by primary care professionals in France. Method T2DM patients, informed and recruited during consulting with their usual care provider, who had attended a structured and validated DSME programme delivered by 13 primary care providers within a multi-professional primary care practice in a deprived area of 20,000 inhabitants, were invited to participate in this study. A qualitative study with semi-structured, in-depth interviews was conducted with study participants, between July 2017 and February 2018. A reflexive thematic analysis of the interviews was carried out. Coding schemes were developed to generate thematic trends in patient descriptions of facilitators and barriers to DSME participation. Results Nineteen interviews (mean length 31 min; [20–44 min]) were completed with T2DM patients. Four themes on facilitators for programme participation emerged from the data: geographical proximity of a DSME programme held in the local multi-professional primary care practice; effective promotion of the DSME programme by the local multi-professional team; pre-existing relationship between patients and their healthcare providers; and potential to establish new social interactions within the neighbourhood by participating in the programme. Three themes on barriers to attendance emerged: integrating the DSME programme into their own schedules; difficulties in expressing themselves in front of a group; and keeping the motivation for self-managing their T2DM. Conclusions From the patient perspective, the programme geographical proximity and the pre-existing patient-healthcare provider relationship were important factors that contributed to participation. Healthcare providers should consider these factors to improve access to DSME programmes and diabetes self-management in deprived populations. Longitudinal studies should be performed to measure the impact of these programmes.

scholarly journals Patient and Provider Dilemmas of type 2 Diabetes Self-Management: a Qualitative Study in Socioeconomically Disadvantaged Communities in Stockholm

2018 ◽  
Author(s):  
Juliet Aweko ◽  
Jeroen De Man ◽  
Pilvikki Absetz ◽  
Claes-Göran Östenson ◽  
Stefan Swartling Peterson ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Daily Life ◽  
Healthcare Providers ◽  
Structured Interview ◽  
Self Management ◽  
Study Patient ◽  
Diabetes Diagnosis ◽  
Management Support ◽  
Provider Perceptions ◽  
Disadvantaged Communities

Studies comparing provider and patient views and experiences of self-management within primary healthcare are particularly scarce in disadvantaged settings. In this qualitative study, patient and provider perceptions of self-management were investigated in five socio-economically disadvantaged communities in Stockholm. Twelve individual interviews and three group interviews were conducted. Semi-structured interview guides included questions on perceptions of diabetes diagnosis, diabetes care services available at primary health care centers, patient and provider interactions, and self-management support. Data was analysed using thematic analysis. Two overarching themes were identified. These were characterized by inherent dilemmas representing confusions and conflicts that patients and providers experienced in their daily life or practice respectively: adopting and maintaining new routines through practical and appropriate lifestyle choices (patients); and balancing expectations and pre-conceptions of self-management (providers). Patients found it difficult to tailor information and lifestyle advice to fit their daily life. Healthcare providers recognized that patients were in need of support to change behavior, but saw themselves as inadequately equipped to deal with the different cultural and social aspects of self-management. This study highlights patient and provider dilemmas that influence the interaction and collaboration between patients and providers with respect to communication and uptake of self-management advice.

scholarly journals Pain self-management experiences in haemophilia patients: a qualitative study

2018 ◽  
Vol 5 (1) ◽  
pp. 76-82 ◽  
Author(s):  
Masoume Rambod ◽  
Farkondeh Sharif ◽  
Zahra Molazem ◽  
Kate Khair
Keyword(s):  
Pain Relief ◽  
Qualitative Study ◽  
Lived Experience ◽  
Sense Of Self ◽  
Healthcare Providers ◽  
Phenomenological Approach ◽  
Complementary Therapy ◽  
Self Management ◽  
Self Awareness ◽  
Structured Interviews

Abstract Background: Pain management can prevent long-term burdens in haemophilia patients and improve their quality of life. The present study aimed to describe and interpret pain experiences in haemophilia patients, focusing on pain self-management in their lives. Methods: This was a qualitative study undertaken using a hermeneutic phenomenological approach. The study involved 14 haemophilia patients referred to a haemophilia clinic affiliated to Shiraz University of Medical Sciences in Iran. Data were collected using semi-structured interviews and field notes. Thematic analysis with van Manen’s methodological framework was applied. Data analysis was performed using MAX. QDA qualitative software (2010). Results: Four themes emerged: a sense of self-awareness and recognition of pain and the factors that affect it, the ability to control and self-manage pain, gradually achieving self-efficacy in pain control, and using cognitive and spiritual strategies for pain relief. Conclusions: The study highlighted the essence of the lived experience of pain self-management and generated its linguistic description. By providing complementary therapy interventions, healthcare providers and family members could increase patients’ self-awareness, recognition, ability to self-manage and control pain effectively, and competence in developing cognitive and spiritual strategies for pain relief.

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