scholarly journals Facilitators and Solutions for Practicing Optimal Guided Asthma Self-Management: The Physician Perspective

2013 ◽  
Vol 20 (4) ◽  
pp. 285-293 ◽  
Author(s):  
Alexandrine J Lamontagne ◽  
Sandra Peláez ◽  
Roland Grad ◽  
Lucie Blais ◽  
Kim L Lavoie ◽  
...  
Keyword(s):  
Health Care Professionals ◽  
Asthma Management ◽  
Patient Characteristics ◽  
Physician Attitudes ◽  
Self Management ◽  
Optimal Care ◽  
Physician Behaviour ◽  
Management Plans ◽  
Guideline Dissemination

OBJECTIVE: To identify key solutions that facilitate the prescription of long-term asthma controller and provision of written self-management plans by physicians.METHODS: One hour individualized semistructured interviews were conducted with physicians. Interviews were transcribed verbatim and analyzed independently by two trained qualitative researchers. A taxonomy of facilitators (contemplated solutions) and experienced solutions was achieved by consensus within the research team.RESULTS: Forty-two physicians (family physicians, pediatricians, emergency physicians, pulmonologists and allergists) were interviewed. The 867 facilitators and solutions, grouped in 10 categories, addressed three physician needs: support physicians in delivering optimal care (guideline dissemination, workplace culture, physician training and experience, physician attitudes toward optimal practice, tools and resources supporting physicians’ decision making); assist patients with following recommendations (patient characteristics, experiences and attitudes; physician behaviour; and tools and resources supporting patient self-management); and offer efficient services (reorganization of care; interprofessional patient management). Suggestions pertaining to the latter two categories were most frequently cited to optimize asthma management and use of self-management plans (eg, access to self-management plans; education by allied health care professionals). The most cited suggestions to support prescribing long-term controller pertained to physician behaviour (eg, involvement in patient education, personalization of prescriptions, feedback to patients of the benefits of long-term controller). The distribution of facilitators and solutions varied across specialties.CONCLUSIONS: Physicians proposed multiple facilitators and solutions to support optimal practice, leading to the development of a novel taxonomy. Key suggestions varied across physician specialties and behaviours sought, emphasizing the need to carefully select the most promising knowledge translation interventions.

Incompatible Images

2009 ◽  
pp. 186-200 ◽  
Author(s):  
Michel J. Sassene
Keyword(s):  
Health System ◽  
Health Systems ◽  
Clinical Evidence ◽  
Asthma Management ◽  
Self Management ◽  
Management Systems ◽  
Use Of Self ◽  
Per Se

This chapter investigates asthmatics’ reasons for not adopting an e-health system for asthma selfmanagement. An understanding of these reasons is particularly relevant, because clinical evidence indicates that, if used, such systems lead to better asthma management. The investigated asthma system is, however, based on a taken-for-granted image of asthmatics as, per se, striving to be symptom-free. This image is incompatible with interviewed asthmatics’ day-to-day performances of their asthma, and renders invisible (a) that their asthma performances emphasize an economy of good passages and of feeling capable, (b) that they achieve the objective of feeling capable in quite different ways, and (c) that feeling capable does not per se equal being symptom-free all the time. To attain long-term use of self-management systems and other patient-centred e-health systems, such systems must acknowledge and link into the manifold performances that comprise users’ ways of living with their disease.

scholarly journals Monitoring Osteoarthritis: A Cross-sectional Survey in General Practice

2013 ◽  
Vol 6 ◽  
pp. CMAMD.S12606 ◽  
Author(s):  
Lorna E. Clarson ◽  
Barbara I. Nicholl ◽  
Annette Bishop ◽  
John J. Edwards ◽  
Rebecca Daniel ◽  
...  
Keyword(s):  
Current Practice ◽  
Ad Hoc ◽  
Postal Survey ◽  
Self Management ◽  
Care Provision ◽  
Cross Sectional Survey ◽  
Optimal Care ◽  
Cross Sectional ◽  
Suboptimal Care ◽  
Management Plans

Background Despite being a highly prevalent chronic condition managed predominantly in primary care and unlike other chronic conditions, osteoarthritis (OA) care is delivered on an ad hoc basis rather than through routine structured review. Evidence suggests current levels of OA care are suboptimal, but little is known about what general practitioners’ (GPs) consider important in OA care, and, thus, the scope to improve inconsistency or poor practice is, at present, limited. Objectives We investigated GPs’ views on and practice of monitoring OA. Methods This was a cross-sectional postal survey of 2500 practicing UK GPs randomly selected from the Binley's database. Respondents were asked if monitoring OA patients was important and how monitoring should be undertaken. Results Responses were received from 768 GPs of whom 70.8% were male and 89.5% were principals within their practices. Despite 55.4% (n = 405) indicating monitoring patients with OA was important and 78.3% (n = 596) considering GPs the appropriate professionals to monitor OA, only 15.2% (n = 114) did so routinely, and 45% (n= 337) did not monitor any OA patients at all. In total, 61.4% (n = 463) reported that patients should self-monitor. Respondents favored monitoring physical function, pain, and analgesia use over monitoring measures of BMI, self management plans, and exercise advice. Conclusions The majority of respondents felt that monitoring OA was important, but this was not reflected in their reported current practice. Much of what they favored for monitoring was in line with published guidance, suggesting provision of suboptimal care does not result from lack of knowledge and interventions to improve OA care must address barriers to GPs engaging in optimal care provision.

Ethical Issues in Concussion Management

2017 ◽  
Vol 22 (1) ◽  
pp. 24-32 ◽  
Author(s):  
Timothy Neal
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Sports Medicine ◽  
Ethical Issues ◽  
Well Being ◽  
Negative Consequences ◽  
Ethical Challenges ◽  
Optimal Care ◽  
Concussion Management

Athletic health care professionals, team physicians, and athletic trainers have an ethical obligation to safeguard the short- and long-term well-being of the athlete they care for. The potential long-term negative consequences to the student-athlete’s physical, cognitive, and mental health as a result of concussions and their mismanagement is a reality. How the athletic health care professional attends to this top priority of providing optimal health care to the concussed athlete while navigating the mitigating circumstances and influences of nonmedical entities found in competitive athletics is one of the great ethical challenges of present day sports medicine. Effectively navigating the complex challenges faced by athletic health care professionals is as important as the care delivered. Understanding the ethical challenges faced by athletic health care decision makers should be a central focus in providing the optimal care the patient deserves.

Impact on a Person’s Daily Life During Episodes of Supraventricular Tachycardia

2016 ◽  
Vol 35 (1) ◽  
pp. 33-43 ◽  
Author(s):  
Ann-Katrin Nordblom ◽  
Anders Broström ◽  
Bengt Fridlund
Keyword(s):  
Supraventricular Tachycardia ◽  
Health Care Professionals ◽  
Daily Life ◽  
Qualitative Content Analysis ◽  
Relevant Information ◽  
Short Term ◽  
Optimal Care ◽  
Semistructured Interviews ◽  
The Impact

Purpose: To describe the impact of episodes of supraventricular tachycardia (SVT) on a person’s daily life from a holistic perspective. Method: A deductive descriptive design was used. Twenty semistructured interviews (12 women and 8 men) were conducted before planned ablation of SVT and were analyzed using qualitative content analysis. Results: Living with SVT had a complex impact on daily life. Initially, the patients described an inhibited existence due to demands to give up things that they had previously been doing, in case the unpredictable episodes of SVT would occur. The episodes caused fatigue and worry, which together created a barrier for living life to the full by making the person give up undertakings. The patients constantly needed to find short-term and long-term strategies to prevent new episodes from happening. Conclusion: Episodes of SVT entail a complex life situation as the person’s entire existence is affected in daily life. To understand the impact of SVT on daily life, nurses and other health care professionals need increased knowledge and understanding to be able to provide support through relevant information and take optimal care measures.

scholarly journals Two for One: A Self-Management Plan Coupled with a Prescription Sheet for Children with Asthma

2008 ◽  
Vol 15 (7) ◽  
pp. 347-354 ◽  
Author(s):  
Francine M Ducharme ◽  
Francisco Noya ◽  
David McGillivray ◽  
Sandy Resendes ◽  
Stéphanie Ducharme-Bénard ◽  
...  
Keyword(s):  
Acute Care ◽  
Health Care Professionals ◽  
Scientific Evidence ◽  
Management Plan ◽  
Self Management ◽  
Traffic Light ◽  
Asthmatic Children ◽  
Expert Opinions ◽  
Management Plans ◽  
Acute Care Settings

BACKGROUND: Despite strong recommendations in the asthma guidelines, the use of written self-management plans remains low among asthmatic patients.OBJECTIVES: To develop a written self-management plan, based on scientific evidence and expert opinions, in a format intended to facilitate its dispensing by health care professionals, and to test the perception of its relevance and clarity by asthmatic children, adolescents and adults.METHODS: Inspired by previously tested self-management plans, surveys of asthma educators, expert opinions and the 2004 Canadian Asthma Guidelines, the authors simultaneously developed French and English versions of a written self-management plan that coupled with a prescription. The self-management plan was tested in parents and their asthmatic children (aged one to 17 years), and it was revised until 85% clarity and perceived relevance was achieved.RESULTS: Ninety-seven children and their parents were interviewed. Twenty per cent had a self-management plan. On the final revision, nearly all items were clear and perceived relevant by 85% or more of the interviewees. Two self-management plans were designed for clinics and acute care settings, respectively. The plans are divided into three control zones identified by symptoms with optional peak flow values and symbolized by traffic light colours. They are designed in triplicate format with a prescription slip, a medical chart copy and a patient copy.CONCLUSION: The written self-management plans, based on available scientific evidence and expert opinions, are clear and perceived to be relevant by children, adolescents and their parents. By incorporating the prescription and chart copies, they were designed to facilitate dispensing by physicians in both clinics and acute care settings.

scholarly journals Evaluating Asthma Mobile Apps to Improve Asthma Self-Management: User Ratings and Sentiment Analysis of Publicly Available Apps

10.2196/15076 ◽  
2020 ◽  
Vol 8 (10) ◽  
pp. e15076 ◽  
Author(s):  
Marlene Camacho-Rivera ◽  
Huy Vo ◽  
Xueqi Huang ◽  
Julia Lau ◽  
Adeola Lawal ◽  
...  
Keyword(s):  
Sentiment Analysis ◽  
Mobile Apps ◽  
Asthma Management ◽  
Ease Of Use ◽  
Self Management ◽  
Average Rating ◽  
Study Results ◽  
Key Features ◽  
User Ratings

Background The development and use of mobile health (mHealth) apps for asthma management have risen dramatically over the past two decades. Asthma apps vary widely in their content and features; however, prior research has rarely examined preferences of users of publicly available apps. Objective The goals of this study were to provide a descriptive overview of asthma mobile apps that are publicly available and to assess the usability of asthma apps currently available on the market to identify content and features of apps associated with positive and negative user ratings. Methods Reviews were collected on June 23, 2020, and included publicly posted reviews until June 21, 2020. To characterize features associated with high or low app ratings, we first dichotomized the average user rating of the asthma app into 2 categories: a high average rating and a low average rating. Asthma apps with average ratings of 4 and above were categorized as having a high average rating. Asthma apps with average ratings of less than 4 were categorized as having a low average rating. For the sentiment analysis, we modeled both 2-word (bi-gram) and 3-word (tri-gram) phrases which commonly appeared across highly rated and lowly rated apps. Results Of the 10 apps that met the inclusion criteria, a total of 373 reviews were examined across all apps. Among apps reviewed, 53.4% (199/373) received high ratings (average ratings of 4 or 5) and 47.2% (176/373) received low ratings (average ratings of 3 or less). The number of ratings across all apps ranged from 188 (AsthmaMD) to 10 (My Asthma App); 30% (3/10) of apps were available on both Android and iOS. From the sentiment analysis, key features of asthma management that were common among highly rated apps included the tracking of peak flow readings (n=48), asthma symptom monitoring (n=11), and action plans (n=10). Key features related to functionality that were common among highly rated apps included ease of use (n=5). Users most commonly reported loss of data (n=14) and crashing of app (n=12) as functionality issues among poorly rated asthma apps. Conclusions Our study results demonstrate that asthma app quality, maintenance, and updates vary widely across apps and platforms. These findings may call into question the long-term engagement with asthma apps, a crucial factor for determining their potential to improve asthma self-management and asthma clinical outcomes.

scholarly journals A qualitative investigation of the allergic rhinitis network from the perspective of the patient

2019 ◽  
Vol 29 (1) ◽  
Author(s):  
Biljana Cvetkovski ◽  
Vicky Kritikos ◽  
Rachel Tan ◽  
Kwok Yan ◽  
Elizabeth Azzi ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Health Care Professionals ◽  
Self Management ◽  
Over The Counter ◽  
Medication Prescription ◽  
Qualitative Exploration ◽  
Term Management ◽  
Selection Of

Abstract Patient self-selection of over-the-counter medicines for the management of allergic rhinitis is suboptimal. The mapping of the allergic rhinitis network demonstrates that patients’ decisions with regards to their allergic rhinitis management can be influenced by up to 11 individuals/resources (alters). This study aimed to identify the role of alters within the allergic rhinitis network and identify the factors that determined their degree of influence as perceived by the patient. This research was a qualitative exploration embedded in an empirical framework and social network theory. People with allergic rhinitis were interviewed about their network and transcripts were analysed deductively and inductively. Transcripts were coded by researchers independently and then discussed until agreement was reached. Forty-one participants described the roles of 17 alters on their allergic rhinitis management. The roles of alters fell within five categories: diagnosis, medication prescription/supply/administration, medication recommendation, information about allergic rhinitis and emotional support. Participant interactions with these alters were often acute and had a long standing effect, with the participants often navigating the long-term management on their own. The significance of the influence of each alter on their allergic rhinitis management was dependent on the level of trust in their relationship, impact of the role made to the participants’ day-to-day management of allergic rhinitis and/or the participant’s beliefs. Allergic rhinitis management was fragmented and had opportunity to be improved by developing strategies, resources and policies to support self-management in collaboration with patients and health-care professionals.

scholarly journals Evaluating Asthma Mobile Apps to Improve Asthma Self-Management: User Ratings and Sentiment Analysis of Publicly Available Apps (Preprint)

2019 ◽  
Author(s):  
Marlene Camacho-Rivera ◽  
Huy Vo ◽  
Xueqi Huang ◽  
Julia Lau ◽  
Adeola Lawal ◽  
...  
Keyword(s):  
Sentiment Analysis ◽  
Mobile Apps ◽  
Asthma Management ◽  
Ease Of Use ◽  
Self Management ◽  
Average Rating ◽  
Study Results ◽  
Key Features ◽  
User Ratings

BACKGROUND The development and use of mobile health (mHealth) apps for asthma management have risen dramatically over the past two decades. Asthma apps vary widely in their content and features; however, prior research has rarely examined preferences of users of publicly available apps. OBJECTIVE The goals of this study were to provide a descriptive overview of asthma mobile apps that are publicly available and to assess the usability of asthma apps currently available on the market to identify content and features of apps associated with positive and negative user ratings. METHODS Reviews were collected on June 23, 2020, and included publicly posted reviews until June 21, 2020. To characterize features associated with high or low app ratings, we first dichotomized the average user rating of the asthma app into 2 categories: a high average rating and a low average rating. Asthma apps with average ratings of 4 and above were categorized as having a high average rating. Asthma apps with average ratings of less than 4 were categorized as having a low average rating. For the sentiment analysis, we modeled both 2-word (bi-gram) and 3-word (tri-gram) phrases which commonly appeared across highly rated and lowly rated apps. RESULTS Of the 10 apps that met the inclusion criteria, a total of 373 reviews were examined across all apps. Among apps reviewed, 53.4% (199/373) received high ratings (average ratings of 4 or 5) and 47.2% (176/373) received low ratings (average ratings of 3 or less). The number of ratings across all apps ranged from 188 (AsthmaMD) to 10 (My Asthma App); 30% (3/10) of apps were available on both Android and iOS. From the sentiment analysis, key features of asthma management that were common among highly rated apps included the tracking of peak flow readings (n=48), asthma symptom monitoring (n=11), and action plans (n=10). Key features related to functionality that were common among highly rated apps included ease of use (n=5). Users most commonly reported loss of data (n=14) and crashing of app (n=12) as functionality issues among poorly rated asthma apps. CONCLUSIONS Our study results demonstrate that asthma app quality, maintenance, and updates vary widely across apps and platforms. These findings may call into question the long-term engagement with asthma apps, a crucial factor for determining their potential to improve asthma self-management and asthma clinical outcomes.

Russian Federalism at the Critical Stage of Development

2008 ◽  
pp. 70-83 ◽  
Author(s):  
E. Bukhvald
Keyword(s):  
Economic Development ◽  
Social Processes ◽  
Self Management ◽  
Intergovernmental Fiscal Relations ◽  
Critical Stage ◽  
Municipal Reform ◽  
Stage Of Development ◽  
Social And Economic Development ◽  
Basic Course

Transformations in the sphere of federal relations concern the most important directions of the reforming processes in the country. However, not all proposed and actually developing components of the federal reform seem well-argued and corresponding to long-term, strategic interests of the Russian statehood. The basic course of reform should meet the objective requirements of further decentralization of governing economic and social processes and the need to ensure strengthening the responsibility of RF subjects’ executive bodies and local self-management for steady social and economic development of their territories. The solution of these problems calls for a new model of federal policy of regional development, specification of some important components of the municipal reform as well as inserting certain amendments into the system of intergovernmental fiscal relations in order to stir up their stimulating function.

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