Abstract 247: Pilot Study Examining Heart Failure Patient Internet Use and Adherence to a Web Based Portal Designed to Support Self-Care.

2013 ◽  
Vol 6 (suppl_1) ◽  
Author(s):  
Redah Z Mahmood ◽  
Judith Grossi ◽  
Todd M Koelling
Keyword(s):  
Computer Use ◽  
Healthcare Providers ◽  
Intervention Group ◽  
Self Care ◽  
Web Based ◽  
Face To Face ◽  
Clinical Events ◽  
Home Based ◽  
Care Information ◽  
Use Of Internet

Background: Experts agree that HF patients should practice appropriate self-care behaviors to minimize the risk of adverse clinical events, including early unplanned readmissions. We sought to understand patient perceptions and adherence to a web-based system designed to support self-care of HF patients. Methods: 100 HF patients were surveyed regarding their computer use and attitudes toward using an internet based web-portal (WP) to support self-care, provide patient education, and communicate with healthcare providers (HCP’s). We then consented 42 patients to participate in a 12 week trial of using the WP to track clinical parameters (daily weights, blood pressure, sodium/fluid intake, exercise), provide links for HF self-education, and update HCP’s on their progress. Patients received a face to face teaching session on accessing and using the WP. Results: The computer use survey (N=100) demonstrated that 72% of patients reported having a computer at home, 67% used email and 71% used the internet. In the WP intervention group (N=41) only 24 (58.5%) were able to successfully access the WP and enter data during the pilot (see table 1). Conclusions: Pilot data showed a significant positive correlation (see table 1) between patients indicating use of internet to access heaIth care information (HCI) and adherence with the WP. Despite strong interest to use a home based WP for self-care and communication with providers, we found that many hurdles prevented patients from using the WP. Internet based educational tools for HF patients may be desirable, but limitations in patients’ ability to access internet based programs may ultimately render the tools ineffective.

Effect of Counseling on Quality of Life and Self-Care Agency for Patients Who are Scheduled for Total Knee Replacement

2021 ◽  
pp. 105477382110589
Author(s):  
Çiğdem Kaya ◽  
Özlem Bilik
Keyword(s):  
Quality Of Life ◽  
Total Knee Replacement ◽  
Knee Replacement ◽  
Intervention Group ◽  
Self Care ◽  
Control Group ◽  
Face To Face ◽  
Total Knee ◽  
Care Agency

This study aims to determine the effect of counseling on quality of life and self-care agency for patients who are scheduled for total knee replacement (TKR). The study has a quantitative and quasi-experimental design with a control group. The patients in the control group ( n = 40) received routine care. Face-to-face and telephone counseling was offered to individuals in the intervention group ( n = 39). The data was collected at face-to-face interviews by using a patient characteristics form, Quality of Life Scale, and Self-Care Agency Scale. The scores for quality of life and self-care agency in the 6th to 8th and 14th to 16th weeks after surgery were very significantly higher in the intervention group than in the control group ( p < .001). This study shows that counseling given by the nurse increases the quality of life and self-care agency of patients undergoing TKR.

An improvement in self-care behaviour in heart failure patients lead to better management of hypertension

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
D.S Sahlin ◽  
S Gerward
Keyword(s):  
Heart Failure ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Controlled Trial ◽  
Intervention Group ◽  
Self Care ◽  
Control Group ◽  
Chi Square ◽  
Home Based ◽  
Number Of Patients

Abstract Background A common heart failure (HF) aetiology is hypertension (HTN), second only to ischemic heart disease and with a prevalence in the HF community of between 62% and 84%, depending on sex and ejection-fraction. Undertreated HTN leads to worse prognosis and resistant HTN is defined as blood pressure (BP) exceeding 140/90 mmHg, in spite of pharmacological treatment. Since one constituent of self-care behaviour is treatment adherence, we wished to study whether patients exposed to a digital intervention shown to improve self-care behaviour, would also display improved BP control. Methods SMART-HF was a randomized controlled trial, recruiting patients from seven centres in Region Skåne in southern Sweden, where patients in the intervention group (IG) were equipped with a digital home-based tool, designed to enhance self-care behaviour for HF-patients and the control group (CG) were subject to standard care. BP data was registered at baseline and after eight months of intervention and self-care behaviour was measured using the European Heart Failure Self-care Behaviour Scale (EHFScB). We used a Chi-square test to analyse whether there was an inter-group difference of prevalence of resistant HTN or a mean arterial pressure (MAP) outside the recommended range of 60 mmHg &lt; MAP &lt;100 mmHg. Results Out of the 118 patients included in the original analysis, 92 (78%) had complete BP measurements. At baseline there was no difference in self-care behaviour between the groups, with CG: 25 [17.5; 32] and IG: 24.5 [18; 30], p=0.61, and 28% of the CG patients and 24% of the IG population displayed resistant HTN, p=0.73. After eight months of intervention the IG had 21% (or 4.5 points) better self-care behaviour compared to the CG, p=0.014, and the fraction of patients with resistant HTN was 30% for the CG and 11% for the IG, p=0.027. There was also a significant effect on the fraction of patients having a MAP &gt;100 mmHg, with 22% in the CG versus 16% in the IG having MAP &gt;100 mmHg at baseline (p=0.39) and 19% in the CG versus 0% in the IG at follow-up (p=0.002). Conclusions There was a significant improvement in self-care behaviour and also a significant reduction in the number of patients with resistant hypertension and elevated mean arterial pressure after eight months of intervention. Funding Acknowledgement Type of funding source: None

scholarly journals Electronic Self-Report Assessment for Cancer and Self-Care Support: Results of a Multicenter Randomized Trial

2014 ◽  
Vol 32 (3) ◽  
pp. 199-205 ◽  
Author(s):  
Donna L. Berry ◽  
Fangxin Hong ◽  
Barbara Halpenny ◽  
Ann H. Partridge ◽  
Jesse R. Fann ◽  
...  
Keyword(s):  
Intervention Group ◽  
Self Care ◽  
Symptom Distress ◽  
Self Report ◽  
Analysis Of Covariance ◽  
Control Group ◽  
Web Based ◽  
Significant Difference ◽  
Distress Scale ◽  
Care Support

Purpose The purpose of this trial was to evaluate the effect of a Web-based, self-report assessment and educational intervention on symptom distress during cancer therapy. Patients and Methods A total of 752 ambulatory adult participants were randomly assigned to symptom/quality-of-life (SxQOL) screening at four time points (control) versus screening, targeted education, communication coaching, and the opportunity to track/graph SxQOL over time (intervention). A summary of the participant-reported data was delivered to clinicians at each time point in both groups. All participants used the assessment before a new therapeutic regimen, at 3 to 6 weeks and 6 to 8 weeks later, completing the final assessment at the end of therapy. Change in Symptom Distress Scale–15 (SDS-15) score from pretreatment to end of study was compared using analysis of covariance and regression analysis adjusting for selected variables. Results We detected a significant difference between study groups in mean SDS-15 score change from baseline to end of study: 1.27 (standard deviation [SD], 6.7) in the control group (higher distress) versus −0.04 (SD, 5.8) in the intervention group (lower distress). SDS-15 score was reduced by an estimated 1.21 (95% CI, 0.23 to 2.20; P = .02) in the intervention group. Baseline SDS-15 score (P < .001) and clinical service (P = .01) were predictive. Multivariable analyses suggested an interaction between age and study group (P = .06); in subset analysis, the benefit of intervention was strongest in those age > 50 years (P = .002). Conclusion Web-based self-care support and communication coaching added to SxQOL screening reduced symptom distress in a multicenter sample of participants with various diagnoses during and after active cancer treatment. Participants age > 50 years, in particular, may have benefited from the intervention.

The Effects of Home-Based Self-Care Education on Blood Pressure and Self-Care Behaviors among Middle-Aged Patients with Primary Hypertension in Iran: A Randomized Clinical Controlled Trial

2021 ◽  
pp. 108482232110127
Author(s):  
Sara Hazrati Gonbad ◽  
Masoumeh Zakerimoghadam ◽  
Shahzad Pashaeypoor ◽  
Shima Haghani
Keyword(s):  
Blood Pressure ◽  
Controlled Trial ◽  
Intervention Group ◽  
Self Care ◽  
Primary Hypertension ◽  
Control Group ◽  
Middle Aged ◽  
Aged Patients ◽  
Care Education ◽  
Home Based

Self-care education (SCE) through home visit is one of the methods with potential effects on self-care. This study aimed to evaluate the effects of home-based SCE on blood pressure and self-care behaviors among middle-aged patients with primary hypertension in Iran. This randomized controlled trial was conducted on 110 middle-aged patients with hypertension recruited from public healthcare centers in the south of Tehran, Iran in September 2019. After convenience sampling, Participants were simple randomly allocated to control and intervention groups. Intervention group received a 2-month home-based SCE while control group received routine care services. Before and 2 months after the intervention, self-care behaviors were assessed using the Hypertension Self-Care Activity Level Effects (H-SCALE). Data were analyzed using the SPSS software (v. 16.0) at a significance level of less than .05. After 2 months, the posttest mean scores of self-care behaviors in medication adherence (17.42 ± 1.03 vs 14.49 ± 1.01, p = .04), physical activity (8.16 ± 0.39 vs 6.47 ± 0.52, p = .01), low-salt diet (52.51 ± 3.8 vs 35.36 ± 3.47, p = .001), and blood pressure control (3.47 ± 0.22 vs 2.42 ± 1.89, p = .001), in the intervention group were significantly greater than the control group. However, there were no significant between-group differences respecting the posttest mean scores of the weight management ( p = .06) and smoking cessation ( p = .2). Also, the mean blood pressure between the 2 groups changed after the intervention, but this difference was not statistically significant. This study suggests the effectiveness of home-based SCE in significantly improving self-care behaviors among patients with hypertension. But more studies are needed to measure the effectiveness of intervention on blood pressure. IRCT code: IRCT20190623043985N1. Registered 06/30/2019, https://fa.irct.ir/trial/40351 .

scholarly journals Predictors of Better Self-Care in Patients with Heart Failure after Six Months of Follow-Up Home Visits

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Melina Maria Trojahn ◽  
Karen Brasil Ruschel ◽  
Emiliane Nogueira de Souza ◽  
Cláudia Motta Mussi ◽  
Vânia Naomi Hirakata ◽  
...  
Keyword(s):  
Heart Failure ◽  
Regression Model ◽  
Home Visiting ◽  
Controlled Trial ◽  
Intervention Group ◽  
Self Care ◽  
Home Visits ◽  
Home Based ◽  
Patients With Heart Failure ◽  
Care Behavior

This study aimed to examine the predictors of better self-care behavior in patients with heart failure (HF) in a home visiting program. This is a longitudinal study nested in a randomized controlled trial (ISRCTN01213862) in which the home-based educational intervention consisted of a six-month followup that included four home visits by a nurse, interspersed with four telephone calls. The self-care score was measured at baseline and at six months using the Brazilian version of the European Heart Failure Self-Care Behaviour Scale. The associations included eight variables: age, sex, schooling, having received the intervention, social support, income, comorbidities, and symptom severity. A simple linear regression model was developed using significant variables (P≤0.20), followed by a multivariate model to determine the predictors of better self-care. One hundred eighty-eight patients completed the study. A better self-care behavior was associated with patients who received intervention (P<0.001), had more years of schooling (P=0.016), and had more comorbidities (P=0.008). Having received the intervention (P<0.001) and having a greater number of comorbidities (P=0.038) were predictors of better self-care. In the multivariate regression model, being in the intervention group and having more comorbidities were a predictor of better self-care.

scholarly journals Digital habits of PR service-users: Implications for home-based interventions during the COVID-19 pandemic

2020 ◽  
Vol 17 ◽  
pp. 147997312093668
Author(s):  
Oliver Polgar ◽  
Maha Aljishi ◽  
Ruth E Barker ◽  
Suhani Patel ◽  
Jessica A Walsh ◽  
...  
Keyword(s):  
Pulmonary Rehabilitation ◽  
The Internet ◽  
Significant Heterogeneity ◽  
Service Users ◽  
Web Based ◽  
Face To Face ◽  
Home Based

Remote models of pulmonary rehabilitation (PR) are vital with suspension of face-to-face activity during the COVID-19 pandemic. We surveyed digital access and behaviours and PR delivery preferences of current PR service users. There was significant heterogeneity in access to and confidence in using the Internet with 31% having never previously accessed the Internet, 48% confident using the Internet and 29% reporting no interest in accessing any component of PR through a Web-based app. These data have implications for the remote delivery of PR during the COVID-19 pandemic and raise questions about the current readiness of service users to adopt Web-based delivered models of PR.

scholarly journals Web-Based and Face-To-Face Autonomy-Supportive Intervention for Physical Education Teachers and Students’ Experiences

2021 ◽  
pp. 672-683
Author(s):  
Henri Tilga ◽  
Hanna Kalajas-Tilga ◽  
Vello Hein ◽  
Andre Koka
Keyword(s):  
Physical Education ◽  
Intervention Group ◽  
Need Satisfaction ◽  
Control Group ◽  
Study Group ◽  
Web Based ◽  
Face To Face ◽  
Psychological Need ◽  
Supportive Interventions

The most of the previous autonomy-supportive interventions conducted have been partially effective and used only web-based or face-to-face approach. In the current study, a combined web-based and face-to-face intervention for physical education (PE) teachers was tested to examine whether it would lead to significant changes in students’ self-reports of autonomy-supportive and controlling behaviours, psychological need satisfaction and frustration, and intrinsic motivation. Participants were 57 PE teachers (Mage = 45.70, SD = 12.79) and their 858 middle-school students (Mage = 13.22, SD = 0.75). A randomized controlled design was adopted in which PE teachers and their students were assigned to the combined face-to-face and web-based, face-to-face alone, web-based alone or control group. Face-to-face intervention was provided to PE teachers within one day in an 8-hour workshop and web-based intervention was provided to PE teachers for a period of four weeks. The combined face-to-face and web-based intervention group was the only study group that demonstrated statistically significant changes in all the study variables (i.e., significant increase in cognitive, organisational, and procedural autonomy-supportive behaviour, in psychological need satisfaction for autonomy, competence and relatedness, and in intrinsic motivation, whereas significant decrease in intimidation, controlling use of grades, and negative conditional regard, and in psychological need frustration for autonomy, competence, and relatedness) compared to the control group at a one-month follow-up. There were no significant differences in any of the study variable, except organisational autonomy support and intimidation, between the web-based intervention group and face-to-face intervention group. Both web-based and face-to-face study group students reported significant gains in most of the study variables compared to the control group students at a one-month follow-up. The current findings suggest that future autonomy-supportive interventions for PE teachers should aim to use combined interventions of face-to-face and web-based approach to gain the greatest intervention effects.

scholarly journals Observational vignette study to examine patient and healthcare provider perceived impact of asthma-related exacerbations in the US

2019 ◽  
Vol 14 ◽  
Author(s):  
Phaedra T. Johnson ◽  
Christopher F. Bell ◽  
John White ◽  
Breanna Essoi ◽  
Linda Nelsen ◽  
...  
Keyword(s):  
Financial Burden ◽  
Healthcare Providers ◽  
Self Care ◽  
Web Based ◽  
The Us ◽  
Household Costs ◽  
Patient Responses ◽  
Care Problems ◽  
Anxiety Depression ◽  
The Impact

Background: Little is known about how patients and healthcare providers (HCPs) perceive the impact of asthmarelated exacerbations. This study examined the impact of asthma-related exacerbations on patients’ lives from these different perspectives. Methods: Web-based surveys were administered to a US sample of adult patients with asthma, and HCPs. Participants reviewed six vignettes describing two hypothetical patients with asthma (25-year-old/single/unemployed/ no dependents; and 45-year-old/married/employed/two young children) experiencing mild, moderate, or severe exacerbations and rated the impact on eight measures: EuroQoL-5 Dimensions (mobility, self-care, usual activities, pain/ discomfort, and anxiety/depression), sleep, household costs, and medical costs. The proportions reporting impact for each measure were calculated for each vignette; and patient responses were compared with HCP responses. Results: 302 patients with asthma and 300 HCPs completed the survey. As exacerbation severity increased, a higher proportion of patients and HCPs reported impact of exacerbations on patients with asthma. Compared with HCPs, a greater proportion of patients reported problems with pain/discomfort related to mild and moderate exacerbations. Compared with patients, HCPs were more likely to indicate sleep impact, mobility problems, and financial burden across all exacerbation severity levels; self-care problems with moderate and severe exacerbations; and problems with usual activities and anxiety/depression for severe exacerbations. Conclusions: Understanding the distinctions between how patients and HCPs perceive the impact of exacerbations is important for optimizing patient care. HCPs may be less aware of patient’s concerns about exacerbation-related pain/ discomfort. Studies are needed to further understand patient-HCP interactions regarding asthma-related exacerbations.

scholarly journals Reluctance to Accept Palliative Care and Recommendations for Improvement

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 168-168
Author(s):  
Anna Rahman ◽  
YuJun Zhu ◽  
Susan Enguidanos ◽  
Valeria Cardenas
Keyword(s):  
Palliative Care ◽  
Controlled Trial ◽  
Healthcare Providers ◽  
Health Condition ◽  
Insurance Companies ◽  
Individual Interviews ◽  
Palliative Care Education ◽  
Home Based ◽  
Care Information ◽  
Seriously Ill Patients

Abstract Although insurance companies are increasingly paying for home-based palliative care (HBPC), enrollment remains low. To identify patient and caregiver perceived barriers to HBPC and their recommendations for overcoming these barriers, we conducted semi-structured individual interviews. Our interview protocol elicited participants’ perspectives on HBPC services; positive and negative aspects of the palliative program explanation; and suggestions for improving HBPC messaging. Seventeen patients and eight caregivers who were eligible for a randomized controlled trial of HBPC were interviewed. Themes related to HBPC referral barriers included reluctance to have home visits, enrollment timing, lack of palliative care knowledge, and patients’ self-perceived health condition. Themes related to recommendations for overcoming these obstacles included ensuring that HBPC referrals come from healthcare providers or insurance companies and presenting HBPC more clearly. Findings reinforce the need for palliative care education among seriously ill patients and the importance of delivering palliative care information and referrals from trusted sources.

scholarly journals A systematic Review of the Mediating Role of Knowledge, Self-efficacy and Self-care Behaviour in Telehealth Patients with Heart Failure

2012 ◽  
Vol 18 (7) ◽  
pp. 384-391 ◽  
Author(s):  
Yvette Ciere ◽  
Martin Cartwright ◽  
Stanton P Newman
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Self Efficacy ◽  
Healthcare Providers ◽  
Self Care ◽  
Self Monitoring ◽  
Mediating Role ◽  
Home Based ◽  
Patients With Heart Failure ◽  
Remote Assessment

We conducted a systematic review of controlled trials and pre-post studies to examine whether the putative benefits of telehealth, notably, improvements in clinical outcomes and quality of life, are mediated by increases in knowledge, self-efficacy and self-care behaviour in patients with heart failure. Telehealth was defined as any system of home-based self-monitoring of signs or symptoms of heart failure that transferred data for remote assessment by healthcare providers. Seven electronic databases were searched for studies that assessed any of six pathways in a proposed model. Data were independently extracted by two reviewers. Twelve studies met the inclusion criteria and provided evidence for or against one or more of the six pathways. Although all of the pathways in the model can be theoretically justified and three of the six relationships have been established in heart failure samples outside the context of telehealth, none of the pathways in the model were supported by the telehealth studies reviewed. Failure to replicate previously established relationships emphasizes the weakness of the telehealth literature, which impedes our ability to address questions such as how telehealth might achieve beneficial outcomes.

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