Adaptive Challenges and Family Support: Patient Self-Management during Treatment for Chronic Hepatitis C

The authors describe a family’s adaptive challenges and adaptive work during a family member’s treatment for Chronic Hepatitis C. We audiorecorded index and final clinical visits and interviewed participants (patients and providers) following the visits. We interviewed by telephone and reviewed medical records over the course of treatment. Transcripts were analyzed using directed content analysis. Three themes were identified: family adaptive challenges, patient-described aspects of family members’ adaptive challenges, and family adaptive work. There were four subthemes related to family adaptive work. The adaptive leadership framework for chronic illness provided direction for future family intervention.

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Clinical Encounters and Treatment Initiation for Chronic Hepatitis C Patients: Applications of Adaptive Leadership Framework for Chronic Illness

SAGE Open ◽

10.1177/2158244018824461 ◽

2019 ◽

Vol 9 (1) ◽

pp. 215824401882446 ◽

Cited By ~ 1

Author(s):

Donald E. Bailey ◽

Andrew J. Muir ◽

Judith A. Adams ◽

N. Marcus Thygeson ◽

Hants Williams ◽

...

Keyword(s):

Health Care ◽

Chronic Hepatitis ◽

Hepatitis C ◽

Chronic Illness ◽

Chronic Hepatitis C ◽

Health Care Providers ◽

The United States ◽

Clinical Encounter ◽

Adaptive Leadership ◽

Care Providers

Chronic hepatitis C (CHC) is the most common blood-borne infection in the United States. Patients with CHC undergoing treatment face many challenges including adherence to medications and management of symptoms; health care practitioners are well positioned to facilitate patients’ ability to address these challenges. We used the Adaptive Leadership for Chronic Illness Framework to investigate the difficulties inherent in affecting behavior change in patients undergoing treatment. We enrolled 11 patient participants and 10 provider participants. We used data from the first clinical encounter between patients and providers during which treatment was discussed. We found examples of adaptive leadership and categorized these behaviors into three themes: support for medication, coping with family/home life, and strategizing to manage employment. We also saw examples of what we termed missed opportunities for adaptive leadership. This study illustrates the contributions of adaptive leadership behaviors by health care providers and the potential risk to patients in their absence.

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Abstract P115: Fatigue Adaptation Among Stroke Survivors: A Sc oping Review

Stroke ◽

10.1161/str.52.suppl_1.p115 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Chiao-Hsin Teng ◽

Ratchanok Phonyiam ◽

Leslie L Davis ◽

Ruth A Anderson

Keyword(s):

Mixed Method ◽

Adaptive Leadership ◽

Conservation Strategies ◽

Stroke Survivors ◽

Daily Routines ◽

Care Partners ◽

Leadership Framework ◽

Adaptive Challenges ◽

Physical Functions ◽

Adaptive Work

Introduction: No study has systematically examined stroke survivors’ challenges with fatigue. We use the Adaptive Leadership Framework for Chronic Illness (ALFCI) to synthesize what survivors’ challenges are with fatigue and how they respond or collaborate with others to achieve poststroke fatigue adaptation. Methods: We searched PubMed, CINAHL, Embase, and PsycInfo using PRISMA-ScR guidelines, gathering studies between 2012 and 2020. Qualitative studies or qualitative findings in mixed-method studies were included if they described stroke survivors’ (cerebral infarction, TIA, and brain hemorrhage) experiences with fatigue and/or care partners’ experiences to help survivors adapt to fatigue. We excluded studies which were not full-text English and did not report empirical data (e.g., literature review or editorial). We used interpretive synthesis to analyze the published qualitative data. Results: Of 714 papers identified, we retained 25 papers (22 qualitative and 3 mixed-method studies). Using ALFCI to synthesize data, we found that survivors with fatigue had many types of adaptive challenges. Fatigue made them less productive and it affected their cognitive, language, and physical functions, as well as sleeping patterns and social activities. To respond to these challenges, survivors did adaptive work such as changing mindset, using energy-conservation strategies, restructuring routines, and exercising. Care partners, health professionals, and others showed leadership by helping survivors adapt to fatigue by giving information about fatigue, assessing survivors’ fatigue levels, reducing survivors’ workload, and collaboratively negotiating for new daily routines. However, some studies indicated survivors needed fatigue education from professionals. No study interviewed care partners to examine their experiences helping survivors adapt to fatigue. Conclusions: Survivors had many types of challenges and responses towards fatigue. Care partners and others showed leadership by facilitating survivors with fatigue adaptation. Future studies can identify targets for interventions to address poor adaptation to fatigue and also explore care partners’ perspectives.

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