Impact of COVID-19 on perceived wellbeing, self-management and views of novel modalities of care among medically vulnerable patients in Singapore

2021 ◽  
pp. 174239532110674
Author(s):  
Sungwon Yoon ◽  
Pei Shan Hoe ◽  
Angelique Chan ◽  
Rahul Malhotra ◽  
Abhijit Visaria ◽  
...  
Keyword(s):  
Emotional Distress ◽  
Qualitative Interviews ◽  
Self Care ◽  
Self Management ◽  
Physical Interaction ◽  
Vulnerable Patients ◽  
National Cohort ◽  
Multivariable Regression ◽  
Male Patients ◽  
The Impact

Objectives This study aims to examine the impact of COVID-19 measures on wellbeing and self-management in medically vulnerable non-COVID patients and their views of novel modalities of care in Singapore. Methods Patients with cardiovascular disease (CVD), respiratory disease, chronic kidney disease, diabetes and cancer were recruited from the SingHealth cluster and national cohort of older adults. Data on demographics, chronic conditions and perceived wellbeing were collected using questionnaire. We performed multivariable regression to examine factors associated with perceived wellbeing. Qualitative interviews were conducted to elicit patient's experience and thematically analyzed. Results A total of 91 patients participated. Male patients compared with female patients perceived a lower impact of the pandemic on subjective wellbeing. Patients with CVD compared to those having conditions other than CVD perceived a lower impact. Impacts of the pandemic were primarily described in relation to emotional distress and interference in maintaining self-care. Hampering of physical activity featured prominently, but most did not seek alternative ways to maintain activity. Despite general willingness to try novel care modalities, lack of physical interaction and communication difficulties were perceived as main barriers. Discussion Findings underline the need to alleviate emotional distress and develop adaptive strategies to empower patients to maintain wellbeing and self-care.

scholarly journals Living With the Burden of Pseudobulbar Affect: A Qualitative Analysis of the Effects of Education on Patient Experience

2020 ◽  
Vol 7 (6) ◽  
pp. 1324-1330 ◽  
Author(s):  
Wendy Turell ◽  
Anne Roc ◽  
Erik Pioro ◽  
Alexandra Howson
Keyword(s):  
Neurological Diseases ◽  
Qualitative Interviews ◽  
Virtual Education ◽  
Self Management ◽  
Effective Mechanism ◽  
Pseudobulbar Affect ◽  
Neurological Conditions ◽  
The Impact ◽  
Education Symposium ◽  
Insight Into

Pseudobulbar affect (PBA) is associated with several neurological diseases and is underrecognized in clinical practice; however, PBA symptoms are often attributed to psychiatric or mood disorders rather than to neurological etiology. Until recently, there were no US Food and Drug Administration therapies approved for treating this condition, and there are currently few resources to support patients in the recognition and self-management of PBA symptoms. We evaluated the impact of a virtual education symposium on patient knowledge and self-efficacy via qualitative interviews. This evaluation of education impact provides unique insight into the experience of managing PBA symptoms; suggests that there is extensive need for educational resources to support patients with PBA and enable them to engage effectively with their providers; and affirms that online learning is an effective mechanism for delivering education to patients that enables them to more effectively self-manage symptoms in the context of chronic neurological conditions such as PBA.

Development and utility of m-health enabled nutrition informatics intervention for self-care management of type 2 diabetes in home settings (Preprint)

2021 ◽  
Author(s):  
Abhijeet Prasad Sinha ◽  
Manmohan Singhal ◽  
Mansi Gupta ◽  
Ashish Joshi
Keyword(s):  
Public Health ◽  
Type 2 Diabetes ◽  
Care Management ◽  
Self Care ◽  
The Self ◽  
Self Management ◽  
Integrative Approach ◽  
Health Application ◽  
The Impact

BACKGROUND Diabetes represents an important public health challenge in India and Globally. It affects quality of life and is one of the leading causes of death and disability. The burden on global health is huge and about 463 million adults are currently living with diabetes. 77 million people in India in the age group of 20-79 years are affected by this pandemic and total cost to health expenditure is 8 billion US dollars, therefore huge burden, and great economic cost on Public health. The self-management of diabetes, the research priorities include exploring the concept of diabetes self-management and major research questions would comprise of asking what affects self-management in persons with diabetes and how do m-health application and interventions can impact on the self-management behaviors in development, utility of the m-health app in self-management of person with diabetes. Therefore, this project research is of great significance and would bring an integrative approach on self-care management OBJECTIVE To design, develop and evaluate the impact of m-health enabled nutrition informatics intervention for home based self-management of type 2 diabetes in an Indian setting. METHODS A mixed research study will be conducted between January 2022 and January 2023. A sample of approximately 250 individuals will be recruited and enrolled using a nonprobability complete enumeration sampling method from selected urban settings of Delhi inclusion and exclusion criteria with age20-79 years male and female with Type 2 diabetes and have access to Smart phone Data will be collected using which questionnaires. The collected data will be used to assess use and utility of mobile health application developed. The knowledge, attitudes, practices, and beliefs regarding Diabetes self-care management. Lastly, the study questionnaire system usability survey(SUS) will be used to assess the usability of mobile applications on selfcare management of Diabetes RESULTS A pilot of 250 individuals has been conducted to pretest the DBMS questionnaire. The data collection will be initiated from January 2022, and the initial results are planned for publication by October 2022.Descriptive analysis of the gathered data will be performed using SPSS V11, and reporting of the results will be done at 95% CIs and P=.0.05. CONCLUSIONS The findings of the study would inform the elements essential for the development of m-health intervention to improve self-care management of diabetes at home settings. The usefulness and acceptance of the proposed intervention will be conducted. CLINICALTRIAL DITU/UREC/2021/07/10

Text Messaging to Improve Disease Management in Patients With Painful Diabetic Peripheral Neuropathy

2018 ◽  
Vol 44 (3) ◽  
pp. 237-248 ◽  
Author(s):  
Victoria Bauer ◽  
Nancy Goodman ◽  
Brittany Lapin ◽  
Camille Cooley ◽  
Ed Wang ◽  
...  
Keyword(s):  
Peripheral Neuropathy ◽  
Usual Care ◽  
Health Beliefs ◽  
Diabetic Peripheral Neuropathy ◽  
Text Messaging ◽  
Self Care ◽  
Text Messages ◽  
Self Management ◽  
Painful Diabetic Peripheral Neuropathy ◽  
The Impact

Purpose The purpose of the study was to determine the impact of educational text messages on diabetes self-management activities and outcomes in patients with painful diabetic peripheral neuropathy (pDPN). Methods Patients with pDPN identified from a large integrated health system who agreed to participate were randomized to 6 months of usual care (UC) or UC plus twice-daily diabetes self-management text messages (UC+TxtM). Outcomes included the Pain Numerical Rating Scale, Summary of Diabetes Self-Care Activities (SDSCA), questions on diabetes health beliefs, and glycated hemoglobin (A1C). Changes from baseline were evaluated at 6 months and compared between groups. Results Demographic characteristics were balanced between groups (N = 62; 53% female, mean age = 63 years, 94% type 2 diabetes), as were baseline measures. After 6 months, pain decreased with UC+TxtM from 6.3 to 5.5 and with UC from 6.5 to 6.0, with no difference between groups. UC+TxtM but not UC was associated with significant improvements from baseline on all SDSCA subscales. On diabetes health beliefs, UC+TxtM patients reported significantly increased benefits and reduced barriers and susceptibility relative to UC at 6 months. A1C declined in both groups, but neither change was significant relative to baseline. Conclusions Patients with pDPN who receive twice-daily text messages regarding diabetes management reported reduced pain relative to baseline, although this change was not significant compared with usual care. In addition, text messaging was associated with increased self-management activities and improved diabetes health beliefs and total self-care. These results warrant further investigation.

scholarly journals P095 The impact of COVID-19 lockdown on clinical care, self-management, and mental health in patients with inflammatory arthritis

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Melissa Sweeney ◽  
Lewis Carpenter ◽  
Savia de Souza ◽  
Hema Chaplin ◽  
Hsiu Tung ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Emotional Distress ◽  
Inflammatory Arthritis ◽  
Clinical Care ◽  
Self Management ◽  
Disease Outcomes ◽  
Reduced Physical Activity ◽  
Vas Scores ◽  
The Impact

Abstract Background/Aims  COVID-19 lockdown affected access to clinical care for many vulnerable patients, including those with inflammatory arthritis (IA). It also had the potential to alter self-management behaviours. These changes could in turn impact mental health, especially given that IA patients are already at higher risk of mental health disorders. Thus, the aims of this study were to determine how IA care and self-management were affected by lockdown and assess the impact of these changes on disease outcomes and mental health. Methods  Online questionnaires were completed by 338 participants between June and July 2020. The questionnaires assessed demographics, IA condition, IA self-management, COVID-19 clinical information, quality of life, and mental health. Visual analogue scale (VAS) scores for patient global assessment (PGA) of disease activity, pain, fatigue, and emotional distress were completed relating to the previous week and retrospectively for pre-lockdown (March) and early-lockdown (April). Improvement/worsening in each VAS was considered as a change of 10 points or more from pre-lockdown to the current rating. Linear regressions were conducted to determine factors associated with worse outcomes, controlling for potential confounders including self-reported pre-lockdown status. Results  Mean VAS scores worsened during lockdown for all outcome measures, with over half reporting a more than 10-point worsening (Table 1). Changes to clinical care affected 87% of patients. The most commonly affected services were hospital outpatient appointments (77%), GP appointments (59%), and blood tests (53%). Changes to clinical care were significantly associated with worse PGA (b = 8.95, p=0.01), pain (b = 7.13, p=0.05), fatigue (b = 17.01, p<0.00) and emotional distress (b = 12.78, p<0.01). Regarding self-management, 64% of patients reported changes to diet while 51% reduced physical activity. Change in diet was not significantly associated with any of the outcomes, whereas physical activity was associated with PGA (b=-2.42, p<0.01), pain (b=-2.43, p<0.01), fatigue (b=-2.5, p < 0.01), and emotional distress (b=-2.41, p<0.01). Conclusion  Most patients (87%) had at least one area of clinical care affected by the lockdown. These changes in IA clinical care were associated with worse disease outcomes across all measures and greater emotional distress. In self-management, reduced physical activity was associated with worse outcomes in all physical and mental health measures. P095 Table 1:Mean VAS (0-100) scores and percent changesPGAMarch April June/JulyMean (SD) 44.51 (23.70) 53.18 (24.67) 57.69 (25.29)Better Same WorsePercent 7.9936.6855.33[95% CI] [5.33-11.41][31.54-42.07][49.85-60.71]PainMarch April June/July42.60 (25.60) 51.11 (26.01) 56.66 (26.40)Better Same Worse7.6937.8754.44[5.09-11.07] [32.68-43.28][48.96-59.84]FatigueMarch April June/July46.86 (26.17) 57.11 (25.83) 61.35 (26.51)Better Same Worse10.0634.0255.92[7.07-13.77] [28.98-39.35][50.44-61.29]Emotional DistressMarch April June/July30.96 (26.28) 49.06 (29.09) 48.75 (29.15)Better Same Worse8.2833.14 58.58[5.58-11.75] [28.14-38.43][53.12-63.88] Disclosure  M. Sweeney: None. L. Carpenter: None. S. de Souza: None. H. Chaplin: None. H. Tung: None. E. Caton: None. J. Galloway: None. A. Cope: None. M. Yates: None. S. Norton: None.

scholarly journals Empowerment-based interventions in people with multiple sclerosis: a review study

2019 ◽  
Author(s):  
Sajjad Saadat ◽  
Mehrdad Kalantari ◽  
Mohammad Bagher Kajbaf ◽  
Mozaffar Osseininezhad
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Chronic Disease ◽  
Self Care ◽  
Self Management ◽  
Iranian Studies ◽  
Male Patients ◽  
Review Study

Introdution: Multiple sclerosis is a chronic disease in the nervous system; It has many problems due to its chronic and promising nature. The treatment of this disease includes medical care and empowerment interventions for symptom management. The purpose of this study was to review the empowerment interventions in these patients. Methods: This study was conducted in a Systematic Reviewperiod from January 2000 to June 2018. On indexing sites “Magiran, PubMed, Google Scholar and Science Direct” searched the key words of Multiple Sclerosis, Chronic Disease, Quality of Life, Self-care, Self-management, Rehabilitation, Empowerment, Psychotherapy, Psychological interventions, Clinical Trials, and Randomized Clinical Trial. Out of 1855 articles found, 33 articles were selected for review. Results: The results of this study showed that empowerment interventions in people with MS can be divided into four categories of self-care, self-management, rehabilitation and psychotherapy interventions. Lack of attention to empowerment interventions in people with MS, especially in the Iran, low attention to male patients in implementing interventions, failure to consider the theoretical framework in the formulation of interventions, lack of follow-up test and non-use of virtual intervention methods (Such as using DVDs, consulting and telephone training, etc.) in Iranian studies, is one of the most respected points in previous studies. Conclusion: Empowerment studies have provided significant results in reducing symptoms and improving the quality of life of patients, which can help improve these interventions by considering some of the points.

Mobile applications for heart failure self-management: a systematic review (Preprint)

2021 ◽  
Author(s):  
Leticia Bezerra ◽  
Huong Ly Tong ◽  
John J Atherton ◽  
Rimante Ronto ◽  
Josephine Chau ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mobile Applications ◽  
Evaluation Studies ◽  
Self Care ◽  
Mobile App ◽  
Emergency Department Visits ◽  
Self Management ◽  
Self Monitoring ◽  
Vital Signs Monitoring ◽  
The Impact

BACKGROUND Heart failure is a common cause of hospitalization and patient self-management is essential to avoid decompensation and readmissions. Mobile applications (apps) seem promising in supporting heart failure self-management. OBJECTIVE This study systematically reviews the evidence on the impact of heart failure self-management apps on health outcomes and patient experience. METHODS Four databases (Medline, Embase, CINAHL, and PsycINFO) were searched for studies published from 2008 to 2020 examining interventions that comprised a mobile app targeting heart failure self-management and reported any health-related outcomes or patient perspectives. Studies were independently screened. We performed a narrative synthesis of results. PRISMA guidelines were followed. The protocol was registered in PROSPERO (CRD42020158041). RESULTS Nineteen articles [4 randomized controlled trials (RCTs)], assessing 16 apps and a total of 930 participants were included. The most common app features were symptom monitoring (14 of 16 apps), weight monitoring (13/16), and vital signs monitoring (12/16). RCTs were small and outcomes were predominantly self-reported. Two RCTs reported significant improvement in self-care scale measures, including ‘self-management’ (p=0.01), ‘self-confidence’ (p=0.03) and ‘self-maintenance’ (p=0.03) Two RCTs reported higher unplanned clinic visits. Mortality and emergency department visits were reported in two RCTs and hospital re-admissions in one RCT, with no significant differences. Engagement with the intervention was poorly reported. The most desirable app characteristics were automated self-monitoring and feedback, data integration and sharing, and personalization. CONCLUSIONS Mobile apps may improve self-care, particularly if enabling automated self-monitoring and personalized feedback, but more robust evaluation studies are needed addressing key endpoints for heart failure.

scholarly journals The Impact of a Diabetes Self-Management Education Program Provided through a Telemedicine Link to Rural California Health Care Clinics

2013 ◽  
Vol 6 ◽  
pp. HSI.S10924
Author(s):  
Jim Nuovo
Keyword(s):  
Rural Health ◽  
Education Program ◽  
Management Education ◽  
Self Care ◽  
Self Management ◽  
Post Intervention ◽  
Health Clinics ◽  
Number Of Patients ◽  
Rural Health Clinics ◽  
The Impact

Background This project investigated the impact of a DM self-management education program provided through a telemedicine link at nine rural health clinics in Northern California. Methods Two hundred thirty nine patients were provided with a single 2-hour class on DM delivered through a live televideo connection. Patients provided pre-intervention information on: demographics and overall health, self-care behaviors, and knowledge about DM. All participants completed a post-education survey on knowledge and self-care behaviors. Results There was a significant decrease in the number of patients who felt overwhelmed with their DM; pre-intervention 18.8%; post-intervention 5.4% ( P < 0.0001). Patients increased the number of days they exercised; pre-intervention 3.4 days; post-intervention 3.9 days ( P = 0.02). Patients increased the number of days they checked their feet; pre-intervention 4.2 days; post-intervention 5.6 days ( P < 0.01). Knowledge about DM improved over the study period ( P < 0.01). Conclusions A single 2-hour class on DM administered through a telemedicine link to patients in rural health clinics resulted in feeling less overwhelmed, more knowledgeable about DM, and demonstrated an increase in self-care behavior; ie, exercise and foot care.

scholarly journals The Osteoarthritis Thumb Therapy (OTTER) II Trial: a study protocol for a three-arm multi-centre randomised placebo controlled trial of the clinical effectiveness and efficacy and cost-effectiveness of splints for symptomatic thumb base osteoarthritis

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e028342 ◽  
Author(s):  
Jo Adams ◽  
Paula Barratt ◽  
Nigel K Arden ◽  
Sofia Barbosa Bouças ◽  
Sarah Bradley ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Functional Disability ◽  
Controlled Trial ◽  
Qualitative Interviews ◽  
Outcome Expectations ◽  
Management Programme ◽  
Self Management ◽  
Study Endpoint ◽  
South Central ◽  
The Impact

IntroductionThe economic cost of osteoarthritis (OA) is high. At least 4.4 million people have hand OA in the UK. Symptomatic thumb base OA affects 20% of people over 55 years, causing more pain, work and functional disability than OA elsewhere in the hand. Most evidence-based guidelines recommend splinting for hand OA. Splints that support or immobilise the thumb base are routinely used despite there being limited evidence on their effectiveness. The potential effects of placebo interventions in OA are acknowledged, but few studies investigate the clinical efficacy of rehabilitation interventions nor the impact of any placebo effects associated with splints.Methods and analysisParticipants aged 30 years and over with symptomatic thumb base OA will be recruited into the trial from secondary care occupational therapy and physiotherapy centres. Following informed consent, participants will complete a baseline questionnaire and then be randomised into one of three treatment arms: a self-management programme, a self-management programme plus a verum thumb splint or a self-management programme plus a placebo thumb splint. The primary outcome is the Australian Canadian Osteoarthritis Hand Index (AUSCAN) hand pain scale. The study endpoint is 8 weeks after baseline. Baseline assessments will be carried out prior to randomisation and outcomes collected at 4, 8 and 12 weeks. Cost-effectiveness analysis will be conducted and individual qualitative interviews conducted with up to 40 participants after 8 weeks to explore perceptions and outcome expectations of verum and placebo splints and exercise.Ethics and disseminationSouth Central—Oxford C Research Ethics Committee approved this study (16/SC/0188). The findings will be disseminated to health professional conferences, journals and lay publications for patient organisations. The research will contribute to improving the management of thumb base OA and help clinicians and patients make informed decisions about the value of different interventions.Trial registration numberISRCTN54744256.

scholarly journals Association Between User Engagement of a Mobile Health App for Gout and Improvements in Self-Care Behaviors: Randomized Controlled Trial

10.2196/15021 ◽  
2019 ◽  
Vol 7 (8) ◽  
pp. e15021 ◽  
Author(s):  
Anna Serlachius ◽  
Kiralee Schache ◽  
Anel Kieser ◽  
Bruce Arroll ◽  
Keith Petrie ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Mobile Health ◽  
Illness Perceptions ◽  
Self Care ◽  
Mean Difference ◽  
Trial Registration ◽  
Self Management ◽  
User Engagement ◽  
The Impact

Background Mobile health (mHealth) apps represent a promising approach for improving health outcomes in patients with chronic illness, but surprisingly few mHealth interventions have investigated the association between user engagement and health outcomes. We aimed to examine the efficacy of a recommended, commercially available gout self-management app for improving self-care behaviors and to assess self-reported user engagement of the app in a sample of adults with gout. Objective Our objective was to examine differences in self-reported user engagement between a recommended gout app (treatment group) and a dietary app (active control group) over 2 weeks as well as to examine any differences in self-care behaviors and illness perceptions. Methods Seventy-two adults with gout were recruited from the community and three primary and secondary clinics. Participants were randomized to use either Gout Central (n=36), a self-management app, or the Dietary Approaches to Stop Hypertension Diet Plan (n=36), an app based on a diet developed for hypertension, for 2 weeks. The user version of the Mobile Application Rating Scale (uMARS, scale: 1 to 5) was used after the 2 weeks to assess self-reported user engagement, which included an open-ended question. Participants also completed a self-report questionnaire on self-care behaviors (scale: 1-5 for medication adherence and diet and 0-7 for exercise) and illness perceptions (scale: 0-10) at baseline and after the 2-week trial. Independent samples t tests and analysis of covariance were used to examine differences between groups at baseline and postintervention. Results Participants rated the gout app as more engaging (mean difference –0.58, 95% CI –0.96 to –0.21) and more informative (mean difference –0.34, 95% CI –0.67 to –0.01) than the dietary app at the 2-week follow-up. The gout app group also reported a higher awareness of the importance of gout (mean difference –0.64, 95% CI –1.27 to –0.003) and higher knowledge/understanding of gout (mean difference –0.70, 95% CI –1.30 to –0.09) than the diet app group at follow-up. There were no significant differences in self-care behaviors between the two groups postintervention. The gout app group also demonstrated stronger negative beliefs regarding the impact of gout (mean difference –2.43, 95% CI –3.68 to –1.18), stronger beliefs regarding the severity of symptoms (mean difference –1.97, 95% CI –3.12 to –0.82), and a stronger emotional response to gout (mean difference –2.38, 95% CI –3.85 to –0.90) at follow-up. Participant feedback highlighted the importance of tracking health-related information, customizing to the target group/individual, providing more interactive features, and simplifying information. Conclusions Participants found the commercially available gout app more engaging. However, these findings did not translate into differences in self-care behaviors. The gout app group also demonstrated stronger negative illness perceptions at the follow-up. Overall, these findings suggest that the development of gout apps would benefit from a user-centered approach with a focus on daily, long-term self-care behaviors as well as modifying illness beliefs. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12617001052325; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373217.

Sign in / Sign up

Export Citation Format

Share Document