scholarly journals Promoting the use of self-management in patients with spine pain managed by chiropractors and chiropractic interns: barriers and design of a theory-based knowledge translation intervention

2019 ◽  
Vol 27 (1) ◽  
Author(s):  
Owis Eilayyan ◽  
Aliki Thomas ◽  
Marie-Christine Hallé ◽  
Sara Ahmed ◽  
Anthony C. Tibbles ◽  
...  
Keyword(s):  
Knowledge Translation ◽  
Health Outcomes ◽  
Self Care ◽  
Theoretical Domains Framework ◽  
Action Planning ◽  
Lifestyle Changes ◽  
Self Management ◽  
Behaviour Change Techniques ◽  
Management Support ◽  
Spine Pain

Abstract Background The literature supports the effectiveness of self-management support (SMS) to improve health outcomes of patients with chronic spine pain. However, patient engagement in SMS programs is suboptimal. The objectives of this study were to: 1) assess participation in self-care (i.e. activation) among patients with spine pain, 2) identify patients’ barriers and enablers to using SMS, and 3) map behaviour change techniques (BCTs) to key barriers to inform the design of a knowledge translation (KT) intervention aimed to increase the use of SMS. Methods In summer 2016, we invited 250 patients with spine pain seeking care at the Canadian Memorial Chiropractic College in Ontario, Canada to complete the Patient Activation Measure (PAM) survey to assess the level of participation in self-care. We subsequently conducted individual interviews, in summer 2017, based on the Theoretical Domains Framework (TDF) in a subset of patients to identify potential challenges to using SMS. The interview guide included 20 open-ended questions and accompanying probes. Findings were deductively analysed guided by the TDF. A panel of 7 experts mapped key barriers to BCTs, designed a KT intervention, and selected the modes of delivery. Results Two hundred and twenty-three patients completed the PAM. Approximately 24% of respondents were not actively involved in their care. Interview findings from 13 spine pain patients suggested that the potential barriers to using SMS corresponded to four TDF domains: Environmental Context and Resources; Emotion; Memory, Attention & Decision-Making; and Behavioural Regulation. The proposed theory-based KT intervention includes paper-based educational materials, webinars and videos, summarising and demonstrating the therapeutic recommendations including exercises and other lifestyle changes. In addition, the KT intervention includes Brief Action Planning, a SMS strategy based on motivational interviewing, along with a SMART plan and reminders. Conclusions Almost one quarter of study participants were not actively engaged in their spine care. Key barriers likely to influence uptake of SMS among patients were identified and used to inform the design of a theory-based KT intervention to increase their participation level. The proposed multi-component KT intervention may be an effective strategy to optimize the quality of spine pain care and improve patients’ health-outcomes.

scholarly journals Overcoming obstacles: collaboration for change

2004 ◽  
pp. T19-T22 ◽  
Author(s):  
MM Funnell
Keyword(s):  
Health Outcomes ◽  
Diabetes Care ◽  
Interactive Learning ◽  
Diabetes Education ◽  
Self Care ◽  
Self Management ◽  
Management Support ◽  
The Past ◽  
Major Shift ◽  
Training Programmes

Effective diabetes care requires a partnership between prepared, proactive practice teams and informed, activated patients. Diabetes education helps to overcome many of the barriers to effective self-management by enabling people with diabetes to make informed decisions about their day-to-day self-care. Both psychosocial and health outcomes have been improved through a variety of training programmes; however, education must be coupled with ongoing self-management support if these benefits are to be sustained. The principal goal of diabetes education has undergone a major shift over the past few years--evolving from primarily didactic interventions, focused on encouraging patients to adhere to the prescribed therapy, towards more interactive learning that supports people in making informed, self-directed decisions.

Abstract P126: Self-management Program And Black Women With Hypertension

Hypertension ◽  
2021 ◽  
Vol 78 (Suppl_1) ◽  
Author(s):  
Willie M Abel
Keyword(s):  
Black Women ◽  
Repeated Measures ◽  
Care Management ◽  
Self Care ◽  
The United States ◽  
Management Program ◽  
Lifestyle Changes ◽  
Community Dwelling ◽  
Self Management ◽  
Effective Interventions

Introduction: Prevalence rates of hypertension (HTN) among Black adults (males 58.3% and females 57.6%) in the United States is among the highest in the world. Black females (46%) experience a higher incidence of Stage 2 HTN than Black males (42%) contributing to a greater risk of heart failure, stroke, and kidney disease. Levels of awareness, treatment, and control of HTN among Black women are decreasing. Effective strategies to combat these trends are imperative. Lifestyle changes and medication adherence are proven strategies to facilitate blood pressure (BP) control. Getting individuals with HTN to incorporate these strategies into the context of their everyday physical and social environments where they can be performed independently requires active individual engagement in healthcare behaviors and self-care activities. Aim: This study examined the effects of the Chronic Disease Self-Management Program (CDSMP) on self-care (maintenance, management, and confidence) and BP control in Black women with HTN at baseline and then 3-, 6-, and 9-months post CDSMP. Methods: The current study used data from the Interactive Technology Enhanced Coaching Intervention RCT for Black Women with HTN study. All participants completed a 6-week CDSMP at the beginning of the study. Self-care data were collected using the Self-Care of HTN Inventory along with manual BP readings at baseline, and repeated measures at 3-, 6-, and 9-months. Results: Of the 90 community-dwelling Black women enrolled in the study, 83 completed the CDSMP and 69 completed the study. The mean age was 53.57 ( SD = 10.07) years and the average number of years diagnosed with HTN was 11.06 ( SD = 8.47). All participants had BP readings greater than 130/80 mmHg at baseline and 44.92% (31 of 69) moved to less than 130/80 mmHg at 9-months. A weak negative correlation occurred at 9-months between systolic BP and self-care management, r (67) = -.26, p = .029, and confidence, r (67) = -.25, p = .035; and diastolic BP and self-care management, r (67) = -.31, p = .009, and confidence, r (67) = -.28, p = .018. Conclusion: The CDSMP was feasible, successfully delivered, and well-received by those enrolled in the study. Future studies should evaluate effective interventions for self-care strategies to improve long-term BP control.

The Nexus of M-Health and Self-Care

2019 ◽  
pp. 235-259
Author(s):  
Anastasius S. Moumtzoglou
Keyword(s):  
Mobile Health ◽  
Self Care ◽  
Normal Activity ◽  
Models Of Care ◽  
Self Management ◽  
Management Support ◽  
Long Term Conditions ◽  
Concept Of Health ◽  
Health Related

Self-care emerged from the concept of health promotion in the 1970s while from 2000 onwards the term self-management gained popularity, with a greater focus on long-term conditions and the trend towards more holistic models of care. Although self-management and self-care are often used interchangeably, a distinction between the two concepts can be made. Both can be considered in terms of a continuum, with self-care at one end as “normal activity” and self-management an extension of this. Self-management support is the assistance given to patients in order to encourage daily decisions that improve health-related behaviors and clinical outcomes. The chapter envisions these concepts on a continuum with one pole representing mobile health and the other self-care. It concludes that self-management support is the nexus of mobile health and self-care.

Seeing in 3-D: Examining the Reach of Diabetes Self-Management Support Strategies in a Public Health Care System

2006 ◽  
Vol 35 (5) ◽  
pp. 664-682 ◽  
Author(s):  
Dean Schillinger ◽  
Hali Hammer ◽  
Frances Wang ◽  
Jorge Palacios ◽  
Ivonne McLean ◽  
...  
Keyword(s):  
Public Health ◽  
Limited English Proficiency ◽  
Significant Proportion ◽  
Action Planning ◽  
Safety Net ◽  
Public Health Care ◽  
System Level ◽  
Self Management ◽  
Management Support ◽  
Medical Visits

The authors examined whether tailored self-management support (SMS) strategies reach patients in a safety net system and explored variation by language, literacy, and insurance. English-, Spanish-, and Cantonese-speaking diabetes patients were randomized to weekly automated telephone disease management (ATDM) or monthly group medical visits. The SMS programs employ distinct communication methods but share common objectives, including behavioral “action plans.” Reach was measured using three complementary dimensions: (a) participation among clinics, clinicians, and patients; (b) patient representativeness; and (c) patient engagement with SMS. Participation rates were high across all levels and preferentially attracted Spanish-language speakers, uninsured, and Medicaid recipients. Although both programs engaged a significant proportion in action planning, ATDM yielded higher engagement, especially among those with limited English proficiency and limited literacy. These results provide important insights for health communication and translational research with respect to realizing the public health benefits of SMS and can inform system-level planning to reduce health disparities.

The Nexus of M-Health and Self-Efficacy

2016 ◽  
pp. 341-365 ◽  
Author(s):  
Anastasius S. Moumtzoglou
Keyword(s):  
Mobile Health ◽  
Self Efficacy ◽  
Social Cognitive ◽  
Cognitive Theory ◽  
Self Care ◽  
Normal Activity ◽  
Models Of Care ◽  
Self Management ◽  
Management Support ◽  
Health Related

Self-care emerged from the concept of health promotion in the 1970s while from 2000 onwards the term ‘self-management' gained popularity, with a greater focus on long-term conditions and the trend towards more holistic models of care. Although ‘self-management' and ‘self-care' are often used interchangeably, a distinction between the two concepts can be made. Both can be considered in terms of a continuum, with self-care at one end as ‘normal activity' and self-management an extension of this. Self-management support is the assistance given to patients in order to encourage daily decisions that improve health-related behaviors and clinical outcomes. Self-efficacy, which is grounded in social cognitive theory, is defined as confidence in one's ability to perform given tasks. The chapter envisions these concepts on a continuum with one pole representing mobile health and the other self-efficacy. It concludes that self-management support is the nexus of mobile health and self-efficacy.

scholarly journals A systematic review of mobile health technologies to support self-management of concurrent diabetes and hypertension

2020 ◽  
Vol 27 (6) ◽  
pp. 939-945 ◽  
Author(s):  
Wonchan Choi ◽  
Shengang Wang ◽  
Yura Lee ◽  
Hyunkyoung Oh ◽  
Zhi Zheng
Keyword(s):  
Literature Review ◽  
Health Outcomes ◽  
Systematic Literature Review ◽  
Mobile Health ◽  
Randomized Clinical Trials ◽  
Self Management ◽  
Management Support ◽  
Health Technologies ◽  
Patient Health ◽  
Objectively Measured

Abstract Objective This article reports results from a systematic literature review of the current state of mobile health (mHealth) technologies that have the potential to support self-management for people with diabetes and hypertension. The review aims to (a) characterize mHealth technologies used or described in the mHealth literature and (b) summarize their effects on self-management for people with diabetes and hypertension from the clinical and technical standpoints. Materials and Methods A systematic literature review was conducted following PRISMA guidelines. Online databases were searched in September 2018 to identify eligible studies for review that had been published since 2007, the start of the smartphone era. Data were extracted from included studies based on the PICOS framework. Results Of the 11 studies included for in-depth review, 5 were clinical research examining patient health outcomes and 6 were technology-focused studies examining users’ experiences with mHealth technologies under development. The most frequently used mHealth technology features involved self-management support (n = 11) followed by decision support (n = 6) and shared decision-making (n = 6). Most clinical studies reported benefits associated with mHealth interventions. These included reported improvements in objectively measured patient health outcomes (n = 3) and perceptual or behavioral outcomes (n = 4). Discussion Although most studies reported promising results in terms of the effects of mHealth interventions on patient health outcomes and experience, the strength of evidence was limited by the study designs. Conclusion More randomized clinical trials are needed to examine the promise and limitations of mHealth technologies as assistive tools to facilitate the self-management of highly prevalent comorbidity of chronic conditions, such as diabetes and hypertension.

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.

scholarly journals Effectiveness of diabetes self-management education (DSME) in type 2 diabetes mellitus (T2DM) patients: Systematic literature review

2021 ◽  
Vol 10 (2) ◽  
Author(s):  
Ucik Ernawati ◽  
Titin Andri Wihastuti ◽  
Yulian Wiji Utami
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Management Education ◽  
Self Care ◽  
Lifestyle Changes ◽  
The Self ◽  
Self Management ◽  
Education Intervention

Diabetes mellitus is a chronic disease characterized by high glucose levels (hyperglycemia) due to metabolic disorders that prevent patients from producing sufficient amounts of insulin. This research aims to test the effectiveness of implementing diabetes self-management education in patients with Type 2 diabetes mellitus. The search for relevant articles was carried out through Google Scholar, PubMed, Proquest, and Science Direct using the keywords diabetes mellitus, management education, self-care, diabetes self-management education, DSME, T2DM. The articles were then selected based on inclusion and exclusion criteria. Furthermore, the data were extracted, grouped, and concluded. Based on 15 articles, diabetes self-management education intervention provides significant effectiveness to lifestyle changes and the self-care of T2DM patients. In conclusion, diabetes self-management education intervention has been shown to be effective in dealing with type 2 diabetes mellitus. Furthermore, DSME has a positive effect on lifestyle changes and the self-care of T2DM patients.

scholarly journals Promoting Self-Care in Nursing Encounters with Persons Affected by Long-Term Conditions—A Proposed Model to Guide Clinical Care

2021 ◽  
Vol 18 (5) ◽  
pp. 2223
Author(s):  
Carina Hellqvist
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Clinical Care ◽  
Self Care ◽  
Self Management ◽  
Unique Contribution ◽  
Management Support ◽  
Data Set ◽  
Long Term Conditions

Background: Nursing interventions for persons affected by long-term conditions should focus on providing support to enhance the ability to manage disease in everyday life. Many clinical nurses feel they have inadequate training or experience to provide self-management support in a beneficial and structured way. This study explores the process towards independent self-care and management of disease in persons affected by Parkinson’s disease and the support required from healthcare to achieve this. It presents a nursing model to guide nurses in providing self-management support in the clinical care encounter. Methods: The results from three previously published articles investigating a self-management support program for persons with Parkinson’s disease were combined to form a new data set, and analyzed using qualitative thematic analysis. Results: Three separate, but interrelated, themes were identified, which described the process towards self-management of disease as expressed by the participants of the self-management program. Themes describe the factors important for developing and improving self-management abilities and actions. The results were applied to Orem’s Self-care deficit theory to suggest a model of self-management support in the clinical nursing encounter. Conclusion: This study investigated factors important for self-management and highlighted the unique contribution and focus of nursing support to promote independent self-care.

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