scholarly journals Nurse-led self-management support after organ transplantation—protocol of a multicentre, stepped-wedge randomized controlled trial

Trials ◽  
2022 ◽  
Vol 23 (1) ◽  
Author(s):  
Regina van Zanten ◽  
Monique van Dijk ◽  
Joost van Rosmalen ◽  
Denise Beck ◽  
Robert Zietse ◽  
...  
Keyword(s):  
Organ Transplantation ◽  
Nurse Practitioners ◽  
Standard Care ◽  
Controlled Trial ◽  
Control Period ◽  
Experimental Period ◽  
Self Management ◽  
Management Support ◽  
Management Skills ◽  
Support Skills

Abstract Background Recipients of an organ transplantation face a number of challenges and often need to change their health behaviour. Good self-management skills are essential for optimal clinical outcomes. However, few interventions are available to support post-transplant self-management. To fill this gap, we developed a self-management support intervention offered by nurse practitioners. The primary aim of the study is to implement and test the effectiveness of the ZENN intervention in promoting self-management skills among heart, kidney liver and lung transplant recipients in comparison to standard care. The secondary aim is to assess the self-management support skills of nurse practitioners who will deliver the intervention. Methods This multi-centre stepped-wedge randomized controlled trial will take place from September 2020 until May 2023. All departments will commence with inclusion of patients in the control period. Each department will be randomly assigned to a start date (step in the wedge) to commence the experimental period. Patients in the control period will receive standard care and will be asked to complete questionnaires at baseline (T0), 6 months (T1) and 12 months (T2), to assess self-management, self-regulation, quality of life and adherence. During the experimental period, patients will receive standard care plus the ZENN intervention and receive the same set of questionnaires as participants in the control period. Nurse practitioners will complete a baseline and follow-up questionnaire to assess differences in self-management support skills. Video recordings of outpatient clinic consultations during the control and experimental periods will determine the differences in nurses’ needs-thwarting and needs-supporting skills between the control and experimental period. Discussion The ZENN intervention could be a useful approach to support patients’ self-management skills after organ transplantation and thus promote clinical outcomes as well as avoid adverse events. Trial registration Dutch Trial Register NL8469. Registered on March 19, 2020.

scholarly journals Nurse-led Self-management Support After Organ Transplantation – Protocol of a Multicentre, Stepped-wedge Randomized Controlled Trial

2021 ◽  
Author(s):  
Regina van Zanten ◽  
Monique van Dijk ◽  
Joost van Rosmalen ◽  
Denise Beck ◽  
Robert Zietse ◽  
...  
Keyword(s):  
Organ Transplantation ◽  
Nurse Practitioners ◽  
Standard Care ◽  
Controlled Trial ◽  
Control Period ◽  
Experimental Period ◽  
Self Management ◽  
Management Support ◽  
Management Skills ◽  
Support Skills

Abstract Background: Recipients of an organ transplantation face a number of challenges and often need to change their health behaviour. Good self-management skills are essential for optimal clinical outcomes. However, few interventions are available to support post-transplant self-management. To fill this gap, we developed a self-management support intervention offered by nurse practitioners. The primary aim of the study is to implement and test the effectiveness of the ZENN-intervention in promoting self-management skills among heart, liver, lung and kidney transplant recipients in comparison to standard care. The secondary aim is to assess the self-management support skills of nurse practitioners who will deliver the intervention. Methods: This multi-centre stepped wedge randomized controlled trial will take place from September 2020 until November 2022. All departments will commence with inclusion of patients in the control period. Each department will be randomly assigned to a start date (step in the wedge) to commence the experimental period. Patients in the control period will receive standard care and will be asked to complete questionnaires at baseline (T0), six months (T1) and 12 months (T2), to assess self-management, self-regulation, quality of life and adherence. During the experimental period, patients will receive standard care plus the ZENN-intervention and receive the same set of questionnaires as participants in the control period. Nurse practitioners will complete a baseline and follow-up questionnaire to assess differences in self-management support skills. Video recordings of outpatient clinic consultations during the control and experimental periods will determine the differences in nurses’ needs-thwarting and needs supporting skills between control- and experimental period. Discussion: The ZENN-intervention could be a useful approach to support patients’ self-management skills after organ transplantation and thus promote clinical outcomes as well as avoid adverse events.Trial Registration: Dutch Trial Register, Registration number NL8469, March 19th, 2020, https://www.trialregister.nl/trial/8469

scholarly journals The effectiveness of nurse-led self-management support program for people with chronic kidney disease stage 3-4 (CKD-NLSM): Study protocol for a randomized controlled trial

2021 ◽  
Vol 104 (2) ◽  
pp. 003685042110261
Author(s):  
Al Sawad Ayat Ali ◽  
Soo Kun Lim ◽  
Li Yoong Tang ◽  
Aneesa Abdul Rashid ◽  
Boon-How Chew
Keyword(s):  
Kidney Disease ◽  
Controlled Trial ◽  
Self Management ◽  
Control Group ◽  
Management Support ◽  
Disease Knowledge ◽  
Management Intervention ◽  
Randomized Controlled ◽  
Ckd Stage ◽  
Management Behaviors

The complexity of chronic kidney disease (CKD) and its treatments have made self-management behaviors inevitably challenging. However, supplementing education with self-management skills may improve numerous health outcomes in people with nondialysis CKD. This study protocol describes a randomized controlled trial (RCT) aimed to evaluate the effects of a nurse-led self-management support program as an intervention for kidney disease knowledge and CKD self-management behaviors among people with pre-dialysis CKD. In Phase 1, people with CKD stage 3–4 and their family members are involved in co-designing, development and pilot testing of a theory-based self-management intervention. In Phase 2, we perform a cross-cultural adaptation of the Kidney Disease Knowledge Survey, CKD Self-Management and Self-efficacy for Managing Chronic Disease questionnaires. In Phase 3, a parallel RCT will be conducted to evaluate the intervention where 154 participants with CKD stage 3–4 will be randomly assigned to either the intervention ( n = 77) or control group ( n = 77). The intervention group will receive 6-week self-management program from a nurse-coach in addition to standard usual care, while the control group will receive only standard usual care. Outcome measures include kidney disease knowledge, CKD self-management behavior, self-efficacy, quality of life, blood pressure control and adherence to CKD diet as indicated by 24-h urine urea nitrogen, 24-h urine sodium and net endogenous acid production. Data will be collected at baseline and 12-week post-baseline. The between- and within-group intervention effects will be estimated using the Generalized Estimating Equations. The self-management intervention offers strategies to delay CKD progression and to encourage motivation to better self-manage at home. This study integrates self-management education and psychosocial support with culturally relevant scenarios, and evaluates important self-reported and objective outcomes. Clinical Trials Registration: www.ClinicalTrials.gov , identifier: NCT03974646.

A self‐management support program for older Australians with multiple chronic conditions: a randomised controlled trial

2018 ◽  
Vol 208 (2) ◽  
pp. 69-74 ◽  
Author(s):  
Richard L Reed ◽  
Leigh Roeger ◽  
Sara Howard ◽  
Jodie M Oliver‐Baxter ◽  
Malcolm W Battersby ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Chronic Conditions ◽  
Controlled Trial ◽  
Support Program ◽  
Self Management ◽  
Multiple Chronic Conditions ◽  
Management Support ◽  
Randomised Controlled

scholarly journals Effectiveness of text message based, diabetes self management support programme (SMS4BG): two arm, parallel randomised controlled trial

BMJ ◽  
2018 ◽  
pp. k1959 ◽  
Author(s):  
Rosie Dobson ◽  
Robyn Whittaker ◽  
Yannan Jiang ◽  
Ralph Maddison ◽  
Matthew Shepherd ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Text Message ◽  
Self Management ◽  
Management Support ◽  
Support Programme ◽  
Randomised Controlled

scholarly journals Characteristics of self-management among patients with complex health needs: a thematic analysis review

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e028344 ◽  
Author(s):  
Annie-Pier Gobeil-Lavoie ◽  
Maud-Christine Chouinard ◽  
Alya Danish ◽  
Catherine Hudon
Keyword(s):  
Chronic Diseases ◽  
Thematic Analysis ◽  
Healthcare Providers ◽  
Self Management ◽  
Management Support ◽  
Management Skills ◽  
Healthcare Needs ◽  
Frequent Use ◽  
Dominant Condition ◽  
Use Of Health Services

ObjectiveThere is a gap of knowledge among healthcare providers on characteristics of self-management among patients with chronic diseases and complex healthcare needs. Consequently, the objective of this paper was to identify characteristics of self-management among patients with chronic diseases and complex healthcare needs.DesignThematic analysis review of the literature.MethodsWe developed search strategies for the MEDLINE and CINAHL databases, covering the January 2000–October 2018 period. All articles in English or French addressing self-management among an adult clientele (18 years and older) with complex healthcare needs (multimorbidity, vulnerability, complexity and frequent use of health services) were included. Studies that addressed self-management of a single disease or that did not have any notion of complexity or vulnerability were excluded. A mixed thematic analysis, deductive and inductive, was performed by three evaluators as described by Mileset al.ResultsTwenty-one articles were included. Patients with complex healthcare needs present specific features related to self-management that can be exacerbated by deprived socioeconomic conditions. These patients must often prioritise care based on one dominant condition. They are at risk for depression, psychological distress and low self-efficacy, as well as for receiving contradictory information from healthcare providers. However, the knowledge and experiences acquired in the past in relation to their condition may help them improve their self-management skills.ConclusionsThis review identifies challenges to self-management for patients with complex healthcare needs, which are exacerbated in contexts of socioeconomic insecurity and proposes strategies to help healthcare providers better adapt their self-management support interventions to meet the specific needs of this vulnerable clientele.

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