The Ethics of Self-Management Preparation for Chronic Illness

2005 ◽  
Vol 12 (4) ◽  
pp. 360-369 ◽  
Author(s):  
Barbara K Redman
Keyword(s):  
Chronic Disease ◽  
Health Care Professionals ◽  
High Standard ◽  
Daily Basis ◽  
Essential Elements ◽  
Self Management ◽  
Structural Barriers ◽  
The Usa ◽  
Management Preparation ◽  
Evidence Based Care

While nearly all patients with a chronic disease must self-manage their condition to some extent, preparation for these responsibilities is infrequently assured in the USA. The result can be significant harm and the undermining of a patient’s ability to take advantage of life opportunities and be productive. Agreeing to care for a patient involves a moral responsibility to see that she or he receives the essential elements of care, including the ability to manage the disease on a daily basis. The research base for the efficacy of self-management and for how patients can be prepared to assume it is sufficiently strong that health care professionals must advocate for its inclusion in the routine evidence-based care of individuals with chronic disease. Because patient education is central to nursing’s philosophy and practice, the profession should play a major role in removing structural barriers to self-management preparation and assuring its provision to a high standard of quality.

Factors Influencing Possible Participation in Chronic Disease Self-management Courses

2008 ◽  
Vol 14 (3) ◽  
pp. 19 ◽  
Author(s):  
Rosemary Mahomed ◽  
Winsome St. John ◽  
Elizabeth Patterson
Keyword(s):  
Chronic Disease ◽  
Medical Practitioner ◽  
Subjective Norms ◽  
Transport Cost ◽  
Self Management ◽  
Willingness To Participate ◽  
Participation Rates ◽  
Structural Barriers ◽  
Structured Interviews ◽  
Adequate Funding

Chronic disease self-management (CDSM) courses have been shown to be effective in improving self-management, quality of life and clinical outcomes; however, participation rates in both generic and disease-specific courses are low. The objective of this qualitative study was to explore the attitudes, perceived behavioural control (PBC) and subjective norms of general practice patients with chronic diseases towards future participation in a CDSM course. The study, conducted in 2 006, used semi-structured interviews with a purposive sample of eight men and 11 women who had a chronic disease. The theory of planned behaviour provided a framework for a thematic analysis of the data identifying themes related to attitude, PBC and subjective norms. Nine themes were identified related to attitude. These included a desire for the opportunity to share/gain support; willingness to participate if they were provided with more/new information; basing their choice on severity of disease; trying the program out first; individual coping strategies; reliance on medical practitioner advice; needing some certainty or being afraid of future prospects; doing things in their own particular way; and deciding on the basis of proven results. Six themes emerged related to PBC, which revolved around structural barriers, time, transport, cost, mobility, convenient time and location. Three subjective norms were identified including encouragement from family/friends, medical practitioner and others with the same condition. Several positive attitudes such as the provision of information, opportunities to share and gain support and help with coping - which CDSM courses offer - could be capitalised on when promoting the courses. However, understanding other attitudes such as the importance of disease severity and a need to 'do it my way', reveal misconceptions about the aims of CDSM courses that need to be more clearly communicated when promoting courses. Structural barriers to participating in CDSM courses can easily be overcome by careful planning and adequate funding. Finally, general practitioner encouragement to attend CDSM courses could improve participation rates.

Integration of assistive technology to support self management of chronic disease

2009 ◽  
Author(s):  
H. Zheng ◽  
C.D. Nugent ◽  
P.J. McCullagh ◽  
W.P. Burns ◽  
S. Alexander ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Assistive Technology ◽  
Self Management

scholarly journals Effect of Environmental Pollutants PM2.5, CO, NO2, and O3 on the Incidence and Mortality of SARS-CoV-2 Infection in Five Regions of the USA

2021 ◽  
Vol 18 (15) ◽  
pp. 7810
Author(s):  
Sultan Ayoub Meo ◽  
Abdulelah Adnan Abukhalaf ◽  
Omar Mohammed Alessa ◽  
Abdulrahman Saad Alarifi ◽  
Waqas Sami ◽  
...  
Keyword(s):  
New York ◽  
New Mexico ◽  
Los Angeles ◽  
Environmental Pollution ◽  
Environmental Pollutants ◽  
Daily Basis ◽  
First Case ◽  
Incidence And Mortality ◽  
Unit Increase ◽  
The Usa

In recent decades, environmental pollution has become a significant international public problem in developing and developed nations. Various regions of the USA are experiencing illnesses related to environmental pollution. This study aims to investigate the association of four environmental pollutants, including particulate matter (PM2.5), carbon monoxide (CO), Nitrogen dioxide (NO2), and Ozone (O3), with daily cases and deaths resulting from SARS-CoV-2 infection in five regions of the USA, Los Angeles, New Mexico, New York, Ohio, and Florida. The daily basis concentrations of PM2.5, CO, NO2, and O3 were documented from two metrological websites. Data were obtained from the date of the appearance of the first case of (SARS-CoV-2) in the five regions of the USA from 13 March to 31 December 2020. Regionally (Los Angeles, New Mexico, New York, Ohio, and Florida), the number of cases and deaths increased significantly along with increasing levels of PM2.5, CO, NO2 and O3 (p < 0.05), respectively. The Poisson regression results further depicted that, for each 1 unit increase in PM2.5, CO, NO2 and O3 levels, the number of SARS-CoV-2 infections significantly increased by 0.1%, 14.8%, 1.1%, and 0.1%, respectively; for each 1 unit increase in CO, NO2, and O3 levels, the number of deaths significantly increased by 4.2%, 3.4%, and 1.5%, respectively. These empirical estimates demonstrate an association between the environmental pollutants PM2.5, CO, NO2, and O3 and SARS-CoV-2 infections, showing that they contribute to the incidence of daily cases and daily deaths in the five different regions of the USA. These findings can inform health policy decisions about combatting the COVID-19 pandemic outbreak in these USA regions and internationally by supporting a reduction in environmental pollution.

Q fever: a rare but potentially life-threatening zoonotic disease

2021 ◽  
Vol 14 (2) ◽  
pp. e237155
Author(s):  
Pranav Mahajan ◽  
Kailash Pant ◽  
Shirin Majdizadeh
Keyword(s):  
Chronic Disease ◽  
Cardiovascular System ◽  
Q Fever ◽  
Acute Infection ◽  
Acute Illness ◽  
Unknown Aetiology ◽  
Severe Hepatitis ◽  
The Usa ◽  
Life Threatening ◽  
Acute Q Fever

Q fever can present as a fever of unknown aetiology and can be challenging to diagnose because of the rare incidence. It can present as an acute illness with manifestations, including influenza-like symptoms, hepatitis, pneumonia or chronic disease involving the cardiovascular system. We present a case of a 39-year-old woman in the USA, who developed acute Q fever with associated sepsis and severe hepatitis. She received treatment with recovery from acute infection but currently has symptoms of post Q fever syndrome.

scholarly journals Effectiveness of an eHealth self-management tool for older adults with multimorbidity (KeepWell): protocol for a hybrid effectiveness–implementation randomised controlled trial

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e048350
Author(s):  
Monika Kastner ◽  
Julie Makarski ◽  
Leigh Hayden ◽  
Jemila S Hamid ◽  
Jayna Holroyd-Leduc ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Disease ◽  
Randomised Controlled Trial ◽  
Disease Management ◽  
Chronic Conditions ◽  
Controlled Trial ◽  
Management Tool ◽  
Self Management ◽  
Plain Language ◽  
Randomised Controlled

IntroductionIn response to the burden of chronic disease among older adults, different chronic disease self-management tools have been created to optimise disease management. However, these seldom consider all aspects of disease management are not usually developed specifically for seniors or created for sustained use and are primarily focused on a single disease. We created an eHealth self-management application called ‘KeepWell’ that supports seniors with complex care needs in their homes. It incorporates the care for two or more chronic conditions from among the most prevalent high-burden chronic diseases.Methods and analysisWe will evaluate the effectiveness, cost and uptake of KeepWell in a 6-month, pragmatic, hybrid effectiveness–implementation randomised controlled trial. Older adults age ≥65 years with one or more chronic conditions who are English speaking are able to consent and have access to a computer or tablet device, internet and an email address will be eligible. All consenting participants will be randomly assigned to KeepWell or control. The allocation sequence will be determined using a random number generator.Primary outcome is perceived self-efficacy at 6 months. Secondary outcomes include quality of life, health background/status, lifestyle (nutrition, physical activity, caffeine, alcohol, smoking and bladder health), social engagement and connections, eHealth literacy; all collected via a Health Risk Questionnaire embedded within KeepWell (intervention) or a survey platform (control). Implementation outcomes will include reach, effectiveness, adoption, fidelity, implementation cost and sustainability.Ethics and disseminationEthics approval has been received from the North York General Hospital Research and Ethics Board. The study is funded by the Canadian Institutes of Health Research and the Ontario Ministry of Health. We will work with our team to develop a dissemination strategy which will include publications, presentations, plain language summaries and an end-of-grant meeting.Trial registration numberNCT04437238.

scholarly journals Exercise Counseling in Pregnancy: Do Women Perceive Receiving the Information They Need?

2021 ◽  
pp. 155982762199185
Author(s):  
Connor Evins ◽  
Jasmine Dennis ◽  
Karson Mostert ◽  
Shiv Patel ◽  
David Enyart ◽  
...  
Keyword(s):  
Health Care ◽  
Pregnant Women ◽  
Health Care Professionals ◽  
Structural Barriers ◽  
Exercise Frequency ◽  
Exercise Counseling ◽  
Care Survey ◽  
Survey Results ◽  
Disproportionate Number ◽  
Exercise During Pregnancy

The American College of Obstetricians and Gynecologists recommends that women exercise throughout pregnancy unless they have a condition-related contraindication. This study’s purpose was to determine if pregnant women perceive receiving exercise counseling by their providers with details of frequency, intensity, type, and time (FITT principle). Women in 2 postpartum care units of a large health care system were invited to complete a voluntary, anonymous survey regarding whether they received exercise counseling during their prenatal care. Survey results were descriptively reported, stratified by demographic variables, and analyzed using Fisher’s exact tests. Of 224 postpartum women surveyed, 130 (58.0%) perceived receiving exercise counseling during pregnancy; 119 (91.5%) did not recall receiving counseling on exercise frequency. Though 165 (73.6%) exercised before becoming pregnant, 64 (38.8%) ceased exercise during pregnancy. Eighty-eight (39.3%) received advice from other sources/non–health care professionals. Privately insured women reported receiving exercise counseling at a higher rate (70.1%) than those on Medicaid (44.8%) or uninsured (40.0%; P = .004). A disproportionate number of pregnant women perceived not receiving adequate prenatal exercise counseling or received incomplete counseling. Women at a socioeconomic disadvantage may be vulnerable. As social determinants of health, structural barriers, and socioeconomic status likely contribute, women may benefit from more targeted inclusive and equitable messaging.

Normal Neonatal Electroencephalogram at a Glance

2020 ◽  
Vol 34 (4) ◽  
pp. 236-240
Author(s):  
Alberto M. Cappellari
Keyword(s):  
Health Care Professionals ◽  
Neonatal Intensive Care ◽  
Neonatal Period ◽  
Rapid Evolution ◽  
Essential Elements ◽  
Brain Maturation ◽  
Rich Variety ◽  
Physiological Markers ◽  
Electroencephalogram Eeg ◽  
Provide Health Care

Interpreting neonatal electroencephalogram (EEG) presents a challenge owing to rapid evolution of EEG patterns occurring during brain maturation in the neonatal period and rich variety of normal patterns of EEG activity, which is difficult to categorize completely. Furthermore, the description of some aspects during maturation varies in different studies. Neonatal EEG is unfamiliar to most neurologists, and its interpretation requires knowledge of the physiological markers of electrogenesis maturation. The purpose of this review was to provide health-care professionals in the neonatal intensive care unit with guidance on the more common normal maturational features of the neonatal EEG. A simplified layout with the essential elements of normal neonatal EEG is included.

Self-management factors associated with quality of life among women with endometriosis: a cross-sectional Australian survey

2020 ◽  
Author(s):  
Rebecca O’Hara ◽  
Heather Rowe ◽  
Jane Fisher
Keyword(s):  
Quality Of Life ◽  
Chronic Disease ◽  
Disease Management ◽  
Self Efficacy ◽  
Chronic Disease Management ◽  
Self Management ◽  
Cross Sectional ◽  
Female Population ◽  
Management Factors

Abstract STUDY QUESTION What self-management factors are associated with quality of life among women with endometriosis? SUMMARY ANSWER Greater self-efficacy was associated with improved physical and mental quality of life. WHAT IS KNOWN ALREADY Women with endometriosis have an impaired quality of life compared to the general female population. However, most studies have investigated quality of life in a hospital or clinic setting rather than a community setting and the association between self-management factors and quality of life have not, to date, been investigated. STUDY DESIGN, SIZE, DURATION A cross-sectional, population-based online survey was performed, which was advertised through women’s, community and endometriosis-specific groups. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 620 women completed the survey for this study. Mental and physical quality of life was assessed using the standardized SF36v2 questionnaire. Self-management factors included self-efficacy, partners in health (active involvement in managing the condition) and performance of self-care activities. Treatment approaches included the use of hormonal treatment, pain medications and complementary therapies and whether the participant had a chronic disease management plan. Hierarchical regression analyses were used to examine whether self-management and treatment factors were associated with quality of life. MAIN RESULTS AND THE ROLE OF CHANCE Both physical and mental quality of life were significantly lower among women with endometriosis compared to the mean scores of the general Australian female population (P &lt; 0.001). Physical quality of life was positively associated with income sufficiency (P &lt; 0.001) and greater self-efficacy (P &lt; 0.001), but negatively associated with age (P &lt; 0.001), pain severity (P &lt; 0.001), use of prescription medications (P &lt; 0.001), having a chronic disease management plan (P &lt; 0.05) and number of self-care activities (P &lt; 0.05). Mental quality of life was positively associated with being older (P &lt; 0.001), partnered (P &lt; 0.001), having a university education (P &lt; 0.05), increasing self-efficacy (P &lt; 0.001) and higher partners in health scores (P &lt; 0.001). LIMITATIONS, REASONS FOR CAUTION Results are derived from a cross-sectional study and can only be interpreted as associations not as causal relationships. The sample was more educated, more likely to speak English and be born in Australia than the general Australian female population of the same age, which may influence the generalizability of these results. WIDER IMPLICATIONS OF THE FINDINGS This study investigated a knowledge gap by investigating quality of life of women with endometriosis in a large community sample. Self-efficacy was significantly associated with both physical and mental quality of life. Supporting women with endometriosis to improve self-efficacy through a structured chronic disease management programme may lead to improvements in this aspect of wellbeing. STUDY FUNDING/COMPETING INTEREST(S) R.O. undertook this research as part of her PhD at Monash University, which was supported by an Australian Government Research Training Program Stipend. J.F. is the Finkel Professor of Global Public Health, which was supported by the Finkel Family Foundation. There are no conflicts of interest to declare. TRIAL REGISTRATION NUMBER NA.

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