scholarly journals Electronic Self-Report Assessment for Cancer and Self-Care Support: Results of a Multicenter Randomized Trial

2014 ◽  
Vol 32 (3) ◽  
pp. 199-205 ◽  
Author(s):  
Donna L. Berry ◽  
Fangxin Hong ◽  
Barbara Halpenny ◽  
Ann H. Partridge ◽  
Jesse R. Fann ◽  
...  

Purpose The purpose of this trial was to evaluate the effect of a Web-based, self-report assessment and educational intervention on symptom distress during cancer therapy. Patients and Methods A total of 752 ambulatory adult participants were randomly assigned to symptom/quality-of-life (SxQOL) screening at four time points (control) versus screening, targeted education, communication coaching, and the opportunity to track/graph SxQOL over time (intervention). A summary of the participant-reported data was delivered to clinicians at each time point in both groups. All participants used the assessment before a new therapeutic regimen, at 3 to 6 weeks and 6 to 8 weeks later, completing the final assessment at the end of therapy. Change in Symptom Distress Scale–15 (SDS-15) score from pretreatment to end of study was compared using analysis of covariance and regression analysis adjusting for selected variables. Results We detected a significant difference between study groups in mean SDS-15 score change from baseline to end of study: 1.27 (standard deviation [SD], 6.7) in the control group (higher distress) versus −0.04 (SD, 5.8) in the intervention group (lower distress). SDS-15 score was reduced by an estimated 1.21 (95% CI, 0.23 to 2.20; P = .02) in the intervention group. Baseline SDS-15 score (P < .001) and clinical service (P = .01) were predictive. Multivariable analyses suggested an interaction between age and study group (P = .06); in subset analysis, the benefit of intervention was strongest in those age > 50 years (P = .002). Conclusion Web-based self-care support and communication coaching added to SxQOL screening reduced symptom distress in a multicenter sample of participants with various diagnoses during and after active cancer treatment. Participants age > 50 years, in particular, may have benefited from the intervention.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 9008-9008
Author(s):  
Donna Lynn Berry ◽  
Fangxin Hong ◽  
Barbara Halpenny ◽  
Qian Wang ◽  
Ann H. Partridge ◽  
...  

9008 Background: Attending to symptoms and side effects promotes safe and effective delivery of cancer therapies. Providing focus to the patient’s report in the clinic can efficiently address the most important concerns, without extending visit times. The web-based electronic self report assessment for cancer (ESRA-C) and clinician summary has been shown to improve patient-clinician communication about symptoms and quality of life issues (SQI). The purpose of this trial was to evaluate the impact of an enhanced ESRA-C intervention (ESRA-C INT) on symptom outcomes. Methods: Patients (planned N=702) with all cancer types treated in stem cell transplant, medical oncology and radiation oncology at two comprehensive cancer centers used ESRA-C to self-report SQI during and after new anti-cancer therapy, with summary reports delivered to clinicians. Patients were randomized to standard ESRA-C (control) or ESRA-C INT adding the opportunity to self-monitor SQI between clinic visits and receive self-care SQI management education, plus custom coaching on how to report SQI to clinicians, all delivered via a secure web sites. We analyzed the intervention effect on Symptom Distress Scale (SDS) scores using a two-sided t-test and multivariate linear regression, adjusting for pre-selected covariates, including baseline SDS, age, service, and work status. Results: Among 757 patients (increased N due to involuntary attrition), demographic variables were balanced between groups except age (t=2.13; p=.03) with a younger INT group (mean 1.97 year difference). Of the 562 patients who completed final reports, the control group reported significantly higher SDS scores (t= 1.98; p = .048). A significant interaction between study group and age was observed; significantly lower SDS scores were found in the ESRA-C INT group among patients > 50 years (-1.95; p=.002), and no significant difference among patients < 50. Conclusions: Adding self-care and communication coaching to ESRA-C, a system to allow self-report and clinician notification of SQI, reduced symptom distress in a large sample of patients during and after active cancer treatment compared with ESRA-C alone. Patients over the age of 50, in particular, may benefit from the intervention.


2021 ◽  
Vol 17 ◽  
Author(s):  
Seyedeh Zahra Masoumi ◽  
Khodayar Oshvandi ◽  
Masoumeh Rostami-Moez ◽  
Arezoo Shayan ◽  
Farideh Kazemi

Background: Infertility can cause low marital satisfaction. Marital satisfaction has an important effect on infertile couples’ health. Objective: This study aimed to assess the effect of relationship enrichment training on improving the marital satisfaction of infertile couples. Methods: This randomized clinical trial was conducted on 50 infertile couples in the infertility center of Fatemieh Hospital in Hamadan, Iran in 2018. Participants were matched for demographic characteristics and randomly assigned to intervention and control groups (each group had 25 couples). Informed consent was obtained from all participants. The Enrich Marital Satisfaction questionnaire and demographic information were used to collect data before the study and two months after the intervention. Two trained midwifery students taught only the intervention group the relationship enrichment topics in seven sessions (each session = 90 minutes). The data were analyzed by SPSS Statistics version 21 using analysis of covariance, independent t-test, chi-square, and Mann–Whitney. The significance level was set at p ≤ 0.05. Results: There was no significant difference in demographic and obstetric information between the two groups (p >0.05). The mean of marital satisfaction in the intervention group significantly increased among women and men from 151.00 ±28.61 to 154.88 ±22.62 and from 152.56 ±27.33 to 159.24 ±22.14, respectively, (p <0.001). Conversely, the mean of marital satisfaction decreased among women and men from 158.13 ±13.86 to 146.25 ±19.53 and from 164.25 ±17.00 to 153.17 ±27.50 in the control group (p=0.02). Conclusion: Relationship enrichment training can be effective in promoting the marital satisfaction of infertile couples. Registration number: The National Center for Strategic Research in medical education, No. 960185.


Author(s):  
Suélem B. de Lorena ◽  
Angela L.B.P. Duarte ◽  
Markus Bredemeier ◽  
Vanessa M. Fernandes ◽  
Eduardo A.S. Pimentel ◽  
...  

BACKGROUND: The effects of stretching exercises in fibromyalgia (FM) deserves further study. OBJECTIVE: To evaluate the effectiveness of a Physical Self-Care Support Program (PSCSP), with emphasis on stretching exercises, in the treatment of FM. METHODS: Forty-five women with FM were randomized to the PSCSP (n= 23) or to a control group (n= 22). The PSCSP consisted of weekly 90-minute learning sessions over 10 weeks, providing instructions on wellness, postural techniques, and active stretching exercises to be done at home. The control group was monitored through 3 medical appointments over 10 weeks and included in a waiting list. The primary outcomes were the Fibromyalgia Impact Questionnaire (FIQ), the Visual Analogue Scale (VAS) for pain, and the Sit and Reach Test (SRT) at the end of the study. RESULTS: Nineteen and 21 patients completed the trial in PSCSP and control groups, respectively. After 10 weeks, the PSCSP group showed significantly better FIQ (difference between adjusted means, -13.64, 95% CI, -21.78 to -5.49, P= 0.002) and SRT scores (7.24 cm, 3.12 to 11.37, P= 0.001) than the CONTROL group, but no significant difference in pain VAS (-1.41, -3.04 to 0.22, P= 0.088). Analysis using multiple imputation (MI) and delta-adjusted MI for missing outcomes rendered similar results. CONCLUSIONS: A PSCSP emphasizing stretching exercises significantly improved FIQ and SRT scores, and may be a helpful therapy for FM.


2018 ◽  
Vol 6 (1) ◽  
pp. 133
Author(s):  
Novita Nurkamilah ◽  
Rondhianto Rondhianto ◽  
Nur Widayati

Diabetes Mellitus (DM) is a chronic disease that requires a continous self-care. A low level ofknowledge about self-care can worsen health condition and cause diabetes distress. The continuingstress can cause hyperglycemia that lead to complications of DM. DSME/S is a structured healtheducation that facilitates DM patients in implementing and maintaining their behavior for sustainableself-care. This research aimed to analyze the effect of DSME/S on diabetes distress in patients withtype 2 DM. This research was quasi experimental with non randomized control group pretestposttest design. Thirty respondents in this study were divided into 15 respondents as theintervention group and 15 respondents as the control group by consequtive sampling technique.DSME/S was conducted in 6 sessions: 4 sessions in the hospital and 2 sessions at respondent'shouse. The data were analyzed by using dependent t test and independent t test with significancelevel of 0.05. The result of dependent t test revealed a significant difference of diabetes distressbetween pretest and posttest both in the intervention group (p=0.001) and in the control group(p=0.046). Furthermore, independent t test showed a significant difference between interventiongroup and control group (p=0.001). The decrease of diabetes distress was higher in the interventiongroup than control group. This result indicates that there was a significant effect of DSME/S ondiabetes distress in patients with type 2 DM. Nurses are expected to apply DSME/S as a dischargeplanning to reduce diabetes distress in patients with type 2 DM.Keywords: diabetes distress, DSME/S, Diabetes Mellitus


2019 ◽  
pp. 29-36

Background: Marital conflict is a type of lack of ongoing meaningful agreement between spouses. The present study aimed to investigate the effectiveness of mindfulness-based cognitive therapy on sexual self-efficacy and marital satisfaction in couples with marital conflicts. Materials and Methods: This quasi-experimental study was carried out on the intervention and control groups with a pretest/posttest design and follow-up. The study population consisted of 30 females who referred to counseling centers in district 1 of Tehran, Iran, in 2018 through simple random sampling. The participants were randomly divided into two groups, each with 15 members. The intervention group received mindfulness-based cognitive therapy, and the control group received no intervention. Data collection tools were the questionnaires of sexual self-efficacy, marital satisfaction, and marital conflicts. The questionnaires were filled out by the participants before and after the intervention and 3 months later. The collected data were analyzed using repeated measurement analysis and analysis of covariance by SPSS software (version 22). Results: The results of the study showed that mindfulness-based cognitive therapy led to increased sexual self-efficacy (P<0.033) and marital satisfaction (P<0.003) in the intervention group; however, in the control group, there was no significant difference in pretest, posttest and follow-up scores. Conclusion: Based on the results, it can be concluded that mindfulness-based cognitive therapy can improve sexual self-efficacy and marital satisfaction in couples with marital conflicts.


2020 ◽  
Vol 9 (2) ◽  
Author(s):  
Maryam Abiz ◽  
Hasan Robabi ◽  
Alireza Salar ◽  
Farshid Saeedinezhad

Background: Tuberculosis (TB) affects various aspects of quality of life (QoL), and self-care is the most important form of primary care and one of the main factors involved in the process of treating chronic diseases and improving the patients’ QoL. Objectives: This study aimed to investigate the effect of self-care education on the QoL of TB patients. Methods: In this quasi-experimental study, 110 TB patients referred to the TB coordinating Center in Zahedan, Southeastern Iran, in 2018, are studied. Participants were selected using convenience sampling and were randomly assigned to the intervention (n = 55) and control (n = 55) groups. Data were collected using the tuberculosis quality of life-version 2 (TBQol-v2). For the intervention group, first, patients and their caregivers were divided into groups compromising of 4 to 6 members, and then three sessions of self-care education, including lectures and questions and answers meetings, each lasted for 30 minutes (in total 90 minutes) were provided to each group. Data were analyzed in SPSS version 21 using descriptive statistical tests, independent t-test, paired t-test, and chi-squared test. Results: Mean of the total QoL score of the two groups before the intervention was 67.56 ± 5.99 and 67.09 ± 5.03, respectively, indicating no significant difference (P = 0.65). But after providing the intervention, the mean score of patients QoL in the intervention group (74.84 ± 4.90) was significantly higher than the control group (67.98 ± 0.68) (P = 0.001). Conclusions: Since self-care education can effectively enhance the QoL of TB patients, it is recommended to provide such educations for both treatment and follow-up of these patients along with directly observed treatment, short-course (DOTS).


2020 ◽  
Vol 12 (1) ◽  
pp. 26-34
Author(s):  
Shabnam Mohammad Pour ◽  
Sevil Hakimi ◽  
Abbas Delazar ◽  
Yousef Javad Zadeh ◽  
Fatemeh Mallah

Background: Pain and distress are two common complications of cesarean section. Among complementary therapies, Eremostachys was introduced as a pain mitigator. This study aimed at investigating the effect of Eremostachys laciniata on cesarean section pain and distress. Materials and methods: This randomized clinical trial was conducted on 86 women who gave childbirth by cesarean section. The control group received 50 mg rectal diclofenac suppository every 8 h for 3 days, and the intervention group received 35 mg E. laciniata total extract suppository every 8 h up to three doses. Pain was measured with the Visual Analogue Scale at 8, 16, and 24 h after cesarean section. The Symptom Distress Scale was completed at 8 and 24 h after cesarean section. The Redness, Edema, Ecchymosis, Discharge, Approximation scale was completed 5 days after cesarean section. Findings: Pain score at 8, 16, and 24 h after surgery (15 min after intervention) was not significantly different between the intervention and control groups. The distress score 24 h after cesarean section showed a significant difference in favor of the control group according to Friedman’s test. There was a significant difference between the two groups in wound healing score, which indicated better efficacy of rectal diclofenac suppository than E. laciniata suppository. We assessed nausea, vomiting, headache, massive hemorrhage, and any type of anaphylactic reaction. No side events were observed in two groups. Conclusion: Rectal E. laciniata suppository could be introduced as a low-complication, appropriate, and effective medication in controlling pain and distress after cesarean section; more studies should be conducted on this matter.


2019 ◽  
Vol 33 (1) ◽  
pp. 46-54
Author(s):  
Ardashir Afrasiabifar ◽  
Zahra Mehri ◽  
Hamid Reza Ghaffarian Shirazi

Orem’s self-care model has been introduced as a nursing model to empower participants with chronic diseases. This study aims to investigate the effectiveness of nursing interventions using Orem’s self-care model with multiple sclerosis participants’ balance and motor function. Sixty-three participants with multiple sclerosis were randomly assigned to intervention and control groups. The nursing intervention using Orem’s self-care model was performed for eight sessions of 45–60 minutes in the intervention group. In the intervention group, a significant increase (improvement) was observed in the mean scores of balance before (17.09 ± 1.97) and after the intervention (33.75 ± 6.01). A significant decrease (improvement) was observed in the mean of motor functions before (4.12 ± 0.34) and after the intervention (1.59 ± 0.71) ( p = 0.001). However, no significant difference existed in the mean scores of balance ( p = 0.10) and motor function in the control group ( p = 0.20). The nursing intervention using Orem’s self-care model improved balance and motor function of participants with multiple sclerosis.


2019 ◽  
Vol 10 (02) ◽  
pp. 261-268 ◽  
Author(s):  
Reza Negarandeh ◽  
Mitra Zolfaghari ◽  
Nazli Bashi ◽  
Maryam Kiarsi

Background Heart failure is one of the serious cardiovascular diseases, which poses a global pandemic and places a heavy burden on health care systems worldwide. The incidence of this disease in Iran is higher than in other Asian countries. To reduce patients' complications, readmission rates, and health care expenditures, it is necessary to design interventions, which are culturally appropriate and based on community needs. Methods In 2016, a randomized clinical trial (IRCT2017010731804N1) was initiated to compare tailored tele-monitoring intervention with usual care. In total, 80 patients completed the study after a follow-up period of 8 weeks. The primary end point was heart failure self-care, which was measured using the Iranian version of the European Heart Failure self-care questionnaire. Secondary end points were heart failure related readmission rates. Results The mean scores for self-care behaviors of the two groups showed significant difference at the baseline (p = 0.045). The results of the analysis of covariance that was used to control the differences in the pretest scores of self-care behaviors showed that the difference between both groups after the intervention was still significant (p < 0.001). The percentage of patients' readmissions in the intervention group (20%) was less than that in the control group (42.2%); however, the results were not statistically significant (p = 0/066). Conclusion This study showed that tele-monitoring improved self-care behaviors in Iranian patients with heart failure but did not reduce their readmission rates.


Author(s):  
Lingling Huang ◽  
Qu Shen ◽  
Qiyu Fang ◽  
Xujuan Zheng

(1) Background: Some primiparous women are usually confronted with many parenting problems after childbirth, which can negatively influence the wellbeing of some mothers and infants. Evidence identified that internet interventions can include more tailored information, reach a larger research group, and supply more anonymity than face-to-face traditional interventions. Therefore, the internet-based support program (ISP) was designed to improve the parenting outcomes for Chinese first-time mothers. (2) Methods: A multicenter, single-blinded, pilot randomized controlled trial was conducted. From May to October 2020, a total of 44 participants were recruited in the obstetrical wards of two tertiary hospitals in China. Eighteen women in the control group received routine postnatal care; while eighteen women in the intervention group accessed to the ISP and routine postnatal care. The duration of intervention was not less than three months. Intervention outcomes were assessed through questionnaires before randomization (T0), immediately after intervention (T1), and three months after intervention (T2). The Self-efficacy in Infant Care Scale (SICS), Edinburgh Postnatal Depression Scale (EPDS), and Postpartum Social Support Scale (PSSS) were included to measure MSE, postpartum depression (PPD), and social support, respectively. (3) Results: No significant difference between the two groups were found in terms of the baseline social-demographic characteristics; and the scores of SICS, EPDS and PSSS at T0 (p > 0.05). Repeated measures multivariate analysis of covariance found that women in the intervention group had a higher MSE score at T1 (6.63, p = 0.007), and T2 (5.75, p = 0.020); a lower EPDS score at T1 (3.11, p = 0.003), and T2 (2.50, p = 0.005); and a higher PSSS score at T1 (4.30, p = 0.001); and no significant difference at T2 (0.35, p = 0.743), compared with women in the control group. (4) Conclusion: The effect of ISP was evaluated to significantly increase primiparous women’s MSE, social support, and to alleviate their PPD symptoms. However, the small sample in pilot study restricted the research results. Therefore, the ISP should be further investigated with a larger, diverse sample to confirm whether it should be adopted as routine postnatal care to support primiparous women on parenting outcomes and mental wellbeing in the early stage of motherhood.


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