The moderating role of informal caregiver’s involvement on the relationship between patient activation and adherence to treatment: Implications for self-management intervention in cancer care.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 12083-12083
Author(s):  
Chiara Acquati ◽  
Judith Hibbard ◽  
Ellen Miller-Sonet ◽  
Anao Zhang ◽  
Elena Ionescu
Keyword(s):  
Cancer Survivors ◽  
Treatment Planning ◽  
Cancer Care ◽  
Informal Caregivers ◽  
Patient Activation ◽  
Self Management ◽  
Adherence To Treatment ◽  
Patient Activation Measure ◽  
Caregiver Involvement ◽  
The Relationship

12083 Background: With increasing demands for a more active role on the part of individuals with cancer and their families in cancer care, patient activation (PA) is emerging as a key factor to promote self-management, adherence to treatment, and satisfaction with treatment planning. The present work investigated the relationship between patient activation and treatment decision making. Given the role informal caregivers play on patient-reported outcomes, it was additionally assessed whether caregiver involvement acted as a moderator of this relationship. Methods: Survey data collected from 504 cancer survivors recruited through online consumer panels were utilized. The survey contained questions concerning treatment options, quality of life, adherence to treatment, next to presence and involvement of informal caregivers. Additionally, the Patient Activation Measure (PAM), sociodemographic and clinical questions were included. A path analysis Structural Equation Modeling (SEM) controlling for covariates was used to examine the relationship between Patient Activation Measure (PAM), caregiver involvement, and the identified outcomes. Moderator analysis was conducted using multiple group SEM. Results: Respondents were mostly women (57.1%), non-Hispanic white (72.9%), middle aged or older adults (68% ≥ 55 y.o.) The four largest cancer type groups were prostate (16.3%), early stage breast (9.7%), gynecological (8.9%), and colorectal cancer (8.3%). Most of the respondents were diagnosed more than 4 years earlier (52.0%). Participants were evenly split between those who received care at an academic cancer center (29.4%) and those treated at community hospital (31.7%). Patient activation was significantly associated with treatment planning being reflective of survivors ’goals and values ( p < 0.001); adherence to treatment ( p = 0.011); and satisfaction ( p < 0.001). Caregiver’s involvement significantly moderated the association between activation and adherence to treatment. Conclusions: Patient activation was positively associated with all three selected outcomes. However, for cancer survivors reporting low rates of caregiver involvement, patient activation was not associated with treatment adherence. Research is needed to deliver and test patient activation interventions inclusive of informal caregivers to improve self-management.

scholarly journals The Role of Self-Management Practices as Mechanisms for Re-Establishing Normality in Cancer Survivors

2016 ◽  
Vol 27 (4) ◽  
pp. 520-533 ◽  
Author(s):  
Catherine Henshall ◽  
Sheila Greenfield ◽  
Nicola Gale
Keyword(s):  
Cancer Survivors ◽  
Management Practices ◽  
Well Being ◽  
Self Management ◽  
Use Of Self ◽  
Lifestyle Activities ◽  
The Relationship ◽  
Static Concept

This article explores the relationship between cancer survivors’ use of self-management practices and their search for normality. Using Frank’s illness narratives and other theoretical literature on normality in chronic illness, it draws on findings from a qualitative study to explore different ways cancer survivors use self-management practices to re-establish normality in their lives post-cancer. The findings suggest that “normality” represents different things to cancer survivors. We suggest that normality in survivorship is not a static concept but is fluid, and at certain times, cancer survivors may display some or all of these different versions of normality. The findings show that self-management practices can help cancer survivors experiment with different health and lifestyle processes to help support their “normal” daily lifestyle activities, quality of life, and well-being.

scholarly journals Using the patient activation measure to examine the self-management support needs of a population of UK workers with long-term health conditions

2021 ◽  
pp. 174239532110434
Author(s):  
Sally Hemming ◽  
Fehmidah Munir
Keyword(s):  
Mental Health ◽  
Patient Activation ◽  
Health Conditions ◽  
Self Management ◽  
Support Needs ◽  
Management Support ◽  
Long Term Conditions ◽  
Mental Health Conditions ◽  
Patient Activation Measure

Objectives To examine differences in patient activation and self-management support needs in a population of UK workers with long-term health conditions. Methods Demographic, health and activation information were taken from the data of participants with long-term conditions, collected via an online cross-sectional survey of workers. The 13-item British patient activation measure measured workers knowledge, skills and confidence towards self-managing. Results Three hundred and seven workers with mental health, musculoskeletal and other conditions completed the patient activation measure. Mental health conditions were most prevalent (36.8%). Workers were higher activated, however workers with mental health conditions were significantly less activated ( p = 0.006). Differences in activation by condition severity and age were revealed. Discussion This study provides insight to the activation of UK workers with long-term conditions. Whilst workers with mental health conditions need more training and education to self-manage, workers are variably activated indicating broader support needs. There is a gap for workplace self-management support. The patient activation measure is used in healthcare to improve people’s self-management and should be considered to be included in the workplace, and could form part of interventions to support workers self-management. More rigorous studies, including the patient activation measure, are needed to identify the best approaches to identifying workers self-management support needs.

scholarly journals Effect of PARACT (PARAmedical Interventions on Patient ACTivation) on the Cancer Care Pathway: Protocol for Implementation of the Patient Activation Measure-13 Item (PAM-13) Version

10.2196/17485 ◽  
2020 ◽  
Vol 9 (12) ◽  
pp. e17485
Author(s):  
Elise Verot ◽  
Wafa Bouleftour ◽  
Corinne Macron ◽  
Romain Rivoirard ◽  
Franck Chauvin
Keyword(s):  
Nursing Care ◽  
Cancer Care ◽  
Care Pathway ◽  
Patient Activation ◽  
Oncology Nurses ◽  
Multicentric Study ◽  
Cancer Centers ◽  
Comprehensive Cancer Centers ◽  
Semistructured Interviews ◽  
Patient Activation Measure

Background The increase in the number of cancer cases and the evolution of cancer care management have become a significant problem for the French health care system, thereby making patient empowerment as a long sought-after goal in chronic pathologies. The implementation of an activation measure via the Patient Activation Measure-13 item (PAM-13) in the course of cancer care can potentially highlight the patient’s needs, with nursing care adapting accordingly. Objective The objectives of this PARACT (PARAmedical Interventions on Patient ACTivation) multicentric study were as follows: (1) evaluate the implementation of PAM-13 in oncology nursing practices in 5 comprehensive cancer centers, (2) identify the obstacles and facilitators to the implementation of PAM-13, and (3) produce recommendations for the dissemination of such interventions in other comprehensive cancer centers. Methods This study will follow the “Reach, Effectiveness, Adoption, Implementation, and Maintenance” framework and will consist of 3 stages. First, a robust preimplementation analysis will be conducted using the Theoretical Domains Framework (TDF) linked to the “Capability, Opportunity, Motivation, and Behavior” model to identify the obstacles and facilitators to implementing new nursing practices in each context. Then, using the Behavior Change Wheel, we will personalize a strategy for implementing the PAM-13, depending on the specificities of each context, to encourage acceptability by the nursing staff involved in the project. This analysis will be performed via a qualitative study through semistructured interviews. Second, the patient will be included in the study for 12 months, during which the patient care pathway will be studied, particularly to collect all relevant contacts of oncology nurses and other health professionals involved in the pathway. The axes of nursing care will also be collected. The primary goal is to implement PAM-13. Secondary factors to be measured are the patient’s anxiety level, quality of life, and health literacy level. The oncology nurses will be responsible for completing the questionnaires when the patient is at the hospital for his/her intravenous chemotherapy/immunotherapy treatment. The questionnaires will be completed thrice in a year: (1) at the time of the patient’s enrollment, (2) at 6 months, and (3) at 12 months. Third, a postimplementation analysis will be performed through semistructured interviews using the TDF to investigate the implementation problems at each site. Results This study was supported by a grant from the French Ministry of Health (PHRIP PARACT 2016-0405) and the Lucien Neuwirth Institute of Cancerology of Saint-Etienne, France. Data collection for this study is ongoing. Conclusions This study would improve the implemented targeted nursing interventions in cancer centers so that a patient is offered a personalized cancer care pathway. Furthermore, measuring the level of activation and the implementation of measures intended to increase such activation could constitute a significant advantage in reducing social health inequalities. Trial Registration ClinicalTrials.gov NCT03240341; https://clinicaltrials.gov/ct2/show/NCT03240341 International Registered Report Identifier (IRRID) DERR1-10.2196/17485

Responsiveness of the Effective Consumer Scale (EC-17)

2009 ◽  
Vol 36 (9) ◽  
pp. 2087-2091 ◽  
Author(s):  
NANCY SANTESSO ◽  
TAMARA RADER ◽  
GEORGE A. WELLS ◽  
ANNETTE M. O’CONNOR ◽  
PETER M. BROOKS ◽  
...  
Keyword(s):  
Self Efficacy ◽  
Decision Aids ◽  
Patient Activation ◽  
Management Program ◽  
Self Management ◽  
Patient Activation Measure ◽  
Standard Deviations ◽  
And Behaviors

Objective.The Effective Consumer Scale (EC-17) comprises 17 items measuring the main skills and behaviors people need to effectively manage their healthcare. We tested the responsiveness of the EC-17.Methods.Participants, in 2 waves of a 6-week Arthritis Self-Management Program (ASMP) from Arthritis Ireland, received a questionnaire at the first and last week of the weekly ASMP. The questionnaire included the EC-17 and 10 other measures for arthritis. Deficits, mean change, and standard deviations were calculated at baseline and Week 6. The EC-17 scores were compared to the Arthritis Self-Efficacy (ASE) and Patient Activation Measure (PAM) scales. Results were presented at OMERACT 9.Results.There is some overlap between the EC-17 and the ASE and PAM; however, most items of greatest deficit in the EC-17 are not covered by those scales. In 327 participants representing both intervention waves (2006 and 2007), the EC-17 was more efficient than the ASE but less efficient than the PAM for detecting improvements after the ASMP, and was moderately correlated with the PAM.Conclusion.The EC-17 appears to measure different skills and attributes than the ASE and PAM. Discussions with participants at OMERACT 9 agreed that it is worthwhile to measure the skills and attributes of an effective consumer, and supported the development of an intervention (such as proposed online decision aids) that would include education in the categories in the EC-17.

scholarly journals Self-management practice, associated factors and its relationship with Health Literacy and Patient Activation among multi-morbid COPD patients from rural Nepal

2019 ◽  
Author(s):  
Uday Narayan Yadav ◽  
Jane Lloyd ◽  
Hassan Hosseinzadeh ◽  
Kedar Prasad Baral ◽  
Narendra Bhatta ◽  
...  
Keyword(s):  
Health Literacy ◽  
Management Practices ◽  
Management Practice ◽  
Multivariable Analysis ◽  
Patient Activation ◽  
Self Management ◽  
Copd Patients ◽  
Rural Nepal ◽  
The Relationship

Abstract Background Chronic Obstructive Pulmonary Disease (COPD) is a progressive and debilitating condition that affects individuals' quality of life . COPD self-management and supports provided by carers is key to the quality of life people living with COPD. Health literacy (HL) and Patient Activation (PA) are main drivers of self-management practices (SMPs). However, their contribution remains to be fully explored. This study aimed to examine the level of self-management practices, and the relationship with socio-demographic factors, HL and PA among multi-morbid COPD patients from rural Nepal. Methods This is a cross-sectional study conducted between July 2018 and January 2019. Patients completed a survey, including Self-management Practices questionnaire (SMPQ), five domains of the Health Literacy Questionnaire (HLQ), and Patient Activation Measure (PAM). The relationship between HL, PAM, and self-management practice was examined using univariate statistics. Multivariable analysis was conducted to identify the factors associated with self-management practice. Results A total of 238 patients responded to the study. The mean score of SMPQ was 45.31(SD=9.00). The HLQ and PAM scores were positively correlated with the total score of SMPQ. Low level of SMPs were found to be positively associated with being uneducated (β=-0.43, p=.001), having a low family income (β=-5.22, p=.002), and, negatively associated with the presence of more than one co-morbidity (β=3.58, p=0.007) after controlling for other socio-demographic variables in the multivariable analysis. Conclusions The overall SMPs among this sample of Nepalese with COPD were low. Our findings highlight the need of implementation of self-management intervention program involving health literacy-focused activities for COPD, creating a support system for patients from low-income family and having low activation level.

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