scholarly journals Do patients with high versus low treatment and illness burden have different needs? A mixed-methods study of patients living on dialysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0260914
Author(s):  
Kasey R. Boehmer ◽  
Kathleen H. Pine ◽  
Samantha Whitman ◽  
Paige Organick ◽  
Anjali Thota ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Management Practices ◽  
Patient Characteristics ◽  
Mixed Methods Study ◽  
Self Management ◽  
End Stage Kidney Disease ◽  
High Burden ◽  
Illness Burden ◽  
Explanatory Sequential Design ◽  
End Stage

Background Approximately 750,000 people in the U.S. live with end-stage kidney disease (ESKD); the majority receive dialysis. Despite the importance of adherence to dialysis, it remains suboptimal, and one contributor may be patients’ insufficient capacity to cope with their treatment and illness burden. However, it is unclear what, if any, differences exist between patients reporting high versus low treatment and illness burden. Methods We sought to understand these differences using a mixed methods, explanatory sequential design. We enrolled adult patients receiving dialysis, including in-center hemodialysis, home hemodialysis, and peritoneal dialysis. Descriptive patient characteristics were collected. Participants’ treatment and illness burden was measured using the Illness Intrusiveness Scale (IIS). Participants scoring in the highest quartile were defined as having high burden, and participants scoring in the lowest quartile as having low burden. Participants in both quartiles were invited to participate in interviews and observations. Results Quantitatively, participants in the high burden group were significantly younger (mean = 48.4 years vs. 68.6 years respectively, p = <0.001). No other quantitative differences were observed. Qualitatively, we found differences in patient self-management practices, such as the high burden group having difficulty establishing a new rhythm of life to cope with dialysis, greater disruption in social roles and self-perception, fewer appraisal focused coping strategies, more difficulty maintaining social networks, and more negatively portrayed experiences early in their dialysis journey. Conclusions and relevance Patients on dialysis reporting the greatest illness and treatment burden have difficulties that their low-burden counterparts do not report, which may be amenable to intervention.

scholarly journals Type 2 diabetes patients’ views on prevention of hypoglycaemia – a mixed methods study investigating self-management issues and self-identified causes of hypoglycaemia

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Stijn Crutzen ◽  
Tessa van den Born-Bondt ◽  
Petra Denig ◽  
Katja Taxis
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Mixed Methods ◽  
Food Intake ◽  
Mixed Methods Study ◽  
Self Management ◽  
Hypoglycaemic Event ◽  
Glucose Levels ◽  
Management Issues

Abstract Background Hypoglycaemia is a common and potentially avoidable adverse event in people with type 2 diabetes (T2D). It can reduce quality of life, increase healthcare costs, and reduce treatment success. We investigated self-management issues associated with hypoglycaemia and self-identified causes of hypoglycaemia in these patients. Methods In this mixed methods study qualitative semi-structured interviews were performed, which informed a subsequent quantitative survey in T2D patients. All interviews were audio recorded, transcribed verbatim and coded independently by two coders using directed content analysis, guided by the Theoretical Domains Framework. Descriptive statistics were used to quantify the self-management issues and causes of hypoglycaemia collected in the survey for the respondents that had experienced at least one hypoglycaemic event in the past. Results Sixteen participants were interviewed, aged 59–84 years. Participants perceived difficulties in managing deviations from routine, and they sometimes lacked procedural knowledge to adjust medication, nutrition or physical activity to manage their glucose levels. Grief and loss of support due to the loss of a partner interfered with self-management and lead to hypoglycaemic events. Work ethic lead some participant to overexerting themselves, which in turn lead to hypoglycaemic events. The participants had difficulties preventing hypoglycaemic events, because they did not know the cause, suffered from impaired hypoglycaemia awareness and/or did not want to regularly measure their blood glucose. When they did recognise a cause, they identified issues with nutrition, physical activity, stress or medication. In total, 40% of respondents reported regular stress as an issue, 24% reported that they regularly overestimated their physical abilities, and 22% indicated they did not always know how to adjust their medication. Around 16% of patients could not always remember whether they took their medication, and 42% always took their medication at regular times. Among the 83 respondents with at least one hypoglycaemic event, common causes for hypoglycaemia mentioned were related to physical activity (67%), low food intake (52%), deviations from routine (35%) and emotional burden (28%). Accidental overuse of medication was reported by 10%. Conclusion People with T2D experience various issues with self-managing their glucose levels. This study underlines the importance of daily routine and being able to adjust medication in relation to more physical activity or less food intake as well as the ability to reduce and manage stress to prevent hypoglycaemic events.

scholarly journals Correction: Combined Use of Web-Based and In-Person Education on Ill Health Self-management Skills in Adults With Bipolar Disorder: Protocol for a Mixed Methods Study

10.2196/33506 ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. e33506
Author(s):  
Anna Hatzioannou ◽  
Andreas Chatzittofis ◽  
Virginia Sunday Koutroubas ◽  
Evridiki Papastavrou ◽  
Maria Karanikola
Keyword(s):  
Bipolar Disorder ◽  
Mixed Methods ◽  
Mixed Methods Study ◽  
Self Management ◽  
Management Skills ◽  
Web Based ◽  
Combined Use

scholarly journals Secure Messaging, Diabetes Self‐Management, and the Importance of Patient Autonomy: A Mixed Methods Study

2020 ◽  
Vol 55 (S1) ◽  
pp. 41-42
Author(s):  
S. Robinson ◽  
M. Zocchi ◽  
D. Netherton ◽  
A. Ash ◽  
C. Purington ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Patient Autonomy ◽  
Mixed Methods Study ◽  
Self Management ◽  
Secure Messaging

Teaching self-management support in Dutch Bachelor of Nursing education: A mixed methods study of the curriculum

2018 ◽  
Vol 68 ◽  
pp. 146-152 ◽  
Author(s):  
Susanne M. van Hooft ◽  
Yvonne N. Becqué ◽  
Jolanda Dwarswaard ◽  
AnneLoes van Staa ◽  
Roland Bal
Keyword(s):  
Nursing Education ◽  
Mixed Methods ◽  
Mixed Methods Study ◽  
Self Management ◽  
Management Support

scholarly journals 3361 Feasibility, Acceptability, and Appropriateness of an Insertable Vaginal Cup to Manage Urinary Incontinence Among Women with Obstetric Fistula in Ghana: A Mixed Methods Study

2019 ◽  
Vol 3 (s1) ◽  
pp. 44-45
Author(s):  
Nessa E Ryan
Keyword(s):  
Urinary Incontinence ◽  
Mixed Methods ◽  
Repeated Measures ◽  
Obstetric Fistula ◽  
Mixed Methods Study ◽  
Relative Advantage ◽  
Self Management ◽  
Future Research ◽  
Leakage Reduction ◽  
The Mean

OBJECTIVES/SPECIFIC AIMS: 1. To assess feasibility (efficacy, safety, acceptability) of the menstrual cup for managing urinary incontinence among women with obstetric fistula 2. To examine pre-implementation facilitators and barriers (including appropriateness) among additional stakeholders METHODS/STUDY POPULATION: Sequential explanatory mixed methods study whereby repeated measures clinical trial results are explained by subsequent interviews with additional women with OF on coping and stigma and other stakeholders on perceptions of fistula self-management. RESULTS/ANTICIPATED RESULTS: Of the 32 patients screened, 11 were eligible (100% consent rate). At baseline, mean (±SD) leakage in ml was 63.2 (±49.2) (95% CI: 30.2-96.3) over two hours, while the mean leakage over two hours of use of the cup was 16.8 (±16.5) (95% CI: 5.7-27.9). The mean difference of 46.4 (±52.1) ml with use of the cup (95% CI: 11.4-81.4) was statistically significant (p = 0.02). With the cup, women experienced an average 61.0% (±37.4) (95% CI: 35.9-86.2) leakage reduction, a difference 10/11 users (91.0%) perceived in reduced leakage. One participant, reporting four previous surgical attempts, experienced a 78.7% leakage reduction. Acceptability was high–women could easily insert (8/11), remove (8/11), and comfortably wear (11/11) the cup and most (10/11) would recommend it. No adverse effects attributable to the intervention were observed on exam, although some women perceived difficulties with insertion and removal. Data collection tools were appropriate with slight modification advised. Interviews highlighted that women were already using various active coping and resistance strategies but lacked access to tools to support coping. Additional stakeholders reported the innovation was a simple, low-cost device that is an appropriate fit with ongoing fistula programming. Pre-implementation facilitators include the clear relative advantage to existing self-management strategies, the potential to build upon existing partnerships to implement, and a tension for change to address surgical gaps. Barriers included additional stakeholder’s perceptions of low user acceptability and appropriateness in some cases and the need for additional study data to inform decision making for practice and policy. DISCUSSION/SIGNIFICANCE OF IMPACT: The innovation is efficacious, acceptable, adds to current coping strategies, and fits within existing fistula programs. Stakeholders’ pre-implementation perceptions highlight the importance of partnerships and the need for an evidence base related to effectiveness, acceptability, and cost. Challenges to address include access to resources within these contexts (water, soap, and safe space to empty cup) and development of a culturally appropriate counseling message. Future research warranted.

A Mixed Methods Study of Symptom Experience in Patients With End-Stage Renal Disease

2020 ◽  
Vol 70 (1) ◽  
pp. 34-43
Author(s):  
Marques Shek Nam Ng ◽  
Cho Lee Wong ◽  
Kai Chow Choi ◽  
Yun Ho Hui ◽  
Eva Hau Sim Ho ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Mixed Methods Study ◽  
Symptom Experience ◽  
Stage Renal Disease ◽  
End Stage

The effect of Bandura's self-efficacy concepts to improve diabetes self-management practices

2020 ◽  
Vol 5 (2) ◽  
pp. 58-61
Author(s):  
Pandora Goode
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Type 2 Diabetes Mellitus ◽  
End Stage Renal Disease ◽  
Management Practices ◽  
Self Management ◽  
Stage Renal Disease ◽  
End Stage

Poor diabetes self-management practices may lead to the development of chronic kidney disease (CKD), which, if left untreated, can progress to end stage renal disease (ESRD). Type 2 diabetes mellitus is the leading cause of ESRD for adults. Improving diabetes self-management practices is an important strategy to decrease the risk of developing CKD.

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