scholarly journals Effect of Self-Management Program on Self-efficacy and Medication Adherence in Patients with Mechanical Heart Valve: a Randomized Clinical Trial

2019 ◽  
Vol 8 (4) ◽  
pp. 207-211
Author(s):  
Leila Javan ◽  
Aanoshirvan Kazemnejad ◽  
Mahin Nomali ◽  
Maasumeh Zakerimoghadam
Keyword(s):  
Medication Adherence ◽  
Heart Valve ◽  
Self Efficacy ◽  
Controlled Trial ◽  
Mechanical Heart Valve ◽  
International Normalized Ratio ◽  
Management Program ◽  
Self Management ◽  
Control Group ◽  
Replacement Surgery

Introduction: Patients with mechanical heart valve need anticoagulant therapy to prevent thrombotic events. The treatment interacts with some foods and drugs. The aim was to evaluate the effect of self- management program on self-efficacy and medication adherence in patients with mechanical heart valve. Methods: This was a randomized controlled trial. eighty eligible patients, with the ability to read and speak in Farsi, aged between 15 to 60, were included in the study from the cardiac surgery clinic in Imam Khomeini hospital affiliated to Tehran University of Medical Sciences (Tehran, Iran) and randomly allocated to intervention and control groups. The participants had no history of psychiatric disorders, had undergone valve replacement surgery at least one year before the study, and were being treated with Warfarin. The intervention was a combination of 2 one- hour selfmanagement education via small groups with 3 to 5 members, self-management educational booklets, and weekly call follow- ups for 8 weeks about 10- 15 minutes. The control group received no intervention. Self- efficacy was the primary outcome and medication adherence, Prothrombin Time (PT), and International Normalized Ratio (INR) were secondary outcomes. Data were analyzed using SPSS13. Results: Although the mean of self-efficacy and medication adherence, PT, and INR values were not different between the two groups at baseline, they improved significantly following the program. Conclusion: Self-management program had a positive effect on self-efficacy and medication adherence of patients with mechanical heart valve.

scholarly journals Theoretical asthma self-management program for Taiwanese adolescents with self-efficacy, outcome-expectancy, health behavior, and asthma symptoms: A randomized controlled trial

2019 ◽  
Author(s):  
Tzu-Jung Tseng ◽  
Chiung-Jung (Jo) Wu ◽  
Anne M Chang
Keyword(s):  
Self Efficacy ◽  
Controlled Trial ◽  
Management Program ◽  
The Self ◽  
Outcome Expectancy ◽  
Self Management ◽  
Control Group ◽  
Asthma Symptoms ◽  
Efficacy Outcome ◽  
Asthma Prevention

Abstract Background: The asthma prevalence of Taiwanese adolescents is continued to rise and affecting sufferers’ daily life. With physical and psychological changes in adolescents, managing asthma can be quite challenges for them and could lead to negative social, emotional and physical impacts if not well managed. Literature found that adolescents with high levels of self-efficacy are more likely to be involved in prevention and management activities. The aim of this study was to develop an effective asthma self-management program by taking account for adolescents’ developmental stages and based on Bandura’s self-efficacy model for this group of young people. Methods: A randomised controlled trial was used to evaluate effects of the newly developed Asthma Self-management Program for Taiwanese adolescents. The outcomes were self-efficacy, outcome-expectancy, asthma prevention and self-management behaviour, and controlling asthma symptoms. Translation and back-translation process were used for original tools in English. Good consistent reliabilities of Chinese versions tools were identified. A t-test or Mann-Whiney U test was employed to determine any mean differences of outcome variables between groups overtime. Results: A sample of 83 patients completed (n = 43 in control group, n = 40 in experimental group) the study. The mean age was 14.3 years (SD = 1.85), two-third of the participants were males. Seventy-six percent (n = 68) had a mild to intermittent level of asthma severity. Significant improvements were found on self-efficacy, t = -2.75; outcome-expectancy, U = 646, prevention behaviours, t = -3.62, and management behaviours, t = -3.19, but non-significant results for the outcome of asthma control, U = 716. Conclusions: The results provide evidence to support the efficacy of the asthma self-management program based on the self-efficacy model that has taken considerations of developmental phases. The findings indicated the self-management program improved adolescents’ self-confidence in carrying out asthma prevention and management behaviours for effectively manage their asthma symptoms. Future clinical practice should consider delivering an educational program using multifaceted and interactive learning strategies.

Self-Care Training and Information Support of Patients With Mechanical Heart Valve on International Normalized Ratio and the Bleeding Complications

2020 ◽  
Author(s):  
Shirdel Zandi ◽  
Behzad Imani ◽  
GHolamreza Safarpor
Keyword(s):  
Heart Valve ◽  
Intervention Group ◽  
Mechanical Heart Valve ◽  
Self Care ◽  
International Normalized Ratio ◽  
Information Support ◽  
Bleeding Complications ◽  
Target Range ◽  
Control Group ◽  
Care Training

Abstract BackgroundPatients with mechanical heart valve due to the possibility of coagulation complications require lifelong use of anticoagulants and International Normalized Ratio (INR) control. But if not taken care of properly, anticoagulant therapy itself can put people at risk for bleeding and be life-threatening. ObjectivesThe aim of this study was to determine the effect of Self-care training and information support of patients with mechanical heart valve on INR and the bleeding complications.DesignA randomized double-blind controlled trial.Settings and MethodsParticipants were recruited via convenience sampling from Farshchian hospital in Hamadan, Iran; and were randomly divided into two groups control (n=80) and intervention (n=80). Participants in the control group received only routine training; in addition, the intervention group received 6 sessions of self-care training and 6 months of information support. Monthly the level of INR and incidence of bleeding were determined. Data were analyzed using independent t-test and chi-square in spss16 software at a significance level of 0.05.ResultsDuring 6 months of follow-up, except for the third month, the frequency of INR levels in therapeutic target range (2.5-3.5) in the intervention group was significantly higher than the control group (p<0.05). Also in the intervention group, the incidence of bleeding complications was relatively less than the control group, but this difference was not statistically significant (p>0.05).ConclusionProper self-care training and information support in patients with mechanical heart valve replacement have positive results. By doing self-care, the level of a therapeutic target range of INR maintained and the incidence of bleeding complications can be reduced.

scholarly journals Effect of Physician-Pharmacist Participation in the Management of Ambulatory Cancer Pain Through a Digital Health Platform: Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Lu Zhang ◽  
Howard L McLeod ◽  
Ke-Ke Liu ◽  
Wen-Hui Liu ◽  
Hang-Xing Huang ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Medication Adherence ◽  
Pain Management ◽  
Cancer Pain ◽  
Controlled Trial ◽  
Intervention Group ◽  
Self Management ◽  
Control Group ◽  
Randomized Controlled ◽  
Pain Scores

BACKGROUND Self-management of ambulatory cancer pain is full of challenges. Motivated by the need for better pain management, we developed a WeChat-supported platform, Medication Housekeeper (MediHK), to enhance communication, optimize outcomes, and promote self-management in the home setting. OBJECTIVE We conducted a randomized controlled trial to assess whether the joint physician-pharmacist team through MediHK would provide better self-management of ambulatory patients with cancer pain. METHODS Patients were randomly assigned to either an intervention group or control group. During the 4-week study period, the pharmacist would send 24-hour pain diaries daily, adverse drug reaction (ADR) forms every 3 days, and the Brief Pain Inventory form every 15 days to patients in the intervention group via MediHK. If a patient needed a change in drug/dosage or treatment of an ADR after the comprehensive review, the pharmacist would propose pharmacological interventions to the attending physician, who was then responsible for prescribing or adjusting pain medications. If no adjustments were needed, the pharmacist provided appropriate targeted education based on knowledge deficits. Patients in the control group received conventional care and did not receive reminders to fill out the forms. However, if the control group patients filled out a form via MediHK, the pain management team would review and respond in the same way as for the intervention group. The primary outcomes included pain intensity and pain interference in daily life. Secondary outcomes included patient-reported outcome measures, medication adherence, ADRs, and rehospitalization rates. RESULTS A total of 100 patients were included, with 51 (51%) in the intervention group and 49 (49%) in the control group. The worst pain scores, least pain scores, and average pain scores in the intervention group and the control group were statistically different, with median values of 4 (IQR 3-7) vs 7 (IQR 6-8; <i>P</i>=.001), 1 (IQR 0-2) vs 2 (IQR 1-3; <i>P</i>=.02), and 2 (IQR 2-4) vs 4 (IQR 3-5; <i>P</i>=.001), respectively, at the end of the study. The pain interference on patients' general activity, mood, relationships with others, and interests was reduced, but the difference was not statistically significant compared with the control group (<i>Ps</i>=.10-.76). The medication adherence rate increased from 43% to 63% in the intervention group, compared with an increase of 33% to 51% in the control group (<i>P</i>&lt;.001). The overall number of ADRs increased at 4 weeks, and more ADRs were monitored in the intervention group (<i>P</i>=.003). Rehospitalization rates were similar between the 2 groups. CONCLUSIONS The joint physician-pharmacist team operating through MediHK improved pain management. This study supports the feasibility of integrating the internet into the self-management of cancer pain. CLINICALTRIAL Chinese Clinical Trial Registry ChiCTR1900023075; https://www.chictr.org.cn/showproj.aspx?proj=36901

Effect of Patient-Centered Self-Management Program on Blood Pressure, Renal Function Control, and the Quality of Life of Patients With Hypertensive Nephropathy: A Longitudinal Randomized Controlled Trial

2021 ◽  
pp. 109980042110618
Author(s):  
Mei-Chen Lee ◽  
Shu-Fang Vivienne Wu ◽  
Kuo-Cheng Lu ◽  
Wen-Hug Wang ◽  
Yen-Yen Chen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Blood Pressure ◽  
Controlled Trial ◽  
Management Program ◽  
Self Management ◽  
Control Group ◽  
Patient Centered ◽  
Hypertensive Nephropathy ◽  
Experimental Group

This longitudinal study with a randomized controlled trial evaluated the long-term effectiveness of the patient-centered self-management intervention program on the control of blood pressure and renal function, as well as the quality of life of patients with hypertensive nephropathy. The control group ( n = 38) received usual care while the experimental group ( n = 38) participated in a patient-centered self-management program. After the pre-test, the intervention was performed with the experimental group once a week for a total of 4 weeks. Then, the post-test was performed 1, 3, and 6 months later. A questionnaire was used to collect the demographic data and disease characteristics, laboratory data, and quality of life scale. This study tracked three time points (i.e., 1, 3, and 6 months) after the intervention and found that the experimental group achieved significant results in controlling systolic blood pressure ( p < 0.001), diastolic blood pressure ( p = 0.007), and eGFR ( p = 0.013). Significant results were achieved in the overall quality of life ( p < 0.001) and the quality of life in the physical (PHC; p < 0.001) and mental health components (MHC; p < 0.001). Furthermore, the effects in the experimental group lasted for as long as 6 months and were better than those in the control group. Moreover, this program can provide nursing staff with a reference different from traditional health education methods.

scholarly journals Effects of Customized Long-Message Service and Phone-Based Health-Coaching on Elderly People with Hypertension

2019 ◽  
Author(s):  
Myoungsuk KIM
Keyword(s):  
Medication Adherence ◽  
Self Efficacy ◽  
Pragmatic Trial ◽  
Health Coaching ◽  
Text Messages ◽  
Community Dwelling ◽  
Self Management ◽  
Control Group ◽  
Management Behavior ◽  
Phone Calls

Background: We aimed to develop long-message services (LMS) and phone-based health-coaching for community-dwelling seniors diagnosed with hypertension and assess the effects of the programs implemented both separately and together. These programs are easily applicable to seniors diagnosed with hypertension and will help control their blood pressure (BP) in a practical manner. Methods: We conducted a single-blinded, randomized, controlled pragmatic trial. Individuals aged 65 years or older with hypertension at two senior welfare centers in Seoul, South Korea, who were able to take phone calls and check text messages were enrolled. The study included 124 participants: 31 in the control group, 30 in the health-coaching group, 32 in the LMS group, and 31 in the health-coaching-with-LMS group. Results: Phone-based health-coaching with LMS was effective in improving medication adherence, hypertension self-efficacy, and self-management behavior and decreasing systolic BP as compared to LMS only. There were also improvements in medication adherence, hypertension-related knowledge, hypertension self-efficacy, self-management behavior, and systolic BP in the LMS group as compared to the control group. Conclusion: Using phone-based health-coaching with LMS was effective for managing hypertension in community-dwelling seniors diagnosed with hypertension and could become a useful intervention method.

scholarly journals Effect of Physician-Pharmacist Participation in the Management of Ambulatory Cancer Pain Through a Digital Health Platform: Randomized Controlled Trial

10.2196/24555 ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. e24555
Author(s):  
Lu Zhang ◽  
Howard L McLeod ◽  
Ke-Ke Liu ◽  
Wen-Hui Liu ◽  
Hang-Xing Huang ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Medication Adherence ◽  
Pain Management ◽  
Cancer Pain ◽  
Controlled Trial ◽  
Intervention Group ◽  
Self Management ◽  
Control Group ◽  
Randomized Controlled ◽  
Pain Scores

Background Self-management of ambulatory cancer pain is full of challenges. Motivated by the need for better pain management, we developed a WeChat-supported platform, Medication Housekeeper (MediHK), to enhance communication, optimize outcomes, and promote self-management in the home setting. Objective We conducted a randomized controlled trial to assess whether the joint physician-pharmacist team through MediHK would provide better self-management of ambulatory patients with cancer pain. Methods Patients were randomly assigned to either an intervention group or control group. During the 4-week study period, the pharmacist would send 24-hour pain diaries daily, adverse drug reaction (ADR) forms every 3 days, and the Brief Pain Inventory form every 15 days to patients in the intervention group via MediHK. If a patient needed a change in drug/dosage or treatment of an ADR after the comprehensive review, the pharmacist would propose pharmacological interventions to the attending physician, who was then responsible for prescribing or adjusting pain medications. If no adjustments were needed, the pharmacist provided appropriate targeted education based on knowledge deficits. Patients in the control group received conventional care and did not receive reminders to fill out the forms. However, if the control group patients filled out a form via MediHK, the pain management team would review and respond in the same way as for the intervention group. The primary outcomes included pain intensity and pain interference in daily life. Secondary outcomes included patient-reported outcome measures, medication adherence, ADRs, and rehospitalization rates. Results A total of 100 patients were included, with 51 (51%) in the intervention group and 49 (49%) in the control group. The worst pain scores, least pain scores, and average pain scores in the intervention group and the control group were statistically different, with median values of 4 (IQR 3-7) vs 7 (IQR 6-8; P=.001), 1 (IQR 0-2) vs 2 (IQR 1-3; P=.02), and 2 (IQR 2-4) vs 4 (IQR 3-5; P=.001), respectively, at the end of the study. The pain interference on patients' general activity, mood, relationships with others, and interests was reduced, but the difference was not statistically significant compared with the control group (Ps=.10-.76). The medication adherence rate increased from 43% to 63% in the intervention group, compared with an increase of 33% to 51% in the control group (P<.001). The overall number of ADRs increased at 4 weeks, and more ADRs were monitored in the intervention group (P=.003). Rehospitalization rates were similar between the 2 groups. Conclusions The joint physician-pharmacist team operating through MediHK improved pain management. This study supports the feasibility of integrating the internet into the self-management of cancer pain. Trial Registration Chinese Clinical Trial Registry ChiCTR1900023075; https://www.chictr.org.cn/showproj.aspx?proj=36901

Dose-effect of an asthma self-management program for adolescents: a short report (Preprint)

2020 ◽  
Author(s):  
Chiung-Jung (Jo) Wu ◽  
Anne M. Chang
Keyword(s):  
Medication Adherence ◽  
Self Efficacy ◽  
Secondary Data ◽  
Management Program ◽  
Dose Effect ◽  
Self Management ◽  
High Dose ◽  
Short Report ◽  
Delivery Modes ◽  
Different Levels

UNSTRUCTURED Multiple delivery modes of asthma self-management programs enable adolescents to manage asthma efficiently but have different levels of impacts on health outcomes. Secondary data analysis was used to determine differences in outcomes of asthma self-efficacy, prevention behaviors, asthma medication adherence, and asthma symptoms among the intervention doses. The findings showed participants who completed all intervention components (high dose) had significant greater self-efficacy, prevention behaviors and medication adherence, but no improvements on the asthmatic symptoms. The clinical implementations should take the intervention dose-effect into account and make necessary refinements when care for adolescents with asthma. INTERNATIONAL REGISTERED REPORT RR2-doi.org/10.1016/j.conctc.2017.09.005

Efficacy of a symptom self-management program with virtual reality device on inpatients post-acute myocardial infarction: A pilot randomized controlled trial (Preprint)

2020 ◽  
Author(s):  
Piyanee Klainin-Yobas ◽  
Karen Wei Ling KOH ◽  
Anand Adinath AMBHORE ◽  
Ping CHAI ◽  
Ying Lau
Keyword(s):  
Myocardial Infarction ◽  
Standard Care ◽  
Psychological Symptoms ◽  
Controlled Trial ◽  
Psychosocial Interventions ◽  
Management Program ◽  
Self Management ◽  
Control Group ◽  
Educational Materials ◽  
Relaxation Practice

BACKGROUND Acute myocardial infarction (AMI) is a leading cause of morbidity and mortality worldwide. AMI is associated with poorer quality of life and other psychological symptoms (such as stress, depression and anxiety). Effective psychosocial interventions are essential to help patients post-AMI manage with the psychological symptoms. OBJECTIVE This study aimed to test the efficacy of a newly-developed symptom self-management program on health outcomes among inpatients post-AMI METHODS A pilot randomized, single-blinded, controlled trial was utilized. A convenient sample of 90 was recruited from a tertiary hospital in Singapore. Adult inpatients with stable post-AMI were randomly assigned to the following three groups: IManage-VR, IManage-FF or control group. The IManage-VR and IManage-FF groups received standard care and a symptom self-management program through virtual-reality device or face-to-face method respectively. Two researchers delivered the interventions and assisted with relaxation practice. The control group received only standard care. Data were collected through self-reported questionnaires and physiological instruments. Data analyses included univariate statistics, analysis of variance and repeated measure analysis of variance. RESULTS A total of 90 participants were recruited with 30 in each group. Results indicated that participants in the IManage-VR and IManage-FF group had significantly greater relaxation levels (Partial η2 = 0.11, 0.16), lower objective stress (Partial η2 =0.14, 0.06), and greater knowledge (Partial η2 = 0.62, 0.75) than those of the control group. The two intervention groups had lower subjective stress (Partial η2 = 0.04), depression (Partial η2 = 0.01), and anxiety (Partial η2 = 0.03) than the control but such differences did not achieve statistical significance. Furthermore, most participants (>90%) in the IManage-VR and IManage-FF groups reported that they were satisfied with the programs and they provided positive comments on the contents, educational materials and relaxation practice. CONCLUSIONS This pilot study supports the potential benefits and feasibility of the IManage-VR and IManage-FF interventions on stress, perceived relaxation, knowledge and patient satisfaction. Findings contribute to the current literature on psychosocial interventions for AMI where psychosocial educational materials could be added into the current cardiac rehabilitation programs. Future RCTs with multi-centered sites and larger sample size are required to further test the intervention. CLINICALTRIAL This study has been registered with International Standard Randomised Controlled Trial. Registration Number: ISRCTN61027816. http://www.controlled-trials.com/ ISRCTN61027816.

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