scholarly journals Evaluation of an individualized education program in pituitary diseases: a pilot study

2020 ◽  
Vol 183 (6) ◽  
pp. 551-559
Author(s):  
F Albarel ◽  
I Pellegrini ◽  
H Rahabi ◽  
C Baccou ◽  
L Gonin ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Education Program ◽  
Goal Attainment ◽  
Self Management ◽  
Tertiary Referral Center ◽  
Self Confidence ◽  
Pituitary Disease ◽  
Pituitary Diseases

Introduction The low prevalence of pituitary diseases makes patient autonomy crucial, and self-management programs should be more common. Objectives To assess the efficacy of an education program for patients with pituitary diseases in terms of patients’ quality of life, satisfaction and goal attainment. Design and methods Adult patients with pituitary disorders were recruited in a tertiary referral center and chose at least three of eight possible sessions on various topics, from disease management to psychosocial issues. Patients were included if they attended at least three sessions between 2012 and 2016 and completed the initial, final, and follow-up questionnaires. Data on quality of life (SF36), satisfaction and goal attainment were analyzed. Results Fifty-three patients were included (33 women; mean age, 53.5 years). There were a significant quality of life improvements in terms of physical and psychic limitation scores at the final assessment that persisted at follow-up evaluation. Most patients reached their objectives, especially those on sharing experiences and improving autonomy and self-confidence. More than half set new objectives at the end of the program, the most popular one being to reinforce their knowledge of their pituitary disease, its evolution and treatment (17.1% of patients). The mean overall satisfaction score was 3.75/4. At follow-up evaluation, patients reported improved self-management of pituitary disease (3.6/5) and improved self-efficacy (3.8/5). Conclusion Individualizing the educational objectives of patients with pituitary disease improves the way they live with their disease. If confirmed in other cohorts, this approach could become the gold standard for education programs in rare endocrine diseases.

scholarly journals Impact of Goal Setting and Goal Attainment Methods on Asthma Outcomes

2016 ◽  
Vol 44 (1) ◽  
pp. 103-112 ◽  
Author(s):  
Micah Aaron ◽  
Belinda W. Nelson ◽  
Elena Kaltsas ◽  
Randall W. Brown ◽  
Lara J. Thomas ◽  
...  
Keyword(s):  
Quality Of Life ◽  
African American Women ◽  
Goal Setting ◽  
Goal Attainment ◽  
Self Management ◽  
Factors Associated ◽  
Asthma Symptoms ◽  
Asthma Outcomes

Optimal use of goal-setting strategies in self-management efforts with high-risk individuals with asthma is not well understood. This study aimed to describe factors associated with goal attainment in an asthma self-management intervention for African American women with asthma and determine whether goal attainment methods proved beneficial to goal achievement and improved asthma outcomes. Data came from 212 African American women in the intervention arm of a randomized clinical trial evaluating a telephone-based asthma self-management program. Telephone interview data were collected to assess goals and goal attainment methods identified, asthma symptoms, asthma control, and asthma-related quality of life at baseline and 2-year follow-up. Generalized estimating equations were used to assess the long-term impact of goal setting and goal attainment methods on outcomes. The average age of the sample was 42.1 years ( SD = 14.8). Factors associated with goal attainment included higher education ( p < .01) and fewer depressive symptoms ( p < .01). Using a goal attainment method also resulted in more goals being achieved over the course of the intervention (Estimate [ SE] = 1.25 [0.18]; p < .001) when adjusted for clinical and demographic factors. Use of and types of goal attainment methods and goals were not found to significantly affect asthma control, quality of life, or frequency of nighttime asthma symptoms at follow-up. Using a method to achieve goals led to greater goal attainment. Goal attainment alone did not translate into improved asthma outcomes in our study sample. Further studies are warranted to assess the challenges of self-management in chronic disease patients with complex health needs and how goal setting and goal attainment methods can be strategically integrated into self-management efforts to improve health endpoints.

scholarly journals Pilot randomised clinical trial of an eHealth, self-management support intervention (iVERVE) for stroke: feasibility assessment in survivors 12–24 months post-event

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Dominique A. Cadilhac ◽  
◽  
Nadine E. Andrew ◽  
Doreen Busingye ◽  
Jan Cameron ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Goal Attainment ◽  
Pilot Trial ◽  
Intervention Group ◽  
Trial Registration ◽  
Self Management ◽  
Control Group ◽  
Environment Control

Abstract Background Electronic communication is used in various populations to achieve health goals, but evidence in stroke is lacking. We pilot tested the feasibility and potential effectiveness of a novel personalised electronic self-management intervention to support person-centred goal attainment and secondary prevention after stroke. Methods A phase I, prospective, randomised controlled pilot trial (1:1 allocation) with assessor blinding, intention-to-treat analysis, and a process evaluation. Community-based survivors of stroke were recruited from participants in the Australian Stroke Clinical Registry (AuSCR) who had indicated their willingness to be contacted for research studies. Inclusion criteria include 1–2 years following hospital admission for stroke and living within 50 km of Monash University (Melbourne). Person-centred goals were set with facilitation by a clinician using a standardised template. The intervention group received electronic support messages aligned to their goals over 4 weeks. The control group received only 2–3 electronic administrative messages. Primary outcomes were study retention, goal attainment (assessed using Goal Attainment Scaling method) and satisfaction. Secondary outcomes were self-management (Health Education Impact Questionnaire: 8 domains), quality of life, mood and acceptability. Results Of 340 invitations sent from AuSCR, 73 responded, 68 were eligible and 57 (84%) completed the baseline assessment. At the goal-setting stage, 54/68 (79%) were randomised (median 16 months after stroke): 25 to intervention (median age 69 years; 40% female) and 29 to control (median age 68 years; 38% female). Forty-five (83%) participants completed the outcome follow-up assessment. At follow-up, goal attainment (mean GAS-T score ≥ 50) in the intervention group was achieved for goals related to function, participation and environment (control: environment only). Most intervention participants provided positive feedback and reported that the iVERVE messages were easy to understand (92%) and assisted them in achieving their goals (77%). We found preliminary evidence of non-significant improvements between the groups for most self-management domains (e.g. social integration and support: β coefficient 0.34; 95% CI − 0.14 to 0.83) and several quality-of-life domains in favour of the intervention group. Conclusion These findings support the need for further randomised effectiveness trials of the iVERVE program to be tested in people with new stroke. Trial registration ANZCTR, ACTRN12618001519246. Registered on 11 September 2018—retrospectively registered.

scholarly journals Self-management interventions for people with severe mental illness: systematic review and meta-analysis

2019 ◽  
Vol 214 (5) ◽  
pp. 260-268 ◽  
Author(s):  
Melanie Lean ◽  
Miriam Fornells-Ambrojo ◽  
Alyssa Milton ◽  
Brynmor Lloyd-Evans ◽  
Bronwyn Harrison-Stewart ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Meta Analysis ◽  
Health Problems ◽  
Self Management ◽  
Management Interventions

BackgroundSelf-management is intended to empower individuals in their recovery by providing the skills and confidence they need to take active steps in recognising and managing their own health problems. Evidence supports such interventions in a range of long-term physical health conditions, but a recent systematic synthesis is not available for people with severe mental health problems.AimsTo evaluate the effectiveness of self-management interventions for adults with severe mental illness (SMI).MethodA systematic review of randomised controlled trials was conducted. A meta-analysis of symptomatic, relapse, recovery, functioning and quality of life outcomes was conducted, using RevMan.ResultsA total of 37 trials were included with 5790 participants. From the meta-analysis, self-management interventions conferred benefits in terms of reducing symptoms and length of admission, and improving functioning and quality of life both at the end of treatment and at follow-up. Overall the effect size was small to medium. The evidence for self-management interventions on readmissions was mixed. However, self-management did have a significant effect compared with control on subjective measures of recovery such as hope and empowerment at follow-up, and self-rated recovery and self-efficacy at both time points.ConclusionThere is evidence that the provision of self-management interventions alongside standard care improves outcomes for people with SMI. Self-management interventions should form part of the standard package of care provided to people with SMI and should be prioritised in guidelines: research on best methods of implementing such interventions in routine practice is needed.Declaration of interestsNone.

scholarly journals P1547THE EFFECT OF INTERNET-BASED CLOSED-LOOP MANAGEMENT ON QUALITY OF LIFE IN PATIENTS ON PERITONEAL DIALYSIS, A SELF-CONTROL STUDY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Fang Cao
Keyword(s):  
Quality Of Life ◽  
Peritoneal Dialysis ◽  
Management System ◽  
Closed Loop ◽  
Health Management ◽  
Management Model ◽  
Self Management ◽  
Dialysis Patients

Abstract Background and Aims With the continuous advancement of information technology, mobile Internet has entered every family and shown its unique advantages. The development of hospital's information construction on the management of chronic disease, the continuous improvement of hospital APP and Wechat public number functions have provided intelligent services for patients throughout the process. Along with this process, the way of hospital patient follow-up has gradually expanded and improved, and the automation and intellectualization of follow-up work has become a reality. However, The establishment of peritoneal dialysis health management professional team and the implementation of closed-loop health management model, which is based on the Internet closed-loop management model has no clear impact on the self-management ability, quality of life and treatment effect of peritoneal dialysis patients. To explore the effectiveness of Internet based in-hospital and out of hospital closed loop management on the quality of life of patients with peritoneal dialysis, it is necessary to establish a set of closed loop management system for chronic diseases patients with promotion and practical significance. Method From July 2017 to July 2018, 214 patients with continuous peritoneal dialysis were followed up regularly in the Department of Nephrology of our hospital, and voluntarily participated in this study. The mean follow-up time was 12.6 ± 1.5 months. The differences of blood electrolytes, quality control indexes, self-management ability, quality of life of renal disease and hospital satisfaction were observed before and after closed-loop management. Results Ability of self-management behavior (p &lt; 0.001), quality of life (p &lt; 0.001), satisfaction (p &lt; 0.001), the incidence of infection (p &lt; 0.05), serum albumin (p &lt; 0.05), hemoglobin (p &lt; 0.05)were improved after participating in the closed-loop management. Conclusion The closed-loop management system based on Internet closed-loop management model is effective for the quality of life and treatment effect of peritoneal dialysis patients, which integrates the core functions of follow-up records, intelligent early warning, doctor-patient communication and health education. Through this closed-loop management, medical staff can digitally collect, store, transmit and process the information of in-hospital and out-of-hospital conditions through follow-up analysis, health guidance and remote assistance to achieve the purpose of patient health management. This study shows that this closed-loop management system can effectively manage the health of peritoneal dialysis patients, and provides a replicable model for the management of chronic diseases. Therefore, a comprehensive closed-loop management system based on mobile Internet and information technology, with clinical care as the leading factor and peritoneal dialysis patients as the terminal is a feasible and acceptable follow-up management method for peritoneal dialysis patients and hospitals.

scholarly journals A Children’s Asthma Education Program: Roaring Adventures of Puff (RAP), Improves Quality of Life

2010 ◽  
Vol 17 (2) ◽  
pp. 67-73 ◽  
Author(s):  
Shawna L McGhan ◽  
Eric Wong ◽  
Heather M Sharpe ◽  
Patrick A Hessel ◽  
Puish Mandhane ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Usual Care ◽  
Education Program ◽  
Intervention Group ◽  
Asthma Management ◽  
Control Group ◽  
Asthma Education ◽  
Children With Asthma

BACKGROUND: It is postulated that children with asthma who receive an interactive, comprehensive education program would improve their quality of life, asthma management and asthma control compared with children receiving usual care.OBJECTIVE: To assess the feasibility and impact of ‘Roaring Adventures of Puff’ (RAP), a six-week childhood asthma education program administered by health professionals in schools.METHODS: Thirty-four schools from three health regions in Alberta were randomly assigned to receive either the RAP asthma program (intervention group) or usual care (control group). Baseline measurements from parent and child were taken before the intervention, and at six and 12 months.RESULTS: The intervention group had more smoke exposure at baseline. Participants lost to follow-up had more asthma symptoms. Improvements were significantly greater in the RAP intervention group from baseline to six months than in the control group in terms of parent’s perceived understanding and ability to cope with and control asthma, and overall quality of life (P<0.05). On follow-up, doctor visits were reduced in the control group.CONCLUSION: A multilevel, comprehensive, school-based asthma program is feasible, and modestly improved asthma management and quality of life outcomes. An interactive group education program offered to children with asthma at their school has merit as a practical, cost-effective, peer-supportive approach to improve health outcomes.

A co-produced self-management programme improves psychosocial outcomes for people living with depression

2015 ◽  
Vol 20 (4) ◽  
pp. 242-255 ◽  
Author(s):  
Andy Turner ◽  
Alba X. Realpe ◽  
Louise M. Wallace ◽  
Joanna Kosmala-Anderson
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Health Status ◽  
Management Programme ◽  
Self Management ◽  
Depression Symptoms ◽  
Management Skills ◽  
Content Type

Purpose – There is growing interest in self-management support for people living with mental health problems. The purpose of this paper is to describe the evaluation of a co-designed and co-delivered self-management programme (SMP) for people living with depression delivered as part of large scale National Health Service quality improvement programme, which was grounded in the principles of co-production. The authors investigated whether participants became more activated, were less psychologically distressed enjoyed better health status, and quality of life, and improved their self-management skills after attending the seven-week SMP. Design/methodology/approach – The authors conducted a longitudinal study of 114 people living with depression who attended the SMP. Participants completed self-reported measures before attending the SMP and at six months follow up. Findings – Patient activation significantly improved six months after the SMP (baseline M=49.6, SD=12.3, follow up M=57.2, SD=15.0, t(113)=4.83, p < 0.001; d=0.61). Participants’ experience of depression symptoms as measured by the Patient Health Questionnaire-9 significantly reduced (baseline M=15.5, SD=6.8, follow up M=10.6, SD=6.9, t(106)=7.22, p < 0.001, d=−0.72). Participants’ anxiety and depression as measured by the Hospital Anxiety Depression Scale also decreased significantly (baseline anxiety: M=13.1, SD=4.2, follow up M=10.2, SD=4.4, t(79)=6.29, p < 0.001, d=−0.69); (baseline depression: M=10.3, SD=4.6, follow up M=7.7, SD=4.5, t(79)=5.32, p < 0.001, d=−0.56). The authors also observed significant improvement in participants’ health status (baseline M=0.5, SD=0.3, follow up M=0.6, SD=0.3, t(97)=−3.86, p < 0.001, d=0.33), and health-related quality of life (baseline M=45.4, SD=20.5, follow up M=60.8, SD=22.8, t(91)=−2.71, p=0.008, d=0.75). About 35 per cent of participant showed substantial improvements of self-management skills. Originality/value – The co-produced depression SMP is innovative in a UK mental health setting. Improvements in activation, depression, anxiety, quality of life and self-management skills suggest that the SMP could make a useful contribution to the recovery services in mental health.

scholarly journals Randomised controlled trial of the effects of a self-management patient education program on overall quality of life and knee pain of older people with mild to moderate knee(s) osteoarthritis

2017 ◽  
Vol 4 (2) ◽  
pp. 80
Author(s):  
Alhadi M. Jahan
Keyword(s):  
Quality Of Life ◽  
Patient Education ◽  
Education Program ◽  
Repeated Measures ◽  
Controlled Trial ◽  
Self Management ◽  
Controlled Study ◽  
Control Group ◽  
Human Beings

<p class="abstract"><strong>Background:</strong> Knee osteoarthritis (OA) is the most important chronic rheumatic disease affecting human beings. It is more common among the older population. The objective of OA treatment is to control the symptoms, such as pain, mobility problems and consequently, to improve overall quality of life. Although, self-management patient education programs, such as educational workshops and other learning activities are effective approaches in some chronic diseases, the evidence for arthritis is still inconclusive. The aim of this trial is to compare the effectiveness of an OA of the knee self-management education program with a control group, as determined by improvements in pain and quality of life<span lang="EN-IN">. </span></p><p class="abstract"><strong>Methods:</strong> In this study, we will perform a two-group, randomized (1:1 ratio), controlled study with repeated-measures to examine the differences between the two groups over time. The research sample will be selected from the patients who are referred to a physiotherapy department with a diagnosed mild to moderate knee(s) OA, aging from 45 to 65 years<span lang="EN-IN">.</span></p><p class="abstract"><strong>Conclusions:</strong> Positive findings of this trial will pave the road for new methods of cooperation between patients and healthcare providers. Also, patient education ensures that patients are well-informed about their own health and they could avoid any deterioration and disability due to bad practices. Finally, an increased understanding helps patients to make informed decisions about their healthcare avenues.</p>

Chronic Obstructive Pulmonary Disease Discharge Education and Quality of Life Evaluation: A Feasibility Study

2018 ◽  
Vol 32 (3) ◽  
pp. 328-348 ◽  
Author(s):  
Patricia Conley ◽  
Teresa J. Kelechi ◽  
Lynne S. Nemeth ◽  
Martina Mueller
Keyword(s):  
Quality Of Life ◽  
Chronic Obstructive Pulmonary Disease ◽  
Action Plan ◽  
Phone Call ◽  
Self Management ◽  
Chronic Obstructive ◽  
Secondary Diagnosis ◽  
Obstructive Pulmonary Disease

Background and Purpose:Discharge instructions provided to hospitalized participants with chronic obstructive pulmonary disease (COPD) are essential to promote improved health outcomes, reduce incidence of hospitalization, and enhance quality of life (QOL). This study evaluated the feasibility of implementing the American Lung Association’s COPD Action Plan and assessment of QOL among participants hospitalized for acute exacerbation of COPD or COPD as a primary or secondary diagnosis.Methods:The study was conducted on a cohort of critically ill participants hospitalized on a progressive care unit. The Principal Investigator administered the WHOQOL-BREF Questionnaire to assess QOL before discharge and 30 days after discharge via phone call. Reach, Effectiveness, Adoption, Implementation, and Maintenance was used to evaluate outcomes from the discharge study.Results:Among participants enrolled (n = 50), 13 completed the in-hospital and follow-up phone call. Participants scored (12; 92% answered “yes”) that they learned appropriate COPD self-management skills, such as change in respiratory symptoms and appropriate actions to take. At 30-day follow-up: number of rehospitalizations (12; 99%), no emergency department visits, and (1; 1%) emergency department visit for insulin reaction, not COPD. Most frequent principal admitted diagnosis was acute respiratory failure, and secondary diagnosis was COPD. There was no significant difference in QOL comparing scores at discharge to 30-day follow-up, using the Wilcoxon signed-rank test.Implications for Practice:COPD education can increase participant satisfaction in receiving self-management instructions from an action plan near the time of discharge based on a small sample.

scholarly journals Quality of Life in Postoperative Colorectal Cancer Survivors: A Structural Equation Model

2021 ◽  
Vol 73 (9) ◽  
pp. 576-586
Author(s):  
Chophaka Suttipong ◽  
Siriorn Sindhu ◽  
Ketsarin Utriyaprasit ◽  
Cherdsak Iramaneerat
Keyword(s):  
Quality Of Life ◽  
Colorectal Cancer ◽  
Postoperative Complications ◽  
Nutritional Status ◽  
Indirect Effects ◽  
Self Management ◽  
Equation Modeling ◽  
Caregiver Support

Objective: The present study has been aimed at constructing a causal model to determine factors affecting healthrelatedquality of life (HRQoL) in postoperative patients with colorectal cancer (CRC) following discharge.Materials and Methods: A cross-sectional study was conducted with 396 postoperative CRC cancer patients fromten tertiary hospitals representing each of the four Regions of Thailand. Data was collected through a standardquestionnaire. Structure equation modeling (SEM) was applied to analyze data.Results: The findings revealed that the majority of patients with CRC surgery had a moderate HRQoL. One hundredand twenty-three patients (31.1%) had complications. SEM showed a good fit with ƛ2=40.347, df=28, p=0.062,GFI=0.980, CFI=0.959 and RMSEA=0.033. The final model showed that age, stage of cancer and healthcare servicebeing received following CRC surgery had direct effects on HRQoL. Nutritional status and follow-up outpatientclinic had indirect effects on HRQoL during postoperative complications. Moreover, social support and primaryfamily caregiver support had indirect effects on HRQoL through self-management capacity.Conclusion: The findings of this study emphasized the importance of implementing effective strategies to improvequality of life among postoperative patients with CRC after discharge and indicated these strategies should focuson quality of healthcare service following CRC surgery, self-management capacity and prevention of postoperativecomplications. Postoperative complications can be reduced by providing effective follow-up in outpatient clinicsand nutritional status management, consequently improving quality of life among this population.

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