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

Abstract Background Considering the High Blood Pressure-Health Literacy (HBP-HL) has not been included in the study of Health-Related Quality of Life (HRQoL). The synergistic effects and the potential mechanism HBP-HL, self-management behavior, medication adherence, self-efficacy, social support on HRQoL remain unclear. This study aimed to introduce the conception of HBP-HL, and develop a structural equation model to identify the factors influencing of the HRQoL among Kazakh hypertensive patients. Methods A cross-sectional investigation study was conducted to collect data. Patients with hypertension were recruited through random cluster sampling in Kazakh settlements in Urumqi County, Xinjiang. The one-on-one household interviews were conducted by Kazakh investigators. The questionnaires regarding HBP-HL, HRQoL, self-management behavior, medication adherence, self-efficacy, and social support were collected. In addition, the results of physical examination were also included. A structural equation model was used to assess the association between the measured factors and HRQoL. Results 516 Kazakh patients were recruited, and 94.4% of them had a relatively low HBP-HL score. The mean standardized scores of HRQoL, self-management, medication adherence were poor; they were 63.5, 66.2, and 64.4, respectively. But 96.1% and 98.3% of the participants had high levels of self-efficacy and social support. The structural equation model of the HRQoL had a good overall fit (χ2/df = 2.078, AGFI = 0.944, GFI = 0.968, CFI = 0.947, IFI = 0.949, RMSEA = 0.046). The model indicated that the HBP-HL has the highest correlation with HRQoL, following with self-management behavior, social support, and self-efficacy. Conclusions Evidence from this study demonstrates that low HBP-HL is a major influenced factor of HRQoL among Kazakh hypertensive patients. Future programs should consider HBP-HL as the breakthrough point when designing targeting intervention strategies for Kazakh hypertension patients. Firstly, researchers should give a priority to evaluate patient’s HBP-HL before intervention. Next, tailored interventions are implemented for patients, and and ultimately it will contribute to control blood pressure and improve patients’ HRQoL.

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

Journal of Caring Sciences ◽

10.15171/jcs.2019.029 ◽

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.

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The impact of brief lifestyle self-management education for the control of seizures

British Journal of Nursing ◽

10.12968/bjon.2019.28.6.348 ◽

2019 ◽

Vol 28 (6) ◽

pp. 348-354 ◽

Cited By ~ 3

Author(s):

Karen-leigh Edward ◽

Mark Cook ◽

John Stephenson ◽

Jo-Ann Giandinoto

Keyword(s):

Quality Of Life ◽

Medication Adherence ◽

Self Efficacy ◽

Satisfaction With Life ◽

Self Management ◽

Control Group ◽

Management Intervention ◽

The Impact ◽

Psychological Quality Of Life

Aim: this study examined a brief lifestyle self-management intervention, based on self-determination theory, to manage seizure frequency, and its effects on health-related quality of life and resilience in people with epilepsy aged over 18 years. Background: most people with epilepsy can identify factors that may trigger seizures and may try to avoid these; however, education from clinicians on this varies. Design: a cohort study with control design. Method: sixty participants were purposively sampled and allocated to an intervention or a control group. Results: moderate correlations were found, particularly between: resilience and satisfaction with life; medication adherence and psychological quality of life; and psychological quality of life and satisfaction with life. The mean seizure occurrences between the control and intervention groups were 12.71 (SD 24.55) and 6.76 (SD 13.40) respectively after the intervention. While the study was not powered to assess this, the intervention may be most effective regarding medication adherence and physical health quality of life. Conclusion: the relationship between self-efficacy and seizure management appeared to be strengthened by the programme. This study is the first known to measure resilience in relation to lifestyle self-management for seizure control in people with epilepsy. Relevance to practice: nurses are well placed to work with patients' strengths towards self-efficacy and potentially resilient coping.

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2 Feet 4 Life : feasibility of a foot care self-management intervention for older adults without diabetes

10.32469/10355/76181 ◽

2019 ◽

Author(s):

◽

Jennifer J. O'Connor

Keyword(s):

Older Adults ◽

Self Efficacy ◽

Community Dwelling ◽

Self Management ◽

Control Group ◽

Foot Pain ◽

Foot Care ◽

Foot Health ◽

Management Intervention ◽

Patient Reported

[ACCESS RESTRICTED TO THE UNIVERSITY OF MISSOURI AT REQUEST OF AUTHOR.] Foot problems are prevalent, impact over 30% of older adults, and can lead to loss of function, falls, and hospitalization. This pilot intervention study, based on Social Cognitive Theory, evaluated the feasibility, acceptability and preliminary efficacy of the 2 Feet 4 Life foot care self-management intervention on foot care knowledge, self-efficacy, self-management behaviors, foot pain and foot health. Thirty-two non-diabetic, community-dwelling older adults were recruited from two senior centers. One community center was randomized to receive the Intervention; the other served as Control. Within the Control group, participants were randomized into two subgroups: True Control and Bias Control. The 2 Feet 4 Life intervention consisted of one hour sessions for four consecutive weeks. Assessments occurred at baseline, one month, four months and seven months. Study recruitment and retention goals were met (90.6% retention rate). The intervention was safely and accurately implemented within the anticipated timelines. Although some participants reported difficulties with select vocabulary used on one or more the patient-reported outcome tools, participants found the intervention content valuable and session length and frequency acceptable. Modest improvements in foot care knowledge, foot care behaviors, and foot health were observed in the Intervention group. Based on our analysis, the estimated between group effect size of 2 Feet 4 Life intervention appears to be large for foot care knowledge, self-efficacy, and behaviors. Our findings suggest that the patient-reported and provider-reported outcome tools used in this study require further refinement and psychometric testing. Future fully powered studies need to include diverse samples of older adults with greater variability in foot health and foot pain.

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122 A Medication Self-Management Intervention to Improve Medication Adherence for Older People with Multimorbidity: A Pilot Trial

Age and Ageing ◽

10.1093/ageing/afab030.83 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

pp. i12-i42

Author(s):

C Yang ◽

Z Hui ◽

S Zhu ◽

X Wang ◽

G Tang ◽

...

Keyword(s):

Medication Adherence ◽

Older People ◽

Intervention Group ◽

Self Management ◽

Control Group ◽

Medication Knowledge ◽

Management Intervention ◽

Phone Calls ◽

Patient Reported

Abstract Introduction Medication self-management support has been recognised as an essential element in primary health care to promote medication adherence and health outcomes for older people with chronic conditions. A patient-centred intervention empowering patients and supporting medication self-management activities could benefit older people. This pilot study tested a newly developed medication self-management intervention for improving medication adherence among older people with multimorbidity. Method This was a two-arm randomised controlled trial. Older people with multimorbidity were recruited from a community healthcare centre in Changsha, China. Participants were randomly allocated to either a control group receiving usual care (n = 14), or to an intervention group receiving three face-to-face medication self-management sessions and two follow-up phone calls over six weeks, targeting behavioural determinants of adherence from the Information-Motivation-Behavioural skills model (n = 14). Feasibility was assessed through recruitment and retention rates, outcome measures collection, and intervention implementation. Follow-up data were measured at six weeks after baseline using patient-reported outcomes including medication adherence, medication self-management capabilities, treatment experiences, and quality of life. Preliminary effectiveness of the intervention was explored using generalised estimating equations. Results Of the 72 approached participants, 28 (38.89%) were eligible for study participation. In the intervention group, 13 participants (92.86%) completed follow-up and 10 (71.42%) completed all intervention sessions. Ten participants (71.42%) in the control group completed follow-up. The intervention was found to be acceptable by participants and the intervention nurse. Comparing with the control group, participants in the intervention group showed significant improvements in medication adherence (β = 0.26, 95%CI 0.12, 0.40, P < 0.001), medication knowledge (β = 4.43, 95%CI 1.11, 7.75, P = 0.009), and perceived necessity of medications (β = −2.84, 95%CI -5.67, −0.01, P = 0.049) at follow-up. Conclusions The nurse-led medication self-management intervention is feasible and acceptable among older people with multimorbidity. Preliminary results showed that the intervention may improve patients’ medication knowledge and beliefs and thus lead to improved adherence.

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83 A Medication Self-Management Intervention to Improve Medication Adherence For Older People with Multimorbidity: A Pilot Study

Age and Ageing ◽

10.1093/ageing/afab030.44 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

pp. i12-i42

Author(s):

C Yang ◽

Z Hui ◽

S Zhu ◽

X Wang ◽

G Tang ◽

...

Keyword(s):

Medication Adherence ◽

Pilot Study ◽

Older People ◽

Intervention Group ◽

Self Management ◽

Control Group ◽

Medication Knowledge ◽

Management Intervention ◽

Patient Reported

Abstract Introduction Medication self-management support has been recognised as an essential element in primary health care to promote medication adherence and health outcomes for older people with chronic conditions. A patient-centred intervention empowering patients and supporting medication self-management activities could benefit older people. This pilot study tested a newly developed medication self-management intervention for improving medication adherence among older people with multimorbidity. Method This was a two-arm randomised controlled trial. Older people with multimorbidity were recruited from a community healthcare centre in Changsha, China. Participants were randomly allocated to either a control group receiving usual care (n = 14), or to an intervention group receiving three face-to-face medication self-management sessions and two follow-up phone calls over six weeks, targeting behavioural determinants of adherence from the Information-Motivation-Behavioural skills model (n = 14). Feasibility was assessed through recruitment and retention rates, outcome measures collection, and intervention implementation. Follow-up data were measured at six weeks after baseline using patient-reported outcomes including medication adherence, medication self-management capabilities, treatment experiences, and quality of life. Preliminary effectiveness of the intervention was explored using generalised estimating equations. Results Of the 72 approached participants, 28 (38.89%) were eligible for study participation. In the intervention group, 13 participants (92.86%) completed follow-up and 10 (71.42%) completed all intervention sessions. Ten participants (71.42%) in the control group completed follow-up. The intervention was found to be acceptable by participants and the intervention nurse. Comparing with the control group, participants in the intervention group showed significant improvements in medication adherence (β = 0.26, 95%CI 0.12, 0.40, P < 0.001), medication knowledge (β = 4.43, 95%CI 1.11, 7.75, P = 0.009), and perceived necessity of medications (β = −2.84, 95%CI -5.67, −0.01, P = 0.049) at follow-up. Conclusions The nurse-led medication self-management intervention is feasible and acceptable among older people with multimorbidity. Preliminary results showed that the intervention may improve patients’ medication knowledge and beliefs and thus lead to improved adherence.

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Self-Management Micro-Video Health Education Program for Hemodialysis Patients

Clinical Nursing Research ◽

10.1177/10547738211033922 ◽

2021 ◽

pp. 105477382110339

Author(s):

Qingli Ren ◽

Suhua Shi ◽

Chen Yan ◽

Yang Liu ◽

Wei Han ◽

...

Keyword(s):

Health Education ◽

Education Program ◽

Self Efficacy ◽

Hemodialysis Patients ◽

Self Management ◽

Control Group ◽

Group Comparison ◽

Health Education Program ◽

Significant Group ◽

Problem Solving Skills

Self-management in hemodialysis patients is critical; however, is generally low. This study aimed to examine the effects of a theory-based micro-video health education program on the improvement of self-management, hemodialysis knowledge, and self-efficacy in hemodialysis patients. A pre-test post-test control group quasi-experimental design was used to recruit 80 hemodialysis patients in a dialysis center. The participants were assigned in a 1:1 ratio to receive routine care or a 3-month micro-video health education program. Between-group comparison showed that patients in the intervention group had significantly greater improvement in hemodialysis knowledge than those in the control group ( p < .05). However, no significant group differences were observed in terms of self-management and self-efficacy. Within-group comparison showed that the overall self-management level of patients in both groups improved significantly, particularly in problem-solving skills and self-care dimensions. Therefore, micro-video health education can improve the self-management and hemodialysis knowledge in Chinese patients undergoing hemodialysis. Trial Registration: Registered at ClinicalTrials.gov with study number (ChiCTR1800018172; http://www.chictr.org.cn/index.aspx ).

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Development and Local Contextualization of Mobile Health Messages for Enhancing Disease Management Among Community-Dwelling Stroke Patients in Rural China: Multimethod Study

JMIR mhealth and uhealth ◽

10.2196/15758 ◽

2019 ◽

Vol 7 (12) ◽

pp. e15758

Author(s):

Enying Gong ◽

Wanbing Gu ◽

Erdan Luo ◽

Liwei Tan ◽

Julian Donovan ◽

...

Keyword(s):

Pilot Study ◽

Secondary Prevention ◽

Mobile Phone ◽

Rural China ◽

Text Messages ◽

Community Dwelling ◽

Self Management ◽

Stroke Patients ◽

Dispatching Algorithm ◽

Depth Interviews

Background Rural China has experienced an increasing health burden because of stroke. Stroke patients in rural communities have relatively poor awareness of and adherence to evidence-based secondary prevention and self-management of stroke. Mobile technology represents an innovative way to influence patient behaviors and improve their self-management. Objective This study is part of the System-Integrated Technology-Enabled Model of Care (the SINEMA trial) to improve the health of stroke patients in resource-poor settings in China. This study aimed to develop and pilot-test a mobile phone message–based package, as a component of the SINEMA intervention. Methods The SINEMA trial was conducted in Nanhe County, Hebei Province, China. A total of 4 villages were selected for pretrial contextual research and pilot study. The 5 stages for developing the mobile phone messages were as follows: (1) conducting literature review on existing message banks and analyzing the characteristics of these banks; (2) interviewing stroke patients and caregivers to identify their needs; (3) drafting message contents and designing dispatching algorithms for a 3-month pilot testing; (4) collecting feedback from pilot participants through questionnaire survey and in-depth interviews on facilitators and barriers related to their acceptance and understanding of messages; and (5) finalizing the message-based intervention based on participants’ feedback for the SINEMA trial. Results On the basis of 5 existing message banks screened out of 120 papers and patients’ needs identified from 32 in-depth interviews among stroke patients and caregivers, we developed a message bank containing 224 messages for a pilot study among 54 community-dwelling stroke patients from 4 villages. Of 54 participants, 51 (response rate: 94.4%) completed the feedback survey after receiving daily messages for 3 months. Participants’ mean age was 68 years (SD 9.2), and about half had never been to school. We observed a higher proportion of participants who were in favor of voice messages (23/42, 54%) than text messages (14/40, 35%). Among participants who received voice messages (n=43) and text messages (n=40), 41 and 30, respectively, self-reported a full or partial understanding of the contents, and 39 (39/43, 91%) and 32 (32/40, 80%), respectively, rated the messages as helpful. Analyses of the 32 interviews further revealed that voice messages containing simple and single-theme content, in plain language, with a repeated structure, a slow playback speed, and recorded in local dialect, were preferred by rural stroke patients. In addition, the dispatching algorithm and tools may also influence the acceptance of message-based interventions. Conclusions By applying multiple methodologies and conducting a pilot study, we designed and fine-tuned a voice message–based intervention package for promoting secondary prevention among community-dwelling stroke patients in rural China. Design of the content and dispatching algorithm should engage both experts and end users and adequately consider the needs and preferences of recipients.

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The Effectiveness of Self-Management of Hypertension in Adults Using Mobile Health: Systematic Review and Meta-Analysis

JMIR mhealth and uhealth ◽

10.2196/17776 ◽

2020 ◽

Vol 8 (3) ◽

pp. e17776 ◽

Cited By ~ 1

Author(s):

Ran Li ◽

Ning Liang ◽

Fanlong Bu ◽

Therese Hesketh

Keyword(s):

Systematic Review ◽

Blood Pressure ◽

Health Care ◽

Medication Adherence ◽

Mobile Health ◽

Meta Analysis ◽

Self Management ◽

Narrative Synthesis ◽

Management Behavior ◽

Mhealth Intervention

Background Effective treatment of hypertension requires careful self-management. With the ongoing development of mobile technologies and the scarcity of health care resources, mobile health (mHealth)–based self-management has become a useful treatment for hypertension, and its effectiveness has been assessed in many trials. However, there is a paucity of comprehensive summaries of the studies using both qualitative and quantitative methods. Objective This systematic review aimed to measure the effectiveness of mHealth in improving the self-management of hypertension for adults. The outcome measures were blood pressure (BP), BP control, medication adherence, self-management behavior, and costs. Methods A systematic search was conducted using 5 electronic databases. The snowballing method was used to scan the reference lists of relevant studies. Only peer-reviewed randomized controlled trials (RCTs) published between January 2010 and September 2019 were included. Data extraction and quality assessment were performed by 3 researchers independently, adhering to the validation guideline and checklist. Both a meta-analysis and a narrative synthesis were carried out. Results A total of 24 studies with 8933 participants were included. Of these, 23 studies reported the clinical outcome of BP, 12 of these provided systolic blood pressure (SBP) and diastolic blood pressure (DBP) data, and 16 articles focused on change in self-management behavior and medication adherence. All 24 studies were included in the narrative synthesis. According to the meta-analysis, a greater reduction in both SBP and DBP was observed in the mHealth intervention groups compared with control groups, −3.78 mm Hg (P<.001; 95% CI −4.67 to −2.89) and −1.57 mm Hg (P<.001; 95% CI −2.28 to −0.86), respectively. Subgroup analyses showed consistent reductions in SBP and DBP across different frequencies of reminders, interactive patterns, intervention functions, and study duration subgroups. A total of 16 studies reported better medication adherence and behavioral change in the intervention groups, while 8 showed no significant change. Six studies included an economic evaluation, which drew inconsistent conclusions. However, potentially long-term financial benefits were mentioned in all economic evaluations. All studies were assessed to be at high risk of bias. Conclusions This review found that mHealth self-management interventions were effective in BP control. The outcomes of this review showed improvements in self-management behavior and medication adherence. The most successful mHealth intervention combined the feature of tailored messages, interactive communication, and multifaceted functions. Further research with longer duration and cultural adaptation is necessary. With increasing disease burden from hypertension globally, mHealth offers a potentially effective method for self-management and control of BP. mHealth can be easily integrated into existing health care systems. Trial Registration PROSPERO CRD42019152062; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=152062

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The Effect of a Self-Efficacy-Enhancing Intervention on Perceived Self-Efficacy and Actual Adherence to Healthy Behaviours Among Women with Gestational Diabetes Mellitus

Sultan Qaboos University Medical Journal [SQUMJ] ◽

10.18295/squmj.2018.18.04.014 ◽

2019 ◽

Vol 18 (4) ◽

pp. 513

Author(s):

Iman Al-Hashmi ◽

Felicia Hodge ◽

Karabi Nandy ◽

Elizabeth Thomas ◽

Mary-Lynn Brecht

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Self Efficacy ◽

Patient Adherence ◽

Antenatal Clinic ◽

Text Messages ◽

University Hospital ◽

Control Group ◽

Sultan Qaboos University

Objectives: This study aimed to evaluate the effectiveness of a self-efficacy-enhancing intervention (SEEI) on perceived self-efficacy and actual adherence to healthy behaviours among women with gestational diabetes mellitus (GDM). Methods: This comparative pre-post study was conducted at the Antenatal Clinic of the Sultan Qaboos University Hospital, Muscat, Oman, between October 2016 and January 2017. A total of 90 adult Omani women with GDM were randomised to either a control group receiving standard prenatal care or a SEEI group. The SEEI group received an additional health education session and biweekly text messages to encourage adherence to healthy behaviours. All participants completed self-reported standardised questionnaires to determine perceived self-efficacy and actual adherence at baseline and after four weeks. Results: At baseline, there were no significant differences between the control and SEEI groups in mean scores for perceived self-efficacy (122.9 ± 19.9 versus 118.2 ± 19.5; P = 0.26) or actual adherence to healthy behaviours (3.1 ± 1.2 versus 3.2 ± 1.0; P = 0.23). However, after four weeks, there was a significant positive difference between the SEEI and control groups in terms of pre-post change in scores for both perceived self-efficacy (9.9 ± 19.6 versus −1.8 ± 17.6; P <0.05) and actual adherence to healthy behaviours (1.5 ± 1.1 versus 0.4 ± 0.8; P <0.01). Conclusion: The SEEI was found to significantly improve perceived self-efficacy and actual adherence to healthy behaviours among a group of Omani women with GDM.Keywords: Attitude to Health; Health Behaviors; Self Efficacy; Patient Adherence; Gestational Diabetes; Oman.

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