Obesity Self-Management Education: A Community-Based Project for an Underserved Population

2013 ◽  
Vol 6 (1) ◽  
pp. 30-38
Author(s):  
Ruth Ann Madden ◽  
Heather Kane ◽  
Reina Eisner
Keyword(s):  
Health Care Professionals ◽  
Food Choices ◽  
Self Management ◽  
Obesity Management ◽  
Lifestyle Modifications ◽  
Community Based ◽  
Portion Control ◽  
Use Of Health Care

Obesity is a disease linked to several cardiovascular and endocrine dysfunctions as well as decreased life expectancy and quality of life. Obesity management is a prevalent and persistent concern in primary care. We implemented an educational intervention to promote self-management for 10 patients in a medically underserved clinic to support patients in addressing weight management through positive self-care behaviors. Lifestyle interventions for these participants resulted in self-reported minimal weight loss with significant and sustained lifestyle modifications, such as healthier food choices, portion control, and increased exercise. Recommendations for the future include the use of health care professionals to educate patients about self-management and goal setting with sustained follow-up in treatment of chronic disease.

scholarly journals The Uptake and Use of Telemonitoring in Chronic Care Between 2014 and 2019: Nationwide Survey Among Patients and Health Care Professionals in the Netherlands (Preprint)

2020 ◽  
Author(s):  
Martine W J Huygens ◽  
Helene R Voogdt-Pruis ◽  
Myrah Wouters ◽  
Maaike M Meurs ◽  
Britt van Lettow ◽  
...  
Keyword(s):  
Health Care ◽  
The Netherlands ◽  
Health Care Professionals ◽  
Chronic Care ◽  
Elderly Care ◽  
Care Plan ◽  
Self Management ◽  
Medical Specialists

BACKGROUND Telemonitoring could offer solutions to the mounting challenges for health care and could improve patient self-management. Studies have addressed the benefits and challenges of telemonitoring for certain patient groups. OBJECTIVE This paper will examine the nationwide uptake of telemonitoring in chronic care in the Netherlands from 2014 to 2019 by means of an annual representative survey among patients and health care professionals. METHODS Between 2014 and 2019, approximately 2900 patients with chronic diseases, 700 nurses, and 500 general practitioners (GPs) and medical specialists received a questionnaire. About 30 questions addressed topics about the use of eHealth and experiences with it, including data about telemonitoring. RESULTS Between 2014 and 2019, the use of telemonitoring remained stable for all groups except medical specialists. In medical specialist departments, the use of telemonitoring increased from 11.2% (18/161) in 2014 to 19.6% (36/184) in 2019 (<i>χ</i><sup>2</sup><sub>4</sub>=12.3; <i>P</i>=.02). In 2019, telemonitoring was used by 5.8% (28/485) of people with chronic disease. This was 18.2% (41/225) in GP organizations and 40.4% (44/109), 38.0% (78/205), and 8.9% (29/325) in the organizations of nurses working in primary, secondary, and elderly care, respectively. Up to 10% of the targeted patient group such as diabetics were regarded by health care professionals as suitable for using telemonitoring. The main benefits mentioned by the patients were “comfort” (421/1043, 40.4%) and “living at home for longer/more comfortably” (334/1047, 31.9%). Health care professionals added “improvement of self-management” (63/176, 35.8% to 57/71, 80.3%), “better understanding of the patient’s condition” (47/176, 26.7% to 42/71, 59.2%), “reduction of workload” (53/134, 39.6% of nurses in elderly care), “better tailoring of care plan to the patient’s situation” (95/225, 42.2% of GPs), and “saves time for patients/caregivers” (61/176, 34.7% of medical specialists). Disadvantages mentioned by professionals were that “it takes time to monitor data” (13/130, 10% to 108/225, 48.0%), “it takes time to follow up alerts” (15/130, 11.5% to 117/225, 52.0%), and “it is difficult to estimate which patients can work with telemonitoring” (22/113, 19.5% to 94/225, 41.8%). CONCLUSIONS The uptake of telemonitoring in Dutch chronic care remained stable during 2014-2019 but increased among medical specialists. According to both patients and professionals, telemonitoring improves the quality of life and quality of care. Skills for suitably including eligible patients and for allocating the tasks of data monitoring and follow-up care within the team would help to further increase the use of telemonitoring.

scholarly journals The Uptake and Use of Telemonitoring in Chronic Care Between 2014 and 2019: Nationwide Survey Among Patients and Health Care Professionals in the Netherlands

10.2196/24908 ◽  
2021 ◽  
Vol 23 (5) ◽  
pp. e24908
Author(s):  
Martine W J Huygens ◽  
Helene R Voogdt-Pruis ◽  
Myrah Wouters ◽  
Maaike M Meurs ◽  
Britt van Lettow ◽  
...  
Keyword(s):  
Health Care ◽  
The Netherlands ◽  
Health Care Professionals ◽  
Chronic Care ◽  
Elderly Care ◽  
Care Plan ◽  
Self Management ◽  
Medical Specialists

Background Telemonitoring could offer solutions to the mounting challenges for health care and could improve patient self-management. Studies have addressed the benefits and challenges of telemonitoring for certain patient groups. Objective This paper will examine the nationwide uptake of telemonitoring in chronic care in the Netherlands from 2014 to 2019 by means of an annual representative survey among patients and health care professionals. Methods Between 2014 and 2019, approximately 2900 patients with chronic diseases, 700 nurses, and 500 general practitioners (GPs) and medical specialists received a questionnaire. About 30 questions addressed topics about the use of eHealth and experiences with it, including data about telemonitoring. Results Between 2014 and 2019, the use of telemonitoring remained stable for all groups except medical specialists. In medical specialist departments, the use of telemonitoring increased from 11.2% (18/161) in 2014 to 19.6% (36/184) in 2019 (χ24=12.3; P=.02). In 2019, telemonitoring was used by 5.8% (28/485) of people with chronic disease. This was 18.2% (41/225) in GP organizations and 40.4% (44/109), 38.0% (78/205), and 8.9% (29/325) in the organizations of nurses working in primary, secondary, and elderly care, respectively. Up to 10% of the targeted patient group such as diabetics were regarded by health care professionals as suitable for using telemonitoring. The main benefits mentioned by the patients were “comfort” (421/1043, 40.4%) and “living at home for longer/more comfortably” (334/1047, 31.9%). Health care professionals added “improvement of self-management” (63/176, 35.8% to 57/71, 80.3%), “better understanding of the patient’s condition” (47/176, 26.7% to 42/71, 59.2%), “reduction of workload” (53/134, 39.6% of nurses in elderly care), “better tailoring of care plan to the patient’s situation” (95/225, 42.2% of GPs), and “saves time for patients/caregivers” (61/176, 34.7% of medical specialists). Disadvantages mentioned by professionals were that “it takes time to monitor data” (13/130, 10% to 108/225, 48.0%), “it takes time to follow up alerts” (15/130, 11.5% to 117/225, 52.0%), and “it is difficult to estimate which patients can work with telemonitoring” (22/113, 19.5% to 94/225, 41.8%). Conclusions The uptake of telemonitoring in Dutch chronic care remained stable during 2014-2019 but increased among medical specialists. According to both patients and professionals, telemonitoring improves the quality of life and quality of care. Skills for suitably including eligible patients and for allocating the tasks of data monitoring and follow-up care within the team would help to further increase the use of telemonitoring.

scholarly journals Characteristics Predicting the Outcome in Individuals with Diabetic Foot Ulcerations

2017 ◽  
Vol 107 (3) ◽  
pp. 180-191 ◽  
Author(s):  
Lourdes Vella ◽  
Cynthia Formosa
Keyword(s):  
Ulcer Healing ◽  
Diabetic Foot ◽  
Health Care Professionals ◽  
Hemoglobin A1c ◽  
Foot Ulcer ◽  
Patient Characteristics ◽  
Outpatient Setting ◽  
Foot Complications

Background: We sought to determine patient and ulcer characteristics that predict wound healing in patients living with diabetes. Methods: A prospective observational study was conducted on 99 patients presenting with diabetic foot ulceration. Patient and ulcer characteristics were recorded. Patients were followed up for a maximum of 1 year. Results: After 1 year of follow-up, ulcer characteristics were more predictive of ulcer healing than were patient characteristics. Seventy-seven percent of ulcers had healed and 23% had not healed. Independent predictors of nonhealing were ulcer stage (P = .003), presence of biofilm (P = .020), and ulcer depth (P = .028). Although this study demonstrated that the baseline hemoglobin A1c reading at the start of the study was not a significant predictor of foot ulcer outcome (P = .603, resolved versus amputated), on further statistical analyses, when hemoglobin A1c was compared with the time taken for complete ulcer healing (n = 77), it proved to be significant (P = .009). Conclusions: The factors influencing healing are ulcer stage, presence of biofilm, and ulcer depth. These findings have important implications for clinical practice, especially in an outpatient setting. Prediction of outcome may be helpful for health-care professionals in individualizing and optimizing clinical assessment and management of patients. Identification of determinants of outcome could result in improved health outcomes, improved quality of life, and fewer diabetes-related foot complications.

Supporting Self-Management and Quality of Life in Bipolar Disorder with the Beta PolarUs App: Protocol for a Mixed-Methods Study (Preprint)

2022 ◽  
Author(s):  
Erin E Michalak ◽  
Steven J Barnes ◽  
Emma Morton ◽  
Heather O'Brien ◽  
Greg Murray ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mixed Methods ◽  
Management Strategies ◽  
Community Based Participatory Research ◽  
Self Management ◽  
Community Based ◽  
Self Monitoring ◽  
Web Based ◽  
Beta Version

BACKGROUND Quality of life (QoL) is increasingly recognised as a key outcome of self-management interventions for bipolar disorder (BD). Mobile phone applications (apps) can increase access to evidence-based self-management strategies and provide real-time support. However, while individuals with lived experience desire support with monitoring and improving broader health domains, existing BD apps largely target mood symptoms only. Further, evidence from the broader mHealth literature has shown that the desires and goals of end-users are not adequately taken into account during app development, and as a result engagement with mental health apps is suboptimal. To capitalise on the potential of apps to optimise wellness in BD, there is a need for interventions developed in consultation with real-world users that are designed to support QoL self-monitoring and self-management. Objective: This mixed methods pilot study is designed to evaluate the beta version of the newly developed PolarUs app, which aims to support QoL self-monitoring and self-management in people with BD. Developed using a community-based participatory research framework, the PolarUs app builds on the web-based adaptation of a BD-specific QoL self-assessment measure, and integrates material from a web-based portal providing information on evidence-informed self-management strategies in BD. OBJECTIVE The primary objectives of this project are to: (1) evaluate PolarUs app feasibility (via behavioral usage metrics); (2) evaluate PolarUs impact (via the Brief Quality of Life in Bipolar Disorders, QoL.BD scale, our primary outcomes measure); and (3) explore engagement with the PolarUs app (via both quantitative and qualitative methods). METHODS Study participants will be North American residents (N=150) aged 18-65 years with a DSM-5 diagnosis of BD-I, BD-II or BD not otherwise specified (NOS) as assessed by a structured diagnostic interview. An embedded mixed-methods research design will be adopted; qualitative interviews with a purposefully selected sub-sample (~n=30) of participants will be conducted to explore in more depth feasibility, impact and engagement with the PolarUs app over the 12-week study period. RESULTS At the time of publication of this protocol, the development of the beta version of the PolarUs app is complete. Participant enrollment is expected to begin in February 2022. Data collection is expected to be completed by December 2022. CONCLUSIONS Beyond contributing knowledge on the feasibility and impacts of a novel app to support QoL and self-management in BD, this study is also expected to provide new knowledge on engagement with mHealth apps. Furthermore, it is expected to function as a case study of successful co-design between individuals living with BD, clinicians who specialise in the treatment of BD, and BD researchers, providing a template for future use of community-based participatory research frameworks in mHealth intervention development. Results will be used to further refine the PolarUs app and inform the design of a larger clinical trial.

P1358THE MONITORING OF FIRST LEVEL IN DIAGNOSIS OF COMPLICATION OF VASCULAR ACCESS: MULTICENTRIC STUDY ON 900 HEMODIALIZED PATIENTS WITH FOLLOW UP TO 5 YEARS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Ersilia Satta ◽  
Carmine Romano ◽  
Carmelo Alfarone ◽  
Sandro Gentile ◽  
Domenico Russo
Keyword(s):  
Vascular Access ◽  
Health Care Professionals ◽  
Venous Pressure ◽  
Duplex Ultrasound ◽  
Patient Characteristics ◽  
Multicentric Study ◽  
Flow Monitoring ◽  
The Status

Abstract Background and Aims Vascular Access (VA) is the lifeline of hemodialysis patient. The universal goal of access monitoring is to identify access stenosis and enable intervention prior to thrombosis; thereby, maximizing access longevity and minimizing morbidity. The advent and use of techniques including dynamic and static venous pressure monitoring, physical examination, access flow measurement, imagining and combined imaging and flow monitoring by duplex ultrasound demonstrate that it is possible to predict which accesses are at high risk for future thrombosis. Currently arteriovenous fistula (AVF) and arteriovenous graft (AVF) have been recognized as the permanent access. This study takes advantage of the opportunity to utilize data from 19 associated Dialysis Clinics to examine trends in VA use, trends in patient characteristics and practice associated with VA. Determine the status quo of the overall information related to the VA to start a five years follow up study with the aims to reduce VA complications 8stenosis and thrombosis) and related hospitalization days to improve patient’s quality of life. Method VA data were collected for each patient at study entry. Practice pattern data from the facility medical director, nurse manager and VA surgeon were also analyzed. We have developed a mask on the management database to implement the first level monitoring of access and collected data at each treatment (Fig.1) Results Average age of 801 patients enrolled was 73,5 years. Native AVF was used by 79%, AVG by 2% and CVC by 19%. As the age increase as well as he use of CVC move from 6% (15-39(years) to 50,5% in patients with more than 85 years. Most frequent complications were: Thrombosis 16,5 %, Infectios 5,5%. Related VA hospitalization days are 28,7 % of total days. Average dialysis goals achieved were: QB 290 ml/Min; blood processed 69,7 L; KT/V:1,35. Conclusion By interpreting collecting data for specific performance measures using accurate reports allow health care professionals to highlight the VA performance/inefficiences and provide correct information to the clinical staff to support them in their daily clinical practice and decision making.

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 Process Evaluation of the Community Pharmacist-Led Allergic Rhinitis Management (C-PhARM) Service in Singapore

Pharmacy ◽  
2019 ◽  
Vol 7 (2) ◽  
pp. 56 ◽  
Author(s):  
Joanne Shi Ying Yap ◽  
Colin Wei Qiang Tang ◽  
Helena Mei Ling Hor ◽  
Joy Boon Ka Chong ◽  
Kai Zhen Yap
Keyword(s):  
Allergic Rhinitis ◽  
Community Pharmacist ◽  
Self Management ◽  
Satisfaction Survey ◽  
Patient Assessment ◽  
Intranasal Corticosteroids ◽  
Protected Time ◽  
Service Barriers

A community pharmacist-led allergic rhinitis management (C-PhARM) service involving structured patient assessment, individualised recommendations and follow-up was developed in Watson’s Personal Care Stores Pte Ltd (Singapore) to ensure optimal allergic rhinitis (AR) self-management and appropriate use of intranasal corticosteroids (INC) in Singapore. This retrospective study aimed to evaluate the C-PhARM service processes and identify areas for improving the quality of service. Relevant data was extracted from archived clinical forms, customer satisfaction surveys and pharmacist quality improvement surveys to evaluate the “reach”, “recruitment”, “context” and “fidelity” of service implementation, as well as the “intervention delivered” and “received”. Over the nine months since the launch of the C-PhARM service in April 2016, 45 customers were enrolled, and 32 (71.1%) customers had received at least one follow-up. Recommendations provided at baseline included oral antihistamines (32, 71.1%), INC sprays (28, 62.2%) and counselling on non-pharmacological strategies (27, 60.0%). Among the 29 customers who exited the service, 20 (69%) responded to a satisfaction survey. Although customers deemed pharmacists to be professional and knowledgeable in providing clear and detailed information about AR, pharmacists reported a lack of protected time and interest from customers as service barriers. Sufficient protected time is required for pharmacists to effectively provide clinical service in a community pharmacy.

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 community-based exercise programme in COPD self-management: Two years follow-up of the COPE-II study

2014 ◽  
Vol 108 (10) ◽  
pp. 1481-1490 ◽  
Author(s):  
Marlies Zwerink ◽  
Job van der Palen ◽  
Huib A.M. Kerstjens ◽  
Paul van der Valk ◽  
Marjolein Brusse-Keizer ◽  
...  
Keyword(s):  
Exercise Programme ◽  
Self Management ◽  
Community Based

Experimental Evidence on the Long-Run Impact of Community-Based Monitoring

2017 ◽  
Vol 9 (1) ◽  
pp. 33-69 ◽  
Author(s):  
Martina Björkman Nyqvist ◽  
Damien de Walque ◽  
Jakob Svensson
Keyword(s):  
Health Care ◽  
Health Outcomes ◽  
Lower Cost ◽  
Care Delivery ◽  
Care Provision ◽  
Community Based ◽  
Long Run ◽  
Short Run

We evaluate the longer run impact of a local accountability intervention in primary health care provision in Uganda. Short-run improvements in health care delivery and health outcomes remained in the longer run despite minimal follow-up. We find no impact on the quality of care or health outcomes of a lower cost intervention that focused on encouraging participation but did not provide information on staff performance. We provide suggestive evidence that informed beneficiaries are more likely to identify and challenge (mis)behavior by providers and, as a result, turn their focus to issues that they can manage locally. (JEL H75, I11, I18, O15, O18)

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