Development and evaluation of an eHealth self-management intervention for chronic kidney disease patients in China: protocol for a mixed-method hybrid type 2 trial

2020 ◽  
Author(s):  
Hongxia Shen ◽  
Rianne van der Kleij ◽  
Paul JM van der Boog ◽  
Xiaoyue Song ◽  
Wenjiao Wang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mixed Method ◽  
Self Management ◽  
Evidence Based ◽  
Management Intervention ◽  
Management Interventions ◽  
Improve Health Status ◽  
Improve Health

Abstract Background Chronic kidney disease (CKD) is a significant public health concern. In CKD patients, interventions that support disease self-management have shown to improve health status and quality of life. At the moment, the use of electronic health (eHealth) technology in self-management interventions is becoming more and more popular. Evidence suggests that eHealth-based self-management interventions can improve CKD patients’ health-related outcomes. However, knowledge of the implementation and effectiveness of such interventions in general, and in China in specific, is still limited. This study protocol aims to develop and tailor the evidence-based Dutch ‘Medical Dashboard’ eHealth self-management intervention for patients suffering from CKD in China and evaluate its implementation process and effectiveness. Methods To develop and tailor a Medical Dashboard intervention for the Chinese context, we will use an Intervention Mapping (IM) approach. A literature review and mixed-method study will first be conducted to examine the needs, beliefs, perceptions of CKD patients and care providers towards disease (self-management) and eHealth (self-management) interventions (IM step 1). Based on the results of step 1, we will specify outcomes, performance objectives, and determinants, select theory-based methods and practical strategies. Knowledge obtained from prior results and insights from stakeholders will be combined to tailor the core interventions components of the ‘Medical Dashboard’ self-management intervention to the Chinese context (IM step 2-5). Then, an intervention and implementation plan will be developed. Finally, a 9-month hybrid type 2 trial design (N=60) will be employed to investigate the effectiveness of the intervention using a pilot randomized controlled trial with two parallel arms, and the implementation integrity (fidelity) and determinants of implementation (IM step 6). Discussion Our study will result in the delivery of a culturally tailored, standardized eHealth self-management intervention for CKD patients in China, which has the potential to optimize patients' self-management skills and improve health status and quality of life. Moreover, it will inform future research on the tailoring and translation of evidence-based eHealth self-management interventions in various contexts.

scholarly journals Development and evaluation of an eHealth self-management intervention for patients with chronic kidney disease in China: protocol for a mixed-method hybrid type 2 trial

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Hongxia Shen ◽  
Rianne van der Kleij ◽  
Paul J. M. van der Boog ◽  
Xiaoyue Song ◽  
Wenjiao Wang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mixed Method ◽  
Self Management ◽  
Evidence Based ◽  
Management Intervention ◽  
Management Interventions ◽  
Improve Health Status ◽  
Improve Health

Abstract Background Chronic kidney disease (CKD) is a significant public health concern. In patients with CKD, interventions that support disease self-management have shown to improve health status and quality of life. At the moment, the use of electronic health (eHealth) technology in self-management interventions is becoming more and more popular. Evidence suggests that eHealth-based self-management interventions can improve health-related outcomes of patients with CKD. However, knowledge of the implementation and effectiveness of such interventions in general, and in China in specific, is still limited. This study protocol aims to develop and tailor the evidence-based Dutch ‘Medical Dashboard’ eHealth self-management intervention for patients suffering from CKD in China and evaluate its implementation process and effectiveness. Methods To develop and tailor a Medical Dashboard intervention for the Chinese context, we will use an Intervention Mapping (IM) approach. A literature review and mixed-method study will first be conducted to examine the needs, beliefs, perceptions of patients with CKD and care providers towards disease (self-management) and eHealth (self-management) interventions (IM step 1). Based on the results of step 1, we will specify outcomes, performance objectives, and determinants, select theory-based methods and practical strategies. Knowledge obtained from prior results and insights from stakeholders will be combined to tailor the core interventions components of the ‘Medical Dashboard’ self-management intervention to the Chinese context (IM step 2–5). Then, an intervention and implementation plan will be developed. Finally, a 9-month hybrid type 2 trial design will be employed to investigate the effectiveness of the intervention using a cluster randomized controlled trial with two parallel arms, and the implementation integrity (fidelity) and determinants of implementation (IM step 6). Discussion Our study will result in the delivery of a culturally tailored, standardized eHealth self-management intervention for patients with CKD in China, which has the potential to optimize patients’ self-management skills and improve health status and quality of life. Moreover, it will inform future research on the tailoring and translation of evidence-based eHealth self-management interventions in various contexts. Trial registration Clinicaltrials.gov NCT04212923; Registered December 30, 2019.

scholarly journals Fatigue predicts future reduced social participation, not reduced physical function or quality of life in people with systemic sclerosis

2020 ◽  
pp. 239719832096538
Author(s):  
Susan L Murphy ◽  
Daniel Whibley ◽  
Anna L Kratz ◽  
Janet L Poole ◽  
Dinesh Khanna
Keyword(s):  
Quality Of Life ◽  
Systemic Sclerosis ◽  
Physical Function ◽  
Social Participation ◽  
Self Efficacy ◽  
Self Management ◽  
Management Intervention ◽  
Management Interventions ◽  
Fatigue Severity

Objective: Although fatigue is one of the most problematic symptoms for people with systemic sclerosis, little is known about how fatigue impacts daily life over time. Such information is important when developing fatigue management interventions. This study was conducted to examine (1) if fatigue severity predicted outcomes of worse functioning (social participation, physical function), and quality of life and (2) if level of self-efficacy moderated significant relationships between fatigue and these outcomes. Methods: Data were utilized from a clinical trial in which an online self-management intervention was tested (N = 267). Fatigue, social participation, and physical function were assessed by PROMIS measures. Quality of life was assessed by the EuroQol 5-domain instrument. Linear regressions were performed to examine how baseline fatigue related to functioning and quality of life outcomes 16 weeks later controlling for relevant covariates. PROMIS measures were used to measure self-efficacy in managing symptoms, daily activities, medications and treatments, emotions, and social interactions. Results: Fatigue at baseline significantly predicted social participation 16 weeks later, but did not predict physical functioning or quality of life. Self-efficacy variables did not moderate the association between fatigue and social participation. Conclusion: Fatigue severity predicted decreased social participation in people with systemic sclerosis. Interventions targeting fatigue should include support to maintain participation of social roles and activities. The level of reported self-efficacy did not vary the strength of the association between fatigue and decline in social participation indicating that there may be other targets to treat fatigue intervention beyond self-management.

A self-management intervention to improve quality of life and psychosocial impact for people with type 2 diabetes

2011 ◽  
Vol 20 (17-18) ◽  
pp. 2655-2665 ◽  
Author(s):  
Shu-Fang Vivienne Wu ◽  
Shu-Yuan Liang ◽  
Tsae-Jyy Wang ◽  
Mei-Hui Chen ◽  
Yu-Mei Jian ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Type 2 Diabetes ◽  
Psychosocial Impact ◽  
Self Management ◽  
Improve Quality ◽  
Management Intervention

scholarly journals Evaluating the Effect of Knowledge, Attitude, and Practice on Self-Management in Type 2 Diabetic Patients on Dialysis

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Shima Ghannadi ◽  
Atieh Amouzegar ◽  
Parisa Amiri ◽  
Ronak Karbalaeifar ◽  
Zhale Tahmasebinejad ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Microvascular Complications ◽  
Glycosylated Hemoglobin ◽  
Self Care ◽  
Self Management ◽  
Diabetic Patients ◽  
Attitude And Practice ◽  
Knowledge Attitude And Practice

Background.Type 2 diabetes is an increasingly common condition with several preventable microvascular complications such as kidney damage. Nephropathy is expensive to manage, especially as hospital dialysis treatment. Improving patients’ knowledge, attitude, and practice (KAP) toward their condition can achieve better control, delay complications, and improve their quality of life. This study evaluated the KAP and self-care behaviors of diabetic patients on dialysis and variables that affect it.Methods.This cross-sectional study was conducted at Shahid Beheshti academic hospitals of Tehran, Iran. Face-to-face interviews were held to fill five validated questionnaires: three evaluating KAP, one evaluating self-management, and one evaluating quality of life.Result.117 diabetic patients on hemodialysis (42 females) with mean (SD) age of68.70±9.26years were enrolled in the survey. The scores for patient’s KAP, self-care, and quality of life were59.90±11.23,44.27±8.35,45.06±12.87,46.21±10.23, and26.85±13.23, respectively. There was significant negative correlation between patients’ knowledge and attitude with their glycosylated hemoglobin level and their fasting blood sugar. There was significant correlation between patients’ knowledge and practice with their self-care activities.Conclusion.The present study suggests that patients’ KAP scores have a practical effect upon self-care behavior. This highlights the needs for effective diabetes education programs in developing countries like Iran.

scholarly journals Predictors of Diabetes Self-Management Behaviors in Type 2 Diabetes Patients

2021 ◽  
Author(s):  
Golnaz Azami ◽  
Soh Kim Lam ◽  
Sazlina Shariff-Ghazali ◽  
Salmiah Mohd Said ◽  
Sanaz Aazami ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Type 2 Diabetes ◽  
Linear Regression Analysis ◽  
Self Management ◽  
P Value ◽  
Efficacy Expectation ◽  
The Mean ◽  
Management Behaviors

Objective: Type 2 diabetes mellitus (T2DM) is a chronic condition that requires consistent medical care to help control glycemic indices. Diabetes self-management is found to be essential for optimal glycemic control. This study aimed to investigate the predictors of diabetes self-management in adult with T2DM. Materials and Methods: A cross-sectional study was conducted. A purposive sample of 142 adults with T2DM attended an outpatient endocrine clinic in an academic hospital in Ilam, Iran was invited to participate in this study from September to October 2016. The data were collected using a combination of validated questionnaires and the blood sample. IBM SPSS software version 22 used to conduct the analysis. Hierarchical linear regression analysis with the stepwise method was used to explore the predictors of diabetes self-management.  Results: The mean age of participants was 54.2 ± (11.8) years. The mean duration of diabetes was 8.9 ± (7.4). Hierarchical linear regression analysis determined that self-management behaviors had positive relationship with efficacy expectation (B= 0.445, P-value< 0.01), quality of life (B= 0.222, P-value= 0.02), and has a negative relationship with HbA1c (B= -0.194, P-value= 0.01).  Conclusion: The result of our study indicate that better diabetes self-management behaviors can be predicted by higher efficacy expectation, the better quality of life and lower HbA1c levels. Future interventions should focus on enhancing efficacy expectation, quality of life and optimizing glycemic control to improve self-management of diabetes.

scholarly journals 2294 Do patient comorbidities impact the effectiveness of a COPD self-management program?

2018 ◽  
Vol 2 (S1) ◽  
pp. 41-41
Author(s):  
Emilia Galli Thurber ◽  
Hanan Aboumatar
Keyword(s):  
Quality Of Life ◽  
Patient Outcomes ◽  
The United States ◽  
Management Program ◽  
Emergency Department Visits ◽  
The Self ◽  
Self Management ◽  
Management Intervention ◽  
Comorbidity Burden

OBJECTIVES/SPECIFIC AIMS: Chronic obstructive pulmonary disease (COPD) is a leading cause of both hospitalizations and readmissions in the United States, and about 1 in 5 hospitalized patients with COPD will be readmitted within 30 days. COPD-focused self-management programs are frequently used to help patients better manage their symptoms and prevent hospitalization. However, while the majority of patients with COPD have at least one comorbidity, most trials of COPD self-management programs either excluded patients with significant comorbidities or did not analyze the impact of comorbidities on patient outcomes. Using data from the BREATHE trial of a COPD self-management program, this study aims to determine if patient post-intervention outcomes differ based on the intensity and type of patient comorbidities. METHODS/STUDY POPULATION: In total, 240 patients hospitalized for COPD were randomly assigned to either a comprehensive self-management intervention or usual transitional care. Primary outcomes for this trial were the number of COPD-related hospitalizations and emergency department visits at 6 months and changes in COPD-specific quality of life. To determine whether patient comorbidities modify the effect of the self-management intervention on readmission and quality of life outcomes, we will compare patient outcomes across groups stratified by comorbidity burden (Charlson Comorbidity Index) and type (baseline diagnosis of congestive heart failure, diabetes, and depression). In addition, we will use regression analysis with interaction terms to test for interaction between comorbidity burden/type and intervention assignment. RESULTS/ANTICIPATED RESULTS: We hypothesize that the effect of the self-management intervention will differ in patients with greater comorbidity burden due to competing medical demands for patients with multimorbidity. DISCUSSION/SIGNIFICANCE OF IMPACT: The results of this study will help clinicians better target disease-specific self-management programs to the groups of patients with COPD who are likely to receive the greatest benefit from this type of intervention.

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