scholarly journals Tackling pain after cardiac surgery: It takes a village!

2021 ◽  
Vol 1 (2) ◽  
pp. 308-314
Author(s):  
Geraldine Martorella
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Cardiac Surgery ◽  
Paradigm Shift ◽  
Self Management ◽  
Opioid Misuse ◽  
Management Skills ◽  
Hospital Stays ◽  
Multiple Levels

There is increasing concern regarding the risk to develop chronic pain after cardiac surgery with potential detrimental effects on recovery and quality of life. With shortened hospital stays after cardiac surgery, there needs to be more emphasis placed on self-management skills and the support provided to patients and their informal caregivers during the subacute phase. A paradigm shift needs to occur on multiple levels to prevent chronic pain and opioid misuse after surgery. Initiating this change means redefining the timing, recipients, and content and format of interventions. Several avenues can be examined and translated in practice to promote a successful transition after cardiac surgery.

Improved self-management skills predict improvements in quality of life and depression in patients with chronic disorders

2016 ◽  
Vol 99 (8) ◽  
pp. 1355-1361 ◽  
Author(s):  
Gunda Musekamp ◽  
Jürgen Bengel ◽  
Michael Schuler ◽  
Hermann Faller
Keyword(s):  
Quality Of Life ◽  
Self Management ◽  
Management Skills ◽  
Chronic Disorders

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.

Six-Month Data From a Pilot Self-Management Intervention ForAdolescents With Sickle Cell Disease

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 1675-1675 ◽  
Author(s):  
Lori E Crosby ◽  
Naomi Joffe ◽  
Karen Kalinyak ◽  
Alex Bruck ◽  
Clinton H Joiner
Keyword(s):  
Quality Of Life ◽  
Sickle Cell ◽  
Self Efficacy ◽  
The Self ◽  
Self Management ◽  
Cell Disease ◽  
Management Skills ◽  
Post Intervention ◽  
Management Behaviors

Abstract Background Tanabe and colleagues (2010) highlighted the importance of engaging patients with Sickle Cell Disease (SCD) in disease self-management activities to improve health outcomes. Specifically, they recommended interventions that address disease self-efficacy, patient-provider communication, healthy lifestyle behaviors, future planning, and advocacy. The Stanford Chronic Disease Self-Management Program (CDSMP) is a six-week, structured intervention for adults with a chronic disease that helps them develop self-management skills in all of these areas. The CDSMP has been implemented with adults with a variety of chronic diseases (e.g., arthritis, Type II diabetes), and outcome data has shown improvements in health utilization, health status and self-management behaviors for participants six-months post participation in the CDSMP (Lorig et al. 2001). There is limited data available on the effectiveness of the CDSMP for adults with SCD, particularly young adults and adolescents. As a first step in examining the effectiveness of the CDSMP in adolescents with SCD, we conducted two CDSMP intervention groups with SCD patients 16-24 years of age. Objective The objective of the study was to assess: 1) the feasibility, acceptability and utility of the CDSMP with this population, and, 2) changes in disease self-efficacy, quality of life (QOL), and self-management behaviors from pre to 6-months after participation in the CDSMP. Methods Patients were eligible if they: 1) had a diagnosis of SCD; 2) were followed by the University of Cincinnati Health Complex or Cincinnati Children’s Hospital Medical Center (CCHMC) sickle cell clinics; 3) were between the ages of 16 -24; and, 4) had no significant cognitive limitations. Participants received a letter followed by a phone call inviting them to participate in the CDSMP and were compensated at the end of each weekly session. Results Eighteen adolescents completed the CDSMP (i.e., attended four of the six sessions) and have completed their 6-month follow-up. The majority of patients were female (56%) and had Hb SS (SS 67%; SC 28%; Sβ+Thal 5%); the mean age for participants was 19.06 (SD = 2.44). Acceptability data indicated that sessions 2 and 6 (physical activity and exercise, managing difficult emotions, working with your healthcare provider, and planning for the future) were the most beneficial. Overall participant satisfaction with the CDSMP was high, M=8.88 (SD=1.67) on a scale of 1-10 (10=totally satisfied). Qualitative comments suggest that the participants enjoyed interacting with other patients and learning skills to help manage their illness. Repeated measures ANOVAs were used to examine the QOL and disease self-efficacy data. There was not a significant improvement on PedsQL total scores over time. Patient-reported disease self-efficacy scores showed a positive trend (F(1.572, 9.432) = 3.442, P = .083). Participants reported continuing to use a number of the self-management skills/strategies they learned during the intervention such as better breathing (86.7%), problem solving (73.3%), and action planning (66.7%). Discussion Initial Results from this small pilot suggest that the CDSMP may have some promising benefits as an intervention for adolescents and young adults with SCD given its feasibility, acceptability, and potential impact on disease self-efficacy and utilization of skills learned. In addition to participants being satisfied with the content, structure, and opportunity to interact with other participants, they also reported that they continued to use the self-management skills that they had developed. Disease self-efficacy also trended upwards for participants over the course of the intervention. Although improvements in quality of life were not observed at six-months post-intervention, the small sample size likely had an impact. The next steps will be to examine these outcomes for the duration of the post-intervention period (i.e., nine and twelve-month follow-ups) to determine whether the improvements in disease self-efficacy are maintained and whether we see quality of life improving once analyses are completed with a more complete sample size. Disclosures: No relevant conflicts of interest to declare.

Progressive Tinnitus Management Level 3 Skills Education: A 5-Year Clinical Retrospective

2017 ◽  
Vol 26 (3) ◽  
pp. 242-250 ◽  
Author(s):  
Catherine M. Edmonds ◽  
Cheri Ribbe ◽  
Emily J. Thielman ◽  
James A. Henry
Keyword(s):  
Quality Of Life ◽  
Self Management ◽  
Fiscal Year ◽  
Management Skills ◽  
Management Level ◽  
Quality Of Life Indicators ◽  
Level 3 ◽  
Skills Education ◽  
The Impact

Purpose The primary purpose of this study was to determine whether progressive tinnitus management Level 3 skills education workshops conducted at the Bay Pines and Boston Veterans Affairs hospitals result in consistent use of the presented tinnitus management strategies by patients 1–5 years after completing the workshops. Method In fiscal year (FY) 2015, the tinnitus workshop follow-up form was mailed to all veterans who completed the Level 3 workshops between FY 2010 and FY 2014. Data were compiled to determine which, if any, of the skills taught in the workshops were being used 1–5 years after completion of the workshops and the impact on quality-of-life indicators. Results All self-management skills were being utilized up to 5 years postcompletion; therapeutic sound was utilized the most. The majority of patients reported an improved ability to manage reactions to tinnitus and improved quality-of-life indicators. Over 90% of patients from both sites recommended the program to others with tinnitus. Conclusion The self-management skills taught in the progressive tinnitus management Level 3 workshops are sustained over time even when limited resources prevent the full complement of workshops or the involvement of mental health services. The workshops can also be successfully implemented through remote delivery via videoconferencing (telehealth). Supplemental Materials https://doi.org/10.23641/asha.5370883

Self-management skills and behaviors, self-efficacy, and quality of life in people with epilepsy from underserved populations

2019 ◽  
Vol 98 ◽  
pp. 258-265 ◽  
Author(s):  
Dilip K. Pandey ◽  
Jessica Levy ◽  
Anna Serafini ◽  
Mitra Habibi ◽  
Woojin Song ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Self Efficacy ◽  
Underserved Populations ◽  
Self Management ◽  
Management Skills ◽  
And Behaviors

scholarly journals (376) Impact of the Harborview Chronic Pain Self-Management Program on participants’ quality of life, confidence and pain experience

2017 ◽  
Vol 18 (4) ◽  
pp. S68
Author(s):  
D. Gordon ◽  
A. Meins ◽  
J. Noar ◽  
A. Doorenbos ◽  
D. Tauben ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Management Program ◽  
Self Management ◽  
Pain Experience

Chronic Pain After Cardiac Surgery

2019 ◽  
pp. 166-171
Author(s):  
Jennette D. Hansen ◽  
Mark A. Chaney
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Cardiac Surgery ◽  
Acute Pain ◽  
Multimodal Analgesia ◽  
Minimally Invasive Techniques ◽  
Nerve Blocks ◽  
Peripheral Nerve Blocks ◽  
Invasive Techniques

Chronic pain after cardiac surgery can impair quality of life and rehabilitation. Chronic pain is difficult to study, and depending on how patients are questioned, the incidence of chronic pain after sternotomy is between 17% and 56%, and chronic pain after thoracotomy is between 15% and 80%. Several risk factors are independent predictors for the development of chronic pain. In recent years, minimally invasive techniques have been utilized in cardiac surgery patients to potentially minimize pain and to decrease length of stay in the hospital. At this point in time, no single regimen has been proven superior at preventing chronic pain. An aim to treat acute pain without delaying extubation has been the recent focus of pain management, with research in neuraxial and peripheral nerve blocks. In addition, multimodal analgesia is key for treatment of acute pain to allow patients to deep breathe, cough, and ambulate comfortably without respiratory depression. Some believe treatment of acute pain leads to less development of chronic pain; however, this has not yet been definitively proven.

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