scholarly journals A Cognitive Behavioral Therapy-Informed Self-Management Program for Acute Respiratory Failure Survivors: A Feasibility Study

2021 ◽  
Vol 10 (4) ◽  
pp. 872
Author(s):  
Megan M. Hosey ◽  
Stephen T. Wegener ◽  
Caroline Hinkle ◽  
Dale M. Needham

Background: The number of people surviving critical illness is rising rapidly around the globe. Survivorship comes at a cost, with approximately half of patients with acute respiratory failure (ARF) experiencing clinically significant symptoms of anxiety, and 32–40% of survivors having substantial anxiety symptoms in the months or years after hospitalization. Methods: This feasibility study reports on 11 consecutive ARF patients receiving up to six sessions of a psychological intervention for self-management of anxiety. Results: All 11 patients accepted and received the psychological intervention. Four patients did not fully complete all 6 sessions due to death (n = 1, 2 sessions completed), and early hospital discharge (n = 3, patients completed 2, 3 and 5 sessions). The median (IQR) score (range: 0–100; minimal clinically important difference: 13) for the Visual Analog Scale-Anxiety (VAS-A) pre-intervention was 70 (57, 75) points. During the intervention, all 11 patients had a decrease in VAS-A, with a median (IQR) decrease of 44 (19, 48) points. Conclusions: This self-management intervention appears acceptable and feasible to implement among ARF patients during and after an ICU stay.

2021 ◽  
Vol 42 (5) ◽  
pp. 1198-1203
Author(s):  
Zenong Yin ◽  
Shiyu Li ◽  
Catherine Ortega ◽  
Raudel Bobadilla ◽  
Paula L. Winkler ◽  
...  

2018 ◽  
Vol 2 (S1) ◽  
pp. 41-41
Author(s):  
Emilia Galli Thurber ◽  
Hanan Aboumatar

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.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S69-S69
Author(s):  
Tiffany R Washington ◽  
Chivon Mingo ◽  
Matthew L Smith

Abstract There have been few attempts to implement self-management interventions in dialysis facilities. This paper presentation describes four studies that constitute the formative work necessary to inform implementation. Studies one and two examined the relationship between psychosocial factors and kidney disease self-management, finding depression and cognitive decline to undermine self-management behaviors. Study three examined how dialysis patients define and think about self-management and their interest in participating in a self-management program. Among them, 78% affirmed they would participate in a self-management program if it were offered in their facility. Finally, when examining organizational readiness to implement a self-management intervention in dialysis facilities, staff perceived it to be consistent with facility values, and agreed they were well-positioned to implement the program. Taken together, these findings suggest a self-management intervention would be beneficial and supported, but would require thoughtful implementation considerations. These studies have implications for developmental self-management research with other chronic conditions.


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