scholarly journals How do people with knee osteoarthritis perceive and manage flares? A qualitative study

BJGP Open ◽  
2021 ◽  
pp. BJGPO.2021.0086
Author(s):  
Emma Parry ◽  
Lisa Dikomitis ◽  
George Peat ◽  
Carolyn A. Chew-Graham
Keyword(s):  
Acute Pain ◽  
Help Seeking ◽  
Management Strategies ◽  
Self Management ◽  
Structured Interviews ◽  
Everyday Activity ◽  
Minimal Impact ◽  
Knee Oa ◽  
Disturbed Sleep ◽  
Qualitative Interview Study

BackgroundAcute flares in people with osteoarthritis (OA) are poorly understood. There is uncertainty around the nature of flares, their impact, and how these are managed.AimExplore understandings and experiences of flares in people with knee OA, describe self-management and help-seeking strategiesDesign & settingQualitative interview study of people with knee OA in England, United Kingdom.MethodSemi-structured interviews with 15 people with knee OA. Thematic analysis using constant comparison methods.ResultsWe identified four main themes: experiencing pain, consequences of acute pain, predicting and avoiding acute pain, and response to acute pain. People with OA described minor episodes which were frequent, fleeting, occurred during everyday activity, had minimal impact, and were generally predictable. This contrasted with severe episodes which were infrequent, had greater impact, and were less likely to be predictable. The latter generally led to feelings of low confidence, vulnerability and of being a burden. The term ‘flare’ was often used to describe the severe events but this was applied inconsistently and some would describe a flare as any increase in pain.Participants used numerous self-management strategies but tended to seek help when these had been exhausted, their symptoms led to emotional distress, disturbed sleep, or pain experience worse than usual. Previous experiences shaped whether people sought help and who they sought help from.ConclusionSevere episodes of pain are likely to be synonymous with flares. Developing a common language about flares will allow a shared understanding of these events, early identification and appropriate management.

scholarly journals Exploring Professional Circus Artists’ Experience of Performance-Related Injury and Management: A Qualitative Study

2019 ◽  
Vol 34 (1) ◽  
pp. 14-24
Author(s):  
Timothée Cayrol ◽  
Emma Godfrey ◽  
Jerry Draper-Rodi ◽  
Lindsay Bearne
Keyword(s):  
Help Seeking ◽  
Management Strategies ◽  
Easy Access ◽  
Personal Factors ◽  
Negative Consequences ◽  
Structured Interviews ◽  
Injury Management ◽  
Psychosocial Consequences ◽  
Qualitative Interview Study ◽  
Data Saturation

AIMS: Circus is a physically demanding profession, but injury and help-seeking rates tend to be low. This qualitative interview study explored the perceptions and beliefs about injury and help-seeking of circus artists. METHODS: Ten professional circus artists (5 males, 5 females; mean age 33 yrs, range 27–42) were enrolled. Individual, semi-structured interviews were conducted until data saturation of themes was reached. Data were analysed thematically. FINDINGS: Four themes were identified: 1) the injured artist; 2) professionalism; 3) circus life; and 4) artists’ experience of healthcare. Most participants described the circus as central to their lives, and injuries had wide-ranging psychosocial consequences. Injury adversely affected participants’ mood and threatened their identity. Situational and personal factors (e.g., the belief that pain was normal) pushed participants to use adaptive strategies to perform when injured. Continuous touring and financial constraints affected help-seeking. Easy access to healthcare was rare and participants often self-managed injuries. Experiences of healthcare varied, and participants desired flexible and accessible approaches to prevention and injury management. A modified version of the integrated model of psychological response to injury and rehabilitation process and the concept of identity provided a framework to understand participants. CONCLUSION: Injuries had extensive negative consequences. Work schedules, financial factors, employer support, the artist’s perception of the importance of the show, and the relationship between circus and identity influenced injury management and help-seeking. Injury prevention and management strategies could be optimised by developing centres of expertise, online resources, and better regulations of the profession.

An observational study of pain self-management strategies and outcomes: does type of pain, age, or gender, matter?

2018 ◽  
Vol 18 (4) ◽  
pp. 645-656 ◽  
Author(s):  
Marion K. Slack ◽  
Ramon Chavez ◽  
Daniel Trinh ◽  
Daniel Vergel de Dios ◽  
Jeannie Lee
Keyword(s):  
Chronic Pain ◽  
Acute Pain ◽  
Management Strategies ◽  
Demographic Characteristics ◽  
Self Management ◽  
Treatment Level ◽  
Pain Group ◽  
Age And Gender ◽  
Pain Characteristics ◽  
And Gender

AbstractBackground and aimsAcute pain is differentiated from chronic pain by its sudden onset and short duration; in contrast, chronic pain is characterized by a duration of at least several months, typically considered longer than normal healing time. Despite differences in definition, there is little information on how types of self-management strategies or outcomes differ when pain is chronic rather than acute. Additionally, age and gender are thought to be related to types of strategies used and outcomes. However, strategies used and outcomes can be influenced by level of education, socioeconomic status, occupation, and access to the health care system, which can confound associations to type of pain, age or gender. The purpose of this study was to examine the association of strategies used for pain self-management and outcomes with type of pain, acute or chronic, age, or gender in a socioeconomically homogenous population, pharmacists.MethodsPharmacists with acute or chronic pain and a valid email completed an on-line questionnaire on demographic characteristics, pain characteristics, pharmacological and non-pharmacological strategies for managing pain, and outcomes (e.g. pain intensity). Univariate analysis was conducted by stratifying on type of pain (acute or chronic), then stratifying on gender (men vs. women) and age (younger vs. older). Thea priorialpha level was 0.05.ResultsA total of 366 pharmacists completed the questionnaire, 212 with acute pain (average age=44±12.1; 36% men) and 154 with chronic pain (average age=53±14.0; 48% men). The chronic pain group reported substantially higher levels of pain before treatment, level of post-treatment pain, level of pain at which sleep was possible, and goal pain levels (effect sizes [ES’s]=0.37–0.61). The chronic pain group were substantially more likely to use prescription non-steroidal anti-inflammatory medications (NSAIDS), opioids, and non-prescription pain relievers (ES’s=0.29–0.80), and non-medical strategies (ES’s=0.56–0.77). Participants with chronic pain also were less confident (ES=0.54) and less satisfied (ES=0.52). In contrast, there were no differences within either the acute or chronic pain groups related to gender and outcomes. In the acute pain group, there also were no gender differences related to management strategies. However, younger age in the acute pain group was associated with use of herbal remedies and use of rest. Within the chronic pain group, men were more likely to use NSAIDS and women more likely to use hot/cold packs or massage while older participants were more likely to use massage. Variability in post-treatment level of pain and percent relief was high in all groups (coefficient of variation=25%–100%).ConclusionsThe differences between acute and chronic pain were substantial and included differences in demographic characteristics, pain characteristics, management strategies used, and outcomes. In contrast, few associations between age and gender with either management strategies or outcomes were identified, although the variability was high.ImplicationsWhen managing or researching pain management, acute pain should be differentiated from chronic pain. Because of the substantial variability within the gender and age groups, an individual approach to pain management irrespective of age and gender may be most useful.

Adolescent feedback on predisposing, reinforcing and enabling features in asthma self-management apps

2019 ◽  
Vol 78 (7) ◽  
pp. 770-783
Author(s):  
Courtney A Roberts ◽  
Adam J Sage ◽  
Lorie L Geryk ◽  
Betsy L Sleath ◽  
Delesha M Carpenter
Keyword(s):  
Peak Flow ◽  
Asthma Management ◽  
Persistent Asthma ◽  
Health Behaviours ◽  
Self Management ◽  
Structured Interviews ◽  
Positive Health ◽  
Telephone Interviews ◽  
Qualitative Interview Study ◽  
Mobile Health Apps

Objective:Mobile health apps hold potential to support and reinforce positive health behaviours, especially among young people with chronic diseases like asthma that require continual self-management. We aimed to gain feedback from adolescents with asthma on two existing asthma self-management apps to guide the development of an evidence- and theory-based asthma app that meets their asthma management needs.Design:A qualitative interview study was conducted with adolescents with persistent asthma ( n = 20), aged 12–16.Setting:Interviews took place after the individual’s clinic appointment and during telephone interviews one week later.Methods:Participants provided feedback on two asthma self-management apps during two semi-structured interviews. Interviews were audio-recorded, transcribed verbatim and analysed thematically using MAXQDA 11. The Precede–Proceed Model (PPM) was used as a framework to evaluate perceptions of app features, including utility. Suggestions for improvements, including addition of predisposing, reinforcing and enabling PPM features, were identified.Results:The majority of app features functioned as enabling (e.g. inputting triggers, recording doctor’s appointments and tracking peak flow). However, participants recommended addition of predisposing and reinforcing features, including knowledge on dealing with asthma triggers (predisposing) and a reward system for daily peak flow entry (reinforcing), to support their asthma management.Conclusion:Findings suggest that including predisposing, reinforcing and enabling features in asthma apps could facilitate asthma self-management. Public health professionals should partner with app developers in the development of asthma self-management apps that include predisposing, reinforcing and enabling features to meet user needs and ensure they are effective and accepted behaviour change apps.

It’s like another world: the perceived beneficial effects of an artistically designed multisensory environment

2018 ◽  
Vol 45 (1) ◽  
pp. 52-59 ◽  
Author(s):  
Bliss Cavanagh ◽  
Kirsti Haracz ◽  
Miranda Lawry ◽  
Carole James
Keyword(s):  
Mental Health ◽  
Management Strategies ◽  
Study Data ◽  
Self Management ◽  
Structured Interviews ◽  
Beneficial Effects ◽  
The Arts ◽  
Variation Approach ◽  
Restorative Environment ◽  
Multisensory Environment

Self-management strategies have been identified as having a key role in supporting mental health and preventing mental illness. Evidence suggests that spending time in nature, experiencing or viewing artwork and accessing sensory rooms all support self-management and positive mental health among varied clinical populations. This evidence informed the design of the sensory–art space (SAS), an artistically designed multisensory environment, which drew on themes and images of nature.The aim of this study was to explore the experiences and perceived benefits of the SAS among members of a university community.A maximum variation approach to sampling was used, and 18 participants were included in this qualitative study. Data were gathered via semi-structured interviews, which were audio-recorded and transcribed verbatim for thematic analysis.The findings presented six themes. The two core themes were: it’s like another world, and easy to focus and describe how the SAS produced the beneficial effects described in the four remaining themes of: emotionally nutritious, meditative effects, relaxation and therapeutic.Participants identified beneficial effects of the SAS that were consistent with the evidence for other self-management strategies. The identified benefits also aligned with existing theories suggesting that the SAS functioned as a restorative environment. This study is the first to explore the experience of art in a multisensory and multidimensional capacity, which further contributes to the growing field of receptive engagement with the arts for health outcomes.

scholarly journals Self-management strategies of graduate employees to enhance work engagement

2021 ◽  
Vol 47 ◽  
Author(s):  
Nelesh Dhanpat ◽  
Dorothy L. Danguru ◽  
Oyisa Fetile ◽  
Kholeka Kekana ◽  
Kholosa N. Mathetha ◽  
...  
Keyword(s):  
Employee Engagement ◽  
Work Engagement ◽  
Management Strategies ◽  
Theory And Practice ◽  
The Self ◽  
Self Management ◽  
Research Approach ◽  
Structured Interviews ◽  
Managerial Implications ◽  
Value Add

Orientation: The hiring of graduates is valuable to organisations. It is necessary to understand the self-management behaviours they display and the behaviours required to keep them engaged.Research purpose: The purpose of this study was to explore how self-management strategies enhance work engagement of recent graduates who find themselves in a new environment of the world of work.Motivation for the study: Employee engagement is of both academic and practitioner interest. With organisations hiring graduates, it is valuable to understand the self-management behaviours needed to remain engaged.Research approach/design and method: A qualitative research approach was employed through an interpretivist research paradigm. A purposive sample of 12 graduate employees (median age = 24) in various fields of work were interviewed (women = 11, men = 1; black = 11, coloured = 1). The graduates participated in semi-structured interviews. A thematic analysis was conducted and five themes emerged.Main findings: Through an inductive approach, the five themes that emerged concerning self-management strategies used by graduates to enhance their work engagement are goal setting, self-cueing, self-observation, self-reward and self-punishment and work engagement practices.Practical/managerial implications: Self-management strategies help to sustain an engaged workforce. Organisations that make use of graduate recruitment will largely benefit from the findings.Contribution/value-add: There is limited research on the topic pertaining to graduate employees. Graduates remain relevant in the organisation, and hence, the study makes a contribution to theory and practice. A model is presented with recommendations for graduates and the organisation, which, when implemented, have the potential to enhance work engagement.

scholarly journals How do older adults understand and manage distress? A qualitative study

2019 ◽  
Author(s):  
Alice Moult ◽  
Tom Kingstone ◽  
Carolyn Chew-Graham
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Older People ◽  
Help Seeking ◽  
Management Strategies ◽  
Healthcare Services ◽  
Ethical Review ◽  
Structured Interviews ◽  
Management Options ◽  
Community Groups

Abstract Background Anxiety and depression are prevalent in older adults, however, older people may be reluctant to seek medical help and may manage their own mood problems. Due to stigma, older adults are more likely to perceive and/ or recognise their mood problems as distress. Whilst previous literature has focused on how younger adults self-manage mood problems, little research has explored how older people self-manage distress. The study reported here seeks to address this gap through qualitative methods. Methods This study was approved by Keele University’s ethical review panel. Older adults who self-identified as distressed, depressed or anxious within the previous 12 months were recruited from community groups in North Staffordshire, England. Data were generated through semi-structured interviews and analysed thematically using constant comparison methods. A public and patient involvement and engagement group contributed to development of the research questions and methods, and offered their perspectives on the findings. Results Data saturation was achieved after 18 interviews. Key themes were: experiences of distress, actions taken, help-seeking from healthcare services and perceptions of treatments offered in primary care. Various forms of loss contributed to participants’ distress. Participants initiated their own self-management strategies which included: pursuing independent activities, seeking social support and attending community groups and church. Five participants reported having consulted a GP when distressed but described a lack of acceptable treatments offered. Conclusions To support older adults who are distressed, primary care healthcare professionals need to explore patients’ existing ways of managing mood problems, provide information about a range of management options and consider the use of sign-posting older adults to community resources.

scholarly journals Prevalence of self-reported knee symptoms and management strategies among elderly individuals from Frederiksberg municipality: protocol for a prospective and pragmatic Danish cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e028087
Author(s):  
Elisabeth Marie Ginnerup-Nielsen ◽  
Marius Henriksen ◽  
Robin Christensen ◽  
Berit Lilienthal Heitmann ◽  
Roy Altman ◽  
...  
Keyword(s):  
Cohort Study ◽  
Management Strategies ◽  
Population Level ◽  
Self Management ◽  
Ageing Population ◽  
Surgical Interventions ◽  
Knee Oa ◽  
Pain Medications ◽  
Management And Development ◽  
Registration Number

IntroductionThe Global Burden of Disease 2010 study ranked osteoarthritis (OA) as a leading cause of years lived with disability. With an ageing population, increasing body weight and sedentary lifestyle, a substantial increase especially in knee OA (KOA) is expected. Management strategies for KOA include non-pharmacological, pharmacological and surgical interventions. Meanwhile, over-the-counter pain medications have been discredited as they are associated with several risks with long-term usage. By consequence, the use of exercise and all sorts of complementary and alternative medicine (CAM) for joint pain has increased. The available self-management strategies are plenty, but there is no overview of their use at a population level and whether they are used along with doctors’ prescriptions or replace these. The aim of this study is to estimate the population incidence of developing knee symptoms and analyse the association between (and impact of) the use of self-reported preventive measures and knee symptoms.Methods and analysisThis prospective cohort study pragmatically recruits individuals from the municipality of Frederiksberg, Denmark. All citizens aged 60–69 years old will be contacted annually for 10 years and asked to participate in a web-based survey. The major outcomes are self-reported knee symptoms and their association with use of various management strategies, including use of non-pharmacological treatments and CAM. Secondary outcomes include the influence of treatments on use of healthcare system and surgical procedures. Descriptive and analytic statistics (eg, logistic regression) will be used to provide summaries about the sample and observations made and the associations between self-management and development of knee symptoms.Ethics and disseminationThis study can be implemented without permission from the Health Research Ethics Committee. Permission has been obtained from the Danish Data Protection Agency. Study findings will be disseminated in peer-reviewed journals and presented at relevant conferences.Trial registration numberNCT03472300.

scholarly journals Understanding the impact of incontinence on Veterans’ self-management strategies, quality of life and treatment experiences

2020 ◽  
Author(s):  
Linda Cowan ◽  
Sarah Bradley ◽  
Andrew R. Devendorf ◽  
Lelia Barks ◽  
Tatiana Orozco ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Urinary Incontinence ◽  
Fecal Incontinence ◽  
Healthcare Provider ◽  
Caregiver Burden ◽  
Management Strategies ◽  
Self Management ◽  
List Type ◽  
Structured Interviews

AbstractBackgroundUrinary and fecal incontinence contribute to significant quality of life impairments for patients and caregivers. Preliminary research suggests that incontinence rates may be higher among Veterans. However, few studies have examined incontinence experiences among Veterans and their caregivers.ObjectivesWe aimed to demonstrate the feasibility of conducting a one-year, telephone survey with Veterans and their caregivers to help inform larger studies. By including both Veteran and caregiver perspectives, we explored how incontinence impacts Veterans’ self-management strategies, quality of life, and treatment experiences.DesignWe used a mixed methods design, employing quantitative (i.e., cross-sectional survey) and qualitative approaches (i.e., semi-structured interviews).ParticipantsOur sample included 64 Veterans with urinary incontinence, fecal incontinence, or mixed incontinence, and 36 caregivers. A subset of 18 Veterans and 8 caregivers completed semi-structured interviews.MethodsData were collected via telephone surveys over the course of 1-year from a small research team at the Veterans Health Administration (VHA). Participants completed measures about the Veteran’s incontinence severity, quality of life, and VHA treatment experiences. Interviews asked participants about their perceptions and satisfaction in receiving treatment for the Veterans’ incontinence. Qualitative themes were extracted using a Rapid Assessment Process model.ResultsVeterans’ self-reported physical quality of life correlated negatively and significantly with both urinary and fecal incontinence severity, as well as negatively and significantly with urinary continence bother (rs range: −.36 to −.47, ps < .01). Veterans’ mental quality of life correlated negatively and significantly with urinary incontinence bother (r = −.43, p < .001). About 67% Veterans experienced incontinence symptoms for 5-years or more, yet 44% waited at least 1-year to discuss incontinence with a VHA provider. Most Veterans (92%) reported speaking with a VHA provider about incontinence, while only 42% reported speaking with a non-VHA provider. Qualitative findings revealed that, upon speaking to a provider, Veterans felt comfortable but also desired more incontinence education from their providers, including obtaining more appropriate and tailored treatment options. While most Veterans followed their provider’s treatment recommendations, some felt unsatisfied with treatments that they perceived as embarrassing.ConclusionsRecruiting a substantial sample of Veterans with incontinence, and their caregivers, is feasible using our recruitment methods, which can inform larger studies. Our study revealed that incontinence symptoms interfere significantly with the quality of life of Veterans and their caregivers. Intervening at the healthcare level by educating providers and systematizing inquiry into incontinence for higher risk populations would be fruitful to explore.Contribution of the PaperWhat is already known about this topic?Urinary incontinence is more prevalent than fecal incontinence, and both are associated with significant impairments in physical, mental, and social functioning.Urinary and fecal incontinence become more prevalent with older age and additional chronic health conditions.There is a lack of incontinence diagnoses documented in Veteran’s medical records, even when incontinence is present. Few studies have reported on caregiver burden related to incontinence care.What this paper addsThis study is the first to report on the potential delay between Veteran’s experiencing symptoms of incontinence and informing their healthcare provider or caregiver about those symptoms (sometimes 5-years or more).Insights on Veteran and caregiver satisfaction with incontinence care can guide healthcare interventions to improve incontinence care.Both Veteran quality of life and caregiver burden correlated significantly and negatively with satisfaction with incontinence treatments tried and number of treatments tried. Only 21% of Veterans were satisfied with the treatment plan they were given, suggesting a potential knowledge gap or opportunity for improvement in healthcare provider approaches to incontinence management.

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