scholarly journals Addressing the transition to a chronic condition: exploring independent adoption of self-management by patients with ANCA-associated vasculitis

2021 ◽  
Author(s):  
Ian Litchfield ◽  
Sheila Greenfield ◽  
Lorraine Harper ◽  
Keyword(s):  
Side Effects ◽  
Chronic Condition ◽  
Management Strategies ◽  
Management Programme ◽  
Self Management ◽  
Structured Interviews ◽  
Management Processes ◽  
Additional Support ◽  
Post Hoc ◽  
Consistent Information

Abstract Objective Improvements in care have led to the recognition of Anti-neutrophil cytoplasm antibody associated vasculitis (AAV) as a chronic condition yet the self-management strategies considered a critical component of the care model for patients with more prevalent chronic conditions are yet to be formally integrated into the treatment of AAV patients. The work we present here aims to identify those self-management processes and tasks already being adopted by patients with AAV to help inform existing care and the development of a structured self-management programme. Methods We conducted a series of focus groups and semi-structured interviews with AAV patients collating the data and performing a post-hoc deductive analysis based on a consolidated framework of self-management processes. Results Despite the unique attributes and demands of AAV, patients adopted self-management behaviours previously identified and supported in patients with more prevalent chronic diseases. They proactively accessed information on their disease and learnt to mitigate their symptoms and side effects; they pursued a range of health promotion activities and accessed support from their social network and beyond and ultimately learnt to integrate the condition into their everyday life. Conclusions Our work has highlighted some key areas of self-management that might be usefully and immediately addressed including the provision of more consistent information relating to evolving symptoms and side-effects, additional support in accessing both appropriate care and community-based resources and the use of interventions to bolster resilience. Our findings will inform the development of tailored self-management programme but meantime provide a more contemporary context for current clinician-patient conversations.

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 Evaluation Design of EFFICHRONIC: The Chronic Disease Self-Management Programme (CDSMP) Intervention for Citizens with a Low Socioeconomic Position

2019 ◽  
Vol 16 (11) ◽  
pp. 1883 ◽  
Author(s):  
Siok Swan Tan ◽  
Marta M Pisano ◽  
An LD Boone ◽  
Graham Baker ◽  
Yves-Marie Pers ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Socioeconomic Position ◽  
Chronic Condition ◽  
Healthy Lifestyle ◽  
Target Population ◽  
Management Programme ◽  
Self Management ◽  
Design Data ◽  
Study Objective ◽  
Low Socioeconomic

Background/rationale: The Chronic Disease Self-Management Programme (CDSMP) intervention is an evidence-based program that aims to encourage citizens with a chronic condition, as well as their caregivers, to better manage and maintain their own health. CDSMP intervention is expected to achieve greater health gains in citizens with a low socioeconomic position (SEP), because citizens with a low SEP have fewer opportunities to adhere to a healthy lifestyle, more adverse chronic conditions and a poorer overall health compared to citizens with a higher SEP. In the EFFICHRONIC project, CDSMP intervention is offered specifically to adults with a chronic condition and a low SEP, as well as to their caregivers (target population). Study objective: The objective of our study is to evaluate the benefits of offering CDSMP intervention to the target population. Methods: A total of 2500 participants (500 in each study site) are recruited to receive the CDSMP intervention. The evaluation study has a pre-post design. Data will be collected from participants before the start of the intervention (baseline) and six months later (follow up). Benefits of the intervention include self-management in healthy lifestyle, depression, sleep and fatigue, medication adherence and health-related quality of life, health literacy, communication with healthcare professionals, prevalence of perceived medical errors and satisfaction with the intervention. The study further includes a preliminary cost-effectiveness analysis with a time horizon of six months. Conclusion: The EFFICHRONIC project will measure the effects of the CDSMP intervention on the target population and the societal cost savings in five European settings.

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.

Enhancing Safety via Medication Self-Management and Timely Reporting

2021 ◽  
Author(s):  
Yun Jiang ◽  
Yang Gong
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Side Effects ◽  
Medication Errors ◽  
Chronic Condition ◽  
Self Management ◽  
Prevention Strategies ◽  
Major Threat ◽  
Outpatient Settings ◽  
Rapid Shift

Medication errors have been a major threat to patient safety. Current research on medication errors is largely dependent on in-hospital reports. With the rapid shift of health care to chronic condition management, there is an urgent need to investigate medication errors in the community. In this paper, we discuss that the model of medication self-management developed for outpatient settings may be used to guide the development of prevention strategies for medication errors beyond hospitals. Further, timely reporting medication errors from patients in the communities may be helpful in mitigating the severity of side effects and reducing preventable safety events.

Uptake of self-management strategies in a heart failure management programme

2003 ◽  
Vol 5 (3) ◽  
pp. 371-380 ◽  
Author(s):  
S.P. Wright ◽  
H. Walsh ◽  
K.M. Ingley ◽  
S.A. Muncaster ◽  
G.D. Gamble ◽  
...  
Keyword(s):  
Heart Failure ◽  
Management Strategies ◽  
Management Programme ◽  
Self Management ◽  
Heart Failure Management

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.

scholarly journals Patients’ experiences of a nurse-led home-based heart failure self-management programme: Findings from the process evaluation (Preprint)

2021 ◽  
Author(s):  
Wenru Wang ◽  
Ying Jiang ◽  
Karen Wei Ling Koh ◽  
Hadassah Joann RAMACHANDRAN ◽  
Yee Kian Tay ◽  
...  
Keyword(s):  
Heart Failure ◽  
Process Evaluation ◽  
Controlled Trial ◽  
Self Care ◽  
The Elderly ◽  
Management Programme ◽  
Self Management ◽  
Structured Interviews ◽  
Additional Information ◽  
Home Based

UNSTRUCTURED Aims: To explore participants’ perspectives on a nurse-led home-based heart failure self-management programme (HOM-HEMP) in a randomized controlled trial conducted in Singapore to gain insight into the effectiveness or failure of the study intervention. Design: A descriptive, qualitative approach was adopted. Method: English or Chinese-speaking participants from the intervention arms were recruited through a purposive sampling method from January 2019 to July 2019. Individual, face-to-face, semi-structured interviews were conducted with 11 participants. All the interviews were audio-recorded and transcribed verbatim, with the identifiers of the participants omitted to ensure confidentiality. The thematic analysis approach was used for identifying, analyzing and reporting the patterns (themes) within the data. Results: Six themes emerged from the process evaluation interviews and were categorized according to Donabedian’s structure-process-outcome framework as "intervention structure," "intervention process," and "intervention outcome". These six themes were manageability of intervention, areas for improvement, benefits of visiting, personal accountability in self-care, empowered with knowledge and skills in self-care after the intervention, and increased self-efficacy in cardiac care. Conclusion: The findings of the process evaluation provided additional information about participants' perceptions and experiences with the HOM-HEMP intervention. While home visit may be perceived as resource intensive, it remains the preferred way of engagement for most of the elderly patients. The nurse plays an important role in promoting heart failure self-care. The process of interaction with the patient can be an important empowering process for self-care behaviour changes. Impact: Process evaluation is an important step in the evaluation of a complex intervention. It allows researchers and practitioners to better understand the mechanism by which an intervention generates impact. Therefore, future intervention programmes can leverage on these mechanisms and adapt them to different contexts for better intervention effectiveness.

‘Do it yourself’ sexual health care: the user experience

Sexual Health ◽  
2011 ◽  
Vol 8 (1) ◽  
pp. 23 ◽  
Author(s):  
Paula Baraitser ◽  
Kirsty Collander Brown ◽  
Zachary Gleisner ◽  
Vikki Pearce ◽  
Usha Kumar ◽  
...  
Keyword(s):  
Sexual Health ◽  
Time Pressure ◽  
Waiting Times ◽  
The Self ◽  
Self Management ◽  
Structured Interviews ◽  
Management Options ◽  
Waiting Room ◽  
Sexual Health Care ◽  
Additional Support

Objectives: To describe client experience of self-management within a busy walk-in, sexual health service. Self-management in this context is self-registration and take-home pregnancy tests, chlamydia (Chlamydia trachomatis) and gonorrhoea (Neisseria gonorrhoeae) tests, or condoms dispensed from a free vending machine. Methods: Twenty-four in-depth, semi-structured interviews with users; 19 structured written reports from mystery shoppers paid to visit the service and report their experience; demographic details of those using the self-management option from the clinic database and 40 h of recorded observation in the clinic waiting room. Results: Between 2 September 2008 and 1 September 2009, 18 657 people had 28 545 attendances at the service. Of these, 1845 (6.5%) attendances were self-managed by 1555 individuals (8.3% of all clients). Of those who self-managed, 646 (35%) obtained a chlamydia and gonorrhoea test only, 597 (32%) obtained condoms only and 488 (27%) obtained a pregnancy test only. Users valued the opportunity to self-manage because of the reduced waiting times, autonomy and privacy that such a service offers. Some prefer the additional support offered within a clinical consultation. Users made personalised decisions about self-management based on time pressure, need for additional services and preferred source of support. Users often required help and advice from client support workers to complete the self-management process. This created problems with confidentiality. Conclusions: Self-management is an acceptable option within sexual health services if informal support is available. Self-management options in clinical services could mean that 8% of clients at 6% of visits do not need to see a clinician, thus freeing up clinical capacity.

scholarly journals Strategies to self-manage side-effects of adjuvant endocrine therapy among breast cancer survivors: an umbrella review of empirical evidence and clinical guidelines

2021 ◽  
Author(s):  
Louise H. Hall ◽  
Natalie V. King ◽  
Christopher D. Graham ◽  
Sophie M. C. Green ◽  
Alice Barber ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Side Effects ◽  
Cancer Survivors ◽  
Endocrine Therapy ◽  
Clinical Guidelines ◽  
Breast Cancer Survivors ◽  
Management Strategies ◽  
Self Management ◽  
Primary Research ◽  
High Quality

Abstract Purpose Side-effects of adjuvant endocrine therapy (AET) are common in breast cancer survivors, and can affect adherence to treatment. We synthesised the evidence for strategies to self-manage these side-effects. Methods We searched for systematic reviews and clinical guidelines on self-management strategies for AET side-effects (arthralgia, fatigue, hot flashes, gastrointestinal discomfort, nausea, vulvovaginal symptoms, and sleep disturbance). We searched oncology organisation’s websites and eight databases (Inception-November 2020). Screening, data extraction and quality assessment were completed independently in duplicate. PROSPERO: 2019CRD4201914001. Results We identified 33 systematic reviews and 18 clinical guidelines. 21% of reviews were high quality, and the average quality score for guidelines was 44%. Evidence for most strategies was absent or weak. There was consensus from a low-quality review and multiple guidelines to recommend moisturisers, gels and lubricants for vulvovaginal symptoms. Evidence was weak for physical activity for self-managing most symptoms, although two high-quality reviews indicated yoga and aerobic exercise could reduce fatigue. Primary research was often biased by weak and underpowered study designs. Eleven reviews did not report information on adverse events. Conclusions Most self-management strategies for breast cancer survivors experiencing side-effects from AET lack evidence. Primary research is needed using high-quality well-powered designs focusing on implementable strategies. Implications for Cancer Survivors Patients and clinicians should be aware that although the risk of harm is low for these self-management strategies, the likelihood of benefit is often unclear. Women should consider moisturisers, gels or lubricants for self-managing vulvovaginal symptoms, and yoga or aerobic exercise for alleviating fatigue.

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