scholarly journals Questionnaire Survey-Based Quantitative Assessment of the Impact of Transitional Care on Self-Management of Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Wenjie Xu ◽  
Hui Hu ◽  
Yanjun Mao
Keyword(s):  
Sleep Quality ◽  
Questionnaire Survey ◽  
Transitional Care ◽  
Intervention Group ◽  
Life Quality ◽  
Self Management ◽  
Anxiety And Depression ◽  
Control Group ◽  
Chronic Obstructive ◽  
The Impact

Background and Objective. Chronic obstructive pulmonary disease (COPD) features high morbidity. Different nursing interventions can relieve patient’s burden. This investigation quantitatively assessed the impact of transitional care (TC) on self-management of patients with acute exacerbation of COPD based on a questionnaire survey. Methods. Clinical information of 78 COPD patients treated with TC (intervention group) or routine care (control group) in Shanghai Pulmonary Hospital during March 2019 and August 2020 was gathered. Patients were followed up for 3 months after discharge. The intervention group ( n = 39 ) was subjected to a TC plan for 3 months to help patients and their family caregivers for self-management of COPD. TC was provided by specially trained nurses, and patients were supported by standardized tools. Nursing measures in the control group ( n = 79 ) included transitional support for 30 d after hospital discharge. In this way, patients were guaranteed to follow discharge plans and transit to outpatient nursing. Patient’s anxiety and depression symptoms, sleep quality, survival quality, mobility, and life quality at admission and after 3 months of discharge were assessed by Hospital Anxiety and Depression Scale, Pittsburgh Sleep Quality Index, Quality of Life Scale Abbreviated Version, Activity of Daily Life Scale, St. George’s Respiratory Questionnaire, and COPD Assessment Test. Results. Except for anxiety and depression, patient’s sleep quality, survival quality, mobility, and life quality in two groups were significantly improved. Moreover, average change of total CAT score during 3 months of intervention was -5.44, while that in the control group was -1.74 ( p = 0.011 ). Improvement of survival quality of patients in the intervention group ( p = 0.001 ) was markedly greater than that in the control group ( p = 0.016 ). Conclusion. Altogether, TC based on quantification by questionnaire survey is beneficial to COPD patient’s life quality and self-management.

The Effectiveness of a Healthcare Application and Human Coaching Program in Primary Care Clinics: A Non-randomized Controlled Trial (Preprint)

2021 ◽  
Author(s):  
HyoRim Ju ◽  
EunKyo Kang ◽  
YoungIn Kim ◽  
HyunYoung Ko ◽  
Belong Cho
Keyword(s):  
Primary Care ◽  
Weight Loss ◽  
Sleep Quality ◽  
Chronic Conditions ◽  
Chronic Condition ◽  
Intervention Group ◽  
Self Management ◽  
Control Group ◽  
Primary Care Clinics ◽  
Healthcare Application

BACKGROUND As the global burden of chronic conditions increases, effective management for these are a concern. There is an increasing need for chronic condition management using mobile self-management healthcare applications. OBJECTIVE This study evaluated the effectiveness of a mobile self-management healthcare application combined with human coaching for primary care services in patients with chronic conditions. METHODS A total of 110 patients with hypertension, diabetes, dyslipidemia, and/or metabolic syndrome who visited one of 17 participating primary care clinics from September 2020 to November 2020 were included in this study. Data regarding changes in body weight, sleep conditions, quality of life, depression, anxiety, stress, body mass index, waist circumference, blood sugar levels, blood pressure, and blood lipids levels were recorded. The intervention group (N=65) used a mobile self-management healthcare application with human coaching for 12 weeks, and the control group (N=45) underwent conventional, self-managed health care. RESULTS Patients in the intervention group reported significantly more weight loss than those in the control group (P=.002). The weight loss was markedly greater after using application for nine weeks than using it for four weeks or five to eight weeks (P=.002). Patients in the intervention group reported better sleep quality (P=.04) and duration (P=.004) than those in the control group. CONCLUSIONS The combination of a mobile self-management healthcare application and human coaching in primary care clinics results in better management of chronic conditions. The observed weight loss was greater and sleep quality improved than conventional primary care for patients with at least one chronic condition.

Pharmacist-Led Transition of Care Pilot Targeting Older People After Emergency Department Discharge

2020 ◽  
Vol 35 (6) ◽  
pp. 273-282
Author(s):  
Scott M. Pearson ◽  
Anushka Tandon ◽  
Danielle R. Fixen ◽  
Sunny A. Linnebur ◽  
Gretchen M. Orosz ◽  
...  
Keyword(s):  
Emergency Department ◽  
Older People ◽  
Primary Outcome ◽  
Transitional Care ◽  
Intervention Group ◽  
Chronic Obstructive ◽  
P Value ◽  
Historical Cohort ◽  
Obstructive Pulmonary Disease ◽  
The Impact

OBJECTIVE: To evaluate the impact of a pharmacist-led transitional care intervention targeting high-risk older people after an emergency department (ED) visit.<br/> DESIGN: Retrospective cohort study of older people with ED visits prior to and during a pharmacist-led intervention.<br/> SETTING: Patients receiving primary care from the University of Colorado Health Seniors Clinic.<br/> PARTICIPANTS: The intervention cohort comprised 170 patients with an ED visit between August 18, 2018, and February 19, 2019, and the historical cohort included 166 patients with an ED visit between August 18, 2017, and February 19, 2018. All included patients either had a historical diagnosis of heart failure or chronic obstructive pulmonary disease, or they had an additional ED visit in the previous six months.<br/> INTERVENTIONS: The pilot intervention involved postED discharge telephonic outreach and assessment by a clinical pharmacist, with triaging to other staff if necessary.<br/> MAIN OUTCOME MEASURE: The primary outcome was the proportion of patients with at least one repeat ED visit, hospitalization, or death within 30 days of ED discharge. Outcome rates were also assessed at 90 days postdischarge.<br/> RESULTS: The primary outcome occurred in 21% of the historical cohort and 25% of the intervention cohort (adjusted P-value = 0.48). The incidence of the composite outcome within 90 days of ED discharge was 43% in the historical group compared with 38% in the intervention group (adjusted P-value = 0.29).<br/> CONCLUSION: A pharmacist-led telephonic intervention pilot targeting older people did not appear to have a significant effect on the composite of repeat ED visit, hospitalization, or death within 30 or 90 days of ED discharge. A limited sample size may hinder the ability to make definitive conclusions based on these findings.

scholarly journals Retrospective observational study of the impact on emergency admission of telehealth at scale delivered in community care in Liverpool, UK

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e028981
Author(s):  
Cees van Berkel ◽  
Peter Almond ◽  
Carol Hughes ◽  
Maurice Smith ◽  
Dave Horsfield ◽  
...  
Keyword(s):  
Observational Study ◽  
Subgroup Analysis ◽  
Intervention Group ◽  
Average Treatment Effect ◽  
Retrospective Observational Study ◽  
Control Group ◽  
Chronic Obstructive ◽  
Emergency Admissions ◽  
Percentage Decrease ◽  
The Impact

ObjectiveTo assess the effect of a real world, ongoing telehealth service on the use of secondary healthcare.DesignA retrospective observational study with anonymous matched controls.SettingPrimary and community healthcare. Patients were recruited over 4 years in 89 general practices in Liverpool, UK and remotely managed by a dedicated clinical team in Liverpool Community Health.Participants5154 patients with chronic obstructive pulmonary disease, heart failure or diabetes were enrolled in the programme, of whom 3562 satisfied the inclusion criteria of this study.InterventionAt least 9 weeks of telehealth including vital sign collection, questionnaires, education, support and informal coaching by clinical staff.Primary outcomeReduction in the number of emergency admissions in the 12 months after start, compared with the year before start. Secondary subgroup analysis to improve future targeting and personalisation of the service.ResultThe average number of emergency admissions for the intervention group at baseline is 0.35, 95% CI 0.32 to 0.38. The differential decrease in emergency admissions in the intervention group in comparison with the control group, the average treatment effect, is 0.08, 95 CI 0.05 to 0.11, corresponding to an average percentage decrease of 22.7%. In subgroup analysis, a score is calculated that can be used prospectively to predict individual benefit from the intervention. Patients with an above median score (37%) are predicted average reduction in emergency admissions of 0.15, 95% CI 0.09 to 0.2, corresponding to a percentage decrease in admissions of 25.3%.ConclusionThe telehealth intervention has a positive impact across a wide cohort of patients with different diseases. Prospective scoring of patients and allocation to targeted telehealth interventions is likely to improve the effectiveness and efficiency of the service.

scholarly journals A nurse led intermediate care package in patients who have been hospitalised with an acute exacerbation of chronic obstructive pulmonary disease

Thorax ◽  
2007 ◽  
Vol 63 (3) ◽  
pp. 194-200 ◽  
Author(s):  
M Sridhar ◽  
R Taylor ◽  
S Dawson ◽  
N J Roberts ◽  
M R Partridge
Keyword(s):  
Action Plan ◽  
Intervention Group ◽  
Self Management ◽  
Control Group ◽  
Chronic Obstructive ◽  
Intermediate Care ◽  
Obstructive Pulmonary Disease ◽  
Hospital Readmission Rate ◽  
Care Package ◽  
Oral Steroids

Objectives:To determine the effects of a nurse led intermediate care programme in patients who have been hospitalised with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Design:Randomised controlled trial.Setting:Community and hospital care in west London.Participants:122 patients with COPD.Intervention:A care package incorporating initial pulmonary rehabilitation and self-management education, provision of a written, personalised COPD action plan, monthly telephone calls and 3 monthly home visits by a specialist nurse for a period of 2 years.Main outcome measure:Hospital readmission rate.Secondary outcomes:Unscheduled primary care consultations and quality of life.Results:There were no differences in hospital admission rates or in exacerbation rates between the two groups. Self-management of exacerbations was significantly different and the intervention group were more likely to be treated with oral steroids alone or oral steroids and antibiotics, and the initiators of treatment for exacerbations were statistically more likely to be the patients themselves. 12 patients in the control group died during the 2 year period, eight as a result of COPD, compared with six patients in the intervention group, of whom one died from COPD. This is a significant difference. When the numbers were adjusted to reflect the numbers still alive at 2 years, in the intervention group patients reported a total of 171 unscheduled contacts with their general practitioner (GP) and in the control group, 280 contacts. The number needed to treat was 0.558—ie, for every one COPD patient receiving the intervention and self-management advice, there were 1.79 fewer unscheduled contacts with the GP.Conclusions:An intermediate care package incorporating pulmonary rehabilitation, self-management education and the receipt of a written COPD action plan, together with regular nurse contact, is associated with a reduced need for unscheduled primary care consultations and a reduction in deaths due to COPD but did not affect the hospital readmission rate.

scholarly journals The effect of daily walking exercise on sleep quality in healthy young adults

2020 ◽  
Author(s):  
Feifei Wang ◽  
Szilvia Boros
Keyword(s):  
Young Adults ◽  
Sleep Quality ◽  
Repeated Measures ◽  
Intervention Group ◽  
Control Group ◽  
Beneficial Effects ◽  
Walking Intervention ◽  
Walking Exercise ◽  
Group B ◽  
The Impact

Abstract Purpose Walking has beneficial effects on sleep quality in elderly population and patients in clinical settings. However, less is known whether walking improves sleep quality among healthy young adults. This study examined the effectiveness of a 12-week walking intervention on sleep quality among sedentary young adults. Methods Fifty-four healthy adults aged 19 to 36-years old participated a pedometer based aerobic walking intervention, a cross-over randomized control trial. Participants were assigned into two groups (group A and group B) randomly. The 12-week intervention was divided into three sessions equally. Sleep quality was assessed by Pittsburgh Sleep Quality Index (PSQI) before and after session 1 and session 3. Omron HJ-112 pedometer and daily walking diary facilitated the intervention process. Within group and between group comparisons were made for statistical analysis. Results Within group comparison by repeated measures showed that sleep duration (p < 0.01, F-test 22.79), sleep medication (p < 0.05, F-test 5.22), subjective sleep (p < 0.05, F-test 5.51) and global sleep quality (p < 0.01, F-test 12.19) were significantly improved. The comparison between intervention group and control group showed that sleep disturbance was significantly improved (p < 0.05). Conclusion Daily walking exercise has a significant effect on facilitating sleep quality and sleep components among young adults. Further studies are suggested to examine the impact of walking intensity on sleep quality.

scholarly journals The Teach-Back Effect on Self-Efficacy in Patients with Type 2 Diabetes

2020 ◽  
Vol 16 (1) ◽  
pp. 46-50
Author(s):  
Marhamat Farahaninia ◽  
Tahere Sarboozi Hoseinabadi ◽  
Rasool Raznahan ◽  
Shima Haghani
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Self Efficacy ◽  
Intervention Group ◽  
Self Management ◽  
Control Group ◽  
Training Procedure ◽  
Treatment Regimens ◽  
The Impact

BACKGROUND: Diabetes is a chronic, metabolic disease, which is commonly associated with increased blood glucose levels caused by impaired secretion or function of insulin. Therefore, daily blood glucose control, adherence to a dietary and pharmaceutical regimen, regular physical activity, and foot care are fundamental components of disease management. In order to optimize effective self-management, patients need to be trained. Teach-back is a method which aims to improve patients' understanding and perception of treatment regimens based on the interaction between patient and caregiver. AIM: This study was conducted to investigate the impact of the teach-back method on the effectiveness of self-management in patients with type 2 diabetes (T2D). METHODS: A total of 74 patients with T2D were included in the study by convenience sampling at the Endocrine and Metabolism Clinic. The subjects were assigned to control or intervention group. Data collection was performed by using a demographic data form and a self-efficacy questionnaire that were provided to the patients before and 1 month after training. The patients in the intervention group received a 5-session training program using the teach-back method. The control group received only routine programs. One month after completion of the training sessions, the questionnaires were completed by the subjects in the 2 groups, and the data obtained were analyzed. RESULTS: In contrast to the control group, mean and standard deviation of self-efficacy were significantly higher in the intervention group one month after training by the teach-back method than before training. The two groups did not significantly differ regarding mean score of self-efficacy before training, but there was a significant difference one month after training: the mean score of self-efficacy in the intervention group was significantly higher than in the control group (p < 0.001). CONCLUSIONS: Teach-back is a training procedure aimed at improving patients' understanding of treatment regimens. This study showed that teach-back significantly improved patients' self-efficacy even over as short a period as one month. It may be interesting to study the long-term effects of this simple but effective training method.

scholarly journals GERIATRIC GYMNASTIC TO QUALITY OF SLEEP IN PTSW SENJARAWI BANDUNG

2018 ◽  
Vol 2 (2) ◽  
pp. 223
Author(s):  
Meilirianta Meilirianta ◽  
Maspupah Maspupah
Keyword(s):  
Sleep Quality ◽  
Intervention Group ◽  
The Elderly ◽  
Control Group ◽  
P Value ◽  
Quality Of Sleep ◽  
Control Group Design ◽  
Equivalent Control ◽  
The Impact

Introduction. Elderly has decreased in many body system including the impact on sleep disorder. The purpose of this study was to analize effect of geriatric gymnastic on sleep quality of the elderly. Methods. This research used quasy experiment methods with pre and post test only non equivalent control group design. The population in this study was the elderly as many as 82 people. Sample in this research was 30 participants that are defi ned with total sampling method who was appropriated with the criteria. Sampel was devided into two groups which are 15 people of intervention group and 15 people of control group. Data instrument in measuring the quality of sleep used PSQI (Pittsburgh Sleep Quality Index) by observation. Result. There was a signifi cant effect of geriatric gymnasticon sleep quality of the elderly at Tresna Werdha Senjarawi Social Home Bandung with t-test, p-value 0.000 or < 0.05. Discussion. The geriatric gymnastics can be designed more interest the elderly to follow this activities regulary so can overcome sleep disorders in the elderly.Keywords : Quality of Sleep, Geriatric Gymnastic, Elderly

scholarly journals The Effect of Educational Intervention Based on Model 5A Self-Management Theory on Life Quality in Hypertensive Patients

2019 ◽  
Author(s):  
Farbod Ebadi Fard Azar ◽  
Mahnaz Solhi ◽  
Nemam Ali Azadi ◽  
Arash Ziapour ◽  
Javad Yoosefi Lebni ◽  
...  
Keyword(s):  
Educational Intervention ◽  
Intervention Group ◽  
Life Quality ◽  
Management Program ◽  
Management Theory ◽  
Repeated Measure ◽  
Self Management ◽  
Control Group ◽  
Eligibility Criteria ◽  
Hypertensive Patients

Abstract Background: Hypertension is a major risk factor in heart failure, arterial aneurysms, peripheral arterial disease, chronic kidney disease, stroke and myocardial infarction. Methods: This study was an experimental study. From patients with hypertension presenting to karaj Health Center, 90 patients were selected according to the eligibility criteria and were assigned randomly to two groups, the intervention group (45 patients) and the control group (45 patients). The data were collected through questionnaires. Educational intervention based on self-management theory was designed in 5A method and implemented in the intervention group. The data was collected in three times including before the intervention, 1 month after the intervention and 3 months after the educational intervention. data were analyzed using SPSS software and statistical methods number, percentage, mean, standard deviation and repeated measure test. Results: The results showed that the mean score of various domains of life quality (physical domain¸ psychological domain, social domain, environmental domain) and total score of life quality in the intervention group increased significantly compared to the control group after the educational intervention. Conclusion The results of the study showed that using self-management program is effective in improving the life quality of hypertensive patients.

Effects of the Health Belief Model-Based Intervention on Anxiety, Depression, and Quality of Life in Chronic Obstructive Pulmonary Disease

2021 ◽  
pp. 1-8
Author(s):  
Yating Zhang ◽  
Xiangfang Zhao
Keyword(s):  
Quality Of Life ◽  
Intervention Group ◽  
Health Belief ◽  
Anxiety And Depression ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Belief Model

<b><i>Background:</i></b> Chronic obstructive pulmonary disease (COPD) is a chronic respiratory condition. COPD causes a heavy burden on the patients through negative impacts on the quality of life and psychological health. The health belief model (HBM) is proposed and modified by several social psychologists and is confirmed to have benefits in the recovery of various diseases. This research aimed to explore the effects of the HBM-based intervention on anxiety, depression, and quality of life in COPD patients entering pulmonary rehabilitation (PR). <b><i>Methods:</i></b> This research was conducted at the Tianjin Rehabilitation Recuperate Center of Chinese PLA in 2019. A total of 136 COPD patients were randomized into the intervention group and the control group. In the control group, patients received the PR program. In the intervention group, patients received both PR program and the HBM-based intervention. Quality of life was measured by the COPD assessment test. The outcomes of anxiety and depression were measured by the Hospital Anxiety and Depression Scale. <b><i>Results:</i></b> The HBM-based intervention decreased both anxiety and depression scores among COPD patients. The COPD assessment test score was declined by the HBM-based intervention, which also decreased the serum levels of interleukin-6 and C-reactive protein in COPD patients entering PR. <b><i>Conclusion:</i></b> The HBM-based intervention alleviates anxiety and depression, enhances quality of life, and inhibits inflammation in COPD patients entering PR.

A mobile health application to support self-management in patients with chronic obstructive pulmonary disease: a randomised controlled trial

2020 ◽  
pp. 026921552094693
Author(s):  
LianHong Wang ◽  
YunMei Guo ◽  
Meili Wang ◽  
Yan Zhao
Keyword(s):  
Quality Of Life ◽  
Mobile Health ◽  
Intervention Group ◽  
Smartphone Application ◽  
Self Management ◽  
Control Group ◽  
Chronic Obstructive ◽  
Copd Assessment Test ◽  
Management Behaviour

Objective: To investigate the effects of a mobile health smartphone application to support self-management programmes on quality of life, self-management behaviour and exercise and smoking cessation behaviour in patients with chronic obstructive pulmonary disease (COPD). Design: A randomised controlled, single-blind trial, was carried out from November 2017 to February 2019, which included 78 participants admitted with COPD to the Affiliated Hospital of Zunyi Medical University in Guizhou. The study participants were randomised into intervention ( n = 39) and control groups ( n = 39). Methods: Participants in the intervention group undertook a mobile medical application-based programme in addition to routine care, and participants in the control group received only routine care. The outcome measures were health-related quality of life evaluated by the COPD Assessment-Test, self-management behaviour using the COPD Self-Management Scale and physical activity and smoking behaviour were measured using a self-designed questionnaire. Data collection was conducted at baseline, third month, sixth month and 12th months. Results: Thirty-five participants in the intervention group and 33 in the control group completed the study. Compared to the control group, participants in the intervention group showed statistically significant improvement in the COPD -Assessment -Test scores ( P < 0.01) and in all domains of the COPD Self-Management Scale scores ( P < 0.01) at 12th 12 months. Improvements in the COPD -Assessment -Test scores by 4.3 and 0.3 units, and in the total scores of the COPD Self-Management Scale total score by 23.01 and 2.28 units, respectively, were observed in the intervention and control groups, respectively over the 12-month study period. Meanwhile, the mobile health application programme also improved participants’ exercise and smoking cessation behaviour. Conclusions: The mobile health smartphone application to support self-management programmes was effective in improving health-related quality of life and self-management behaviour in patients with COPD. Trial registration: This study was registered in Chinese clinicaltrials.gov

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