scholarly journals Video consultation as an adequate alternative to face-to-face consultations in CPAP use for patients with obstructive sleep apnea: a Randomized Controlled Trial. (Preprint)

2020 ◽  
Author(s):  
L. Kooij ◽  
P. J. E. Vos ◽  
A. Dijkstra ◽  
E. A. Roovers ◽  
W. H. van Harten
Keyword(s):  
Randomized Controlled Trial ◽  
Self Efficacy ◽  
Controlled Trial ◽  
Outcome Expectancies ◽  
Self Management ◽  
Face To Face ◽  
Randomized Controlled ◽  
Cognitive Components ◽  
Video Consultation ◽  
Over Time

BACKGROUND The effectiveness of Continuous Positive Airway Pressure (CPAP) is dependent on the degree of use, so adherence is essential. Cognitive components (e.g. self-efficacy) are found to be important in predicting CPAP use. Telemedicine interventions are increasingly used to support self-management in different chronic diseases. Especially video consultation is a promising way of supporting OSA patients, and may be beneficial during treatment. So far video consultation is seldom evaluated through thorough controlled research, with only a limited number of outcomes assessed. OBJECTIVE To evaluate the effects of video consultation versus face-to-face consultation for patients with OSA on patients’ CPAP use (minutes/per night), self-efficacy, risk outcomes, outcome expectancies, experiences with technology and, patients’ and professionals’ satisfaction. METHODS A Randomized Controlled Trial was conducted with an intervention- (video consultations) and a usual care group (face-to-face consultations) with CPAP use assessments after 4, 12 and 24 weeks. Patients with confirmed OSA (AHI > 15), requiring CPAP treatment, no history of CPAP treatment, having access to a tablet/smartphone and proficiency of the Dutch language were included in the study. Patients completed questionnaires at baseline and after one month on self-efficacy, risk perception, outcome expectancies (using Self-Efficacy Measure for Sleep Apnea), expectations and experiences with video consultations (covering constructs of the Unified Theory of Acceptance and Use of Technology) and satisfaction. RESULTS In both groups CPAP use decreased over time (P=.01) similarly. No significant difference in change over time (week 4, 12 and 24) between groups was found for CPAP use (P interaction term P=.54). Self-efficacy appeared to have a statistically significant effect on CPAP use in both groups (P=.001), regardless of the intervention arm (P=.27). Patients in both groups were satisfied with the consultations and rated these respectively with an 8.4 and 8.3. The experiences with video consultation were positive, e.g. it did not cost patients effort (92%), they reported to have skills to use it (95%) and they intended to keep using it (95%). All nurses were satisfied with the quality of the sound, video and privacy and security. However, they recommended to use video consultation only in follow-up. CONCLUSIONS To our knowledge, this is the first Randomized Controlled Trial that examined the effects of video consultation on CPAP use over time for newly diagnosed OSA patients in combination with cognitive components and technology acceptance. The findings of this research suggest that, for patients starting CPAP, video consultation can preferably be used in combination with an initial face-to-face consultation and especially for patients with high levels of self-efficacy. Future research should focus on blended care approaches in which self-management and especially self-efficacy is receiving greater emphasis.

The Effect of Mobile Instant Messaging versus Face-to-Face Counseling on the Primiparous Mothers’ Breastfeeding Self-efficacy: A Pilot Randomized Controlled Trial

2020 ◽  
Author(s):  
Manoosh Mehrabi ◽  
Shoale Zarei ◽  
Leila Bazrafkan ◽  
Ali Reza Safarpour
Keyword(s):  
Randomized Controlled Trial ◽  
Self Efficacy ◽  
Instant Messaging ◽  
Controlled Trial ◽  
World Health ◽  
Face To Face ◽  
Randomized Controlled ◽  
The World ◽  
The Impact ◽  
Pilot Randomized Controlled Trial

Abstract Background Increasing breastfeeding rates around the world is one of the most important goals of the World Health Organization. Self-efficacy is a modifying and predictive factor for initiation and continuation of breastfeeding. This study was conducted to investigate the impact of mobile-based education and regular delivery of designed messages on breastfeeding self-efficacy in primiparous mothers. Methods This study was a double blind pilot randomized controlled trial, in which a hundred and twenty primiparous breastfeeding mothers were randomly allocated into two groups using permuted block randomization. The standard method conseling arm received routine counseling interventions and the intervention arm received a mobile instant messaging program in addition to the usual counseling. The main objective of this study was to compare self-efficacy in face-to-face counseling group and mobile instant messaging group. Self-efficacy levels were compared in the two groups before and after the study procedures. Results In this study, 60 mothers were studied in each group, and then the collected data were analyzed. The mean post-test scores in the intervention group (60.40 ± 4.92) and the control group (50.10 ± 7.60) were compared in the main analysis. The results indicated a statistically significant difference (p <0.001). Given the amount of effect size ( d= 0.99; 95% CI=1.19-2.02 ) it appears that there is a high level correlation between the applied intervention and level of self-efficacy among the study participants, especially those with higher levels of education. Secondary findings of the study involved evaluating the effects of education, occupation, family income, lactation duration and spouse support for breastfeeding self-efficacy. Except for the maternal education level, which had a significant relationship with the level of breastfeeding self-efficacy (p= 0.02), the other factors did not show any correlation with self-efficacy in breastfeeding. Conclusion The pilot study provided valuable information for feasibility assessment of randomized controlled trials in future studies with larger sample sizes and more participant diversity.

scholarly journals A Cross-Provider Health Care Management Program for Musculoskeletal Disorders: Results of a Randomized Controlled Trial in 22 German Companies

2021 ◽  
Vol 18 (22) ◽  
pp. 11844
Author(s):  
Kyung-Eun (Anna) Choi ◽  
Lara Lindert ◽  
Lara Schlomann ◽  
Christina Samel ◽  
Martin Hellmich ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Case Management ◽  
Sick Leave ◽  
Musculoskeletal Disorders ◽  
Self Efficacy ◽  
Controlled Trial ◽  
Self Management ◽  
Randomized Controlled ◽  
Management Group

Musculoskeletal disorders (MSDs) are among the most common cause for reduced work capacity and sick leave. Workplace health promotion programs are often neither tailored to the workplace nor the individual needs of the employees. To counteract lacking intersectional care, this four-year randomized controlled trial (RCT) aimed to investigate the effects of modular coordinating case management (treatment group) compared to supported self-management (control group) on MSD specific sick leave days (routine data), workability (WAI), self-efficacy (self-efficacy scale), and pain (German pain questionnaire, GPQ). The study network comprised 22 companies, 15 company health insurance funds, and 12 pension funds in Germany. Overall, 852 participants (Module A/early intervention: n = 651, Module B/rehabilitation: n = 190, Module C/reintegration: n = 10) participated. Both groups achieved fewer sick leave days, higher workability, and less pain (p < 0.0001) at follow-up compared to baseline. At follow-up, the coordinating case management group showed fewer disability days (GPQ), lower disability scores (GPQ), and lower pain intensities (GPQ) than the supported self-management group (p < 0.05), but no superiority regarding MSD specific sick leave days, workability, nor self-efficacy. Module A showed more comprehensive differences. The accompanying process evaluation shows barriers and facilitators for the implementation of the program, especially in a RCT setting.

scholarly journals Efficacy of a Web-Based Self-Management Enhancing Program for Patients with Rheumatoid Arthritis: Explorative Randomized Controlled Trial (Preprint)

2018 ◽  
Author(s):  
Rixt Zuidema ◽  
Sandra van Dulmen ◽  
Maria Nijhuis-van der Sanden ◽  
Inger Meek ◽  
Cornelia van den Ende ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Randomized Controlled Trial ◽  
Outcome Measures ◽  
Self Efficacy ◽  
Controlled Trial ◽  
Intervention Group ◽  
Self Management ◽  
Web Based ◽  
Positive Effects ◽  
Randomized Controlled

BACKGROUND Web-based self-management enhancing programs have the potential to support patients with rheumatoid arthritis (RA) in their self-management; for example, improve their health status by increasing their self-efficacy or taking their prescribed medication. We developed a Web-based self-management enhancing program in collaboration with RA patients and professionals as co-designers on the basis of the intervention mapping framework. Although self-management programs are complex interventions, it is informative to perform an explorative randomized controlled trial (RCT) before embarking on a larger trial. OBJECTIVE This study aimed to evaluate the efficacy of a Web-based self-management enhancing program for patients with RA and identify outcome measures most likely to capture potential benefits. METHODS A multicenter exploratory RCT was performed with an intervention group and a control group. Both groups received care as usual. In addition, the intervention group received 12 months of access to a Web-based self-management program. Assessment occurred at baseline, 6 months, and 12 months. Outcome measures included self-management behavior (Patient Activation Measurement, Self-Management Ability Scale), self-efficacy (Rheumatoid Arthritis task-specific Self-Efficacy, Perceived Efficacy in Patient-Physician Interaction), general health status (RAND-36), focus on fatigue (Modified Pain Coping Inventory for Fatigue), and perceived pain and fatigue (Numeric Rating Scales). A linear mixed model for repeated measures, using the intention-to-treat principle, was applied to study differences between the patients in the intervention (n=78) and control (n=79) groups. A sensitivity analysis was performed in the intervention group to study the influence of patients with high (N=30) and low (N=40) use of the intervention. RESULTS No positive effects were found regarding the outcome measurements. Effect sizes were low. CONCLUSIONS Based on these results, it is not possible to conclude on the positive effects of the intervention or to select outcome measures to be regarded as the primary/main or secondary outcomes for a future trial. A process evaluation should be performed to provide more insight into the low compliance with and effectiveness of the intervention. This can determine for whom this sort of program will work and help to fine-tune the inclusion criteria. CLINICALTRIAL Netherlands Trial Register NTR4871; https://www.trialregister.nl/trial/4726

scholarly journals Enhanced self-efficacy after a self-management programme in pituitary disease: a randomized controlled trial

2017 ◽  
Vol 177 (1) ◽  
pp. 59-72 ◽  
Author(s):  
Cornelie D Andela ◽  
Han Repping-Wuts ◽  
Nike M M L Stikkelbroeck ◽  
Mathilde C Pronk ◽  
Jitske Tiemensma ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Self Efficacy ◽  
Illness Perceptions ◽  
Social Issues ◽  
Controlled Trial ◽  
Self Management ◽  
Future Research ◽  
Control Group ◽  
Randomized Controlled ◽  
Pituitary Disease

ContextPatients with pituitary disease report impairments in Quality of Life (QoL) despite optimal biomedical care. Until now, the effects of a self-management intervention (SMI) addressing psychological and social issues for these patients and their partners have not been studied.ObjectiveTo examine the effects of a SMI i.e. Patient and Partner Education Programme for Pituitary disease (PPEP-Pituitary).Design and subjectsA multicentre randomized controlled trial included 174 patients with pituitary disease, and 63 partners were allocated to either PPEP-Pituitary or a control group. PPEP-Pituitary included eight weekly sessions (90 min). Self-efficacy, bother and needs for support, illness perceptions, coping and QoL were assessed before the intervention (T0), directly after (T1) and after six months (T2). Mood was assessed before and after each session.ResultsPatients in PPEP-Pituitary reported improved mood after each session (except for session 1). In partners, mood only improved after the last three sessions. Patients reported higher self-efficacy at T1 (P = 0.016) which persisted up to T2 (P = 0.033), and less bother by mood problems directly after PPEP-Pituitary (P = 0.01), but more bother after six months (P = 0.001), although this increase was not different from baseline (P = 0.346). Partners in PPEP-Pituitary reported more vitality (P = 0.008) which persisted up to T2 (P = 0.034). At T2, partners also reported less anxiety and depressive symptoms (P ≤ 0.014).ConclusionThis first study evaluating the effects of a SMI targeting psychosocial issues in patients with pituitary disease and their partners demonstrated promising positive results. Future research should focus on the refinement and implementation of this SMI into clinical practice.

Sign in / Sign up

Export Citation Format

Share Document