scholarly journals Theory-Based Digital Interventions to Improve Asthma Self-Management Outcomes: Systematic Review (Preprint)

2018 ◽  
Author(s):  
Helen J Lycett ◽  
Eva M Raebel ◽  
Emilie K Wildman ◽  
Jordi Guitart ◽  
Thomas Kenny ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Clinical Outcomes ◽  
Cognitive Theory ◽  
Self Management ◽  
Care Utilization ◽  
Applied Theory ◽  
Inclusion Criteria ◽  
Management Interventions ◽  
Digital Interventions

BACKGROUND Asthma is a chronic disease requiring effective self-management to control it and prevent mortality. The use of theory-informed digital interventions promoting asthma self-management is increasing. However, there is limited knowledge concerning how and to what extent psychological theory has been applied to the development of digital interventions, or how using theory impacts outcomes. OBJECTIVE The study aimed to examine the use and application of theory in the development of digital interventions to enhance asthma self-management and to evaluate the effectiveness of theory-based interventions in improving adherence, self-management, and clinical outcomes. METHODS Electronic databases (CENTRAL, MEDLINE, EMBASE, and PsycINFO) were searched systematically using predetermined terms. Additional studies were identified by scanning references within relevant studies. Two researchers screened titles and abstracts against predefined inclusion criteria; a third resolved discrepancies. Full-text review was undertaken for relevant studies. Those meeting inclusion criteria were assessed for risk of bias using the Cochrane Collaboration tool. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Study outcomes were classified as medication adherence, self-management, asthma control, clinical markers of health, quality of life, other quality of life outcomes, and health care utilization. Effectiveness was calculated as an average outcome score based on the study’s reported significance. The Theory Coding Scheme (TCS) was used to establish the extent to which each intervention had applied theory and which theoretical constructs or behavioral determinants were addressed. Associations between TCS scores and asthma outcomes were described within a narrative synthesis. RESULTS Fourteen studies evaluating 14 different digital interventions were included in this review. The most commonly cited theories were Social Cognitive Theory, Health Belief Model, and Self-Efficacy Theory. A greater use of theory in the development of interventions was correlated with effective outcomes (r=.657; P=.01): only the 3 studies that met >60% of the different uses of theory assessed by the TCS were effective on all behavioral and clinical outcomes measured. None of the 11 studies that met ≤60% of the TCS criteria were fully effective; however, 3 interventions were partially effective (ie, the intervention had a significant impact on some, but not all, of the outcomes measured). Most studies lacked detail on the theoretical constructs and how they were applied to the development and application of the intervention. CONCLUSIONS These findings suggest that greater use of theory in the development and application of digital self-management interventions for asthma may increase their effectiveness. The application of theory alone may not be enough to yield a successful intervention, and other factors (eg, the context in which the intervention is used) should be considered. A systematic approach to the use of theory to guide the design, selection, and application of intervention techniques is needed.

scholarly journals Self-management interventions for people with severe mental illness: systematic review and meta-analysis

2019 ◽  
Vol 214 (5) ◽  
pp. 260-268 ◽  
Author(s):  
Melanie Lean ◽  
Miriam Fornells-Ambrojo ◽  
Alyssa Milton ◽  
Brynmor Lloyd-Evans ◽  
Bronwyn Harrison-Stewart ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Meta Analysis ◽  
Health Problems ◽  
Self Management ◽  
Management Interventions

BackgroundSelf-management is intended to empower individuals in their recovery by providing the skills and confidence they need to take active steps in recognising and managing their own health problems. Evidence supports such interventions in a range of long-term physical health conditions, but a recent systematic synthesis is not available for people with severe mental health problems.AimsTo evaluate the effectiveness of self-management interventions for adults with severe mental illness (SMI).MethodA systematic review of randomised controlled trials was conducted. A meta-analysis of symptomatic, relapse, recovery, functioning and quality of life outcomes was conducted, using RevMan.ResultsA total of 37 trials were included with 5790 participants. From the meta-analysis, self-management interventions conferred benefits in terms of reducing symptoms and length of admission, and improving functioning and quality of life both at the end of treatment and at follow-up. Overall the effect size was small to medium. The evidence for self-management interventions on readmissions was mixed. However, self-management did have a significant effect compared with control on subjective measures of recovery such as hope and empowerment at follow-up, and self-rated recovery and self-efficacy at both time points.ConclusionThere is evidence that the provision of self-management interventions alongside standard care improves outcomes for people with SMI. Self-management interventions should form part of the standard package of care provided to people with SMI and should be prioritised in guidelines: research on best methods of implementing such interventions in routine practice is needed.Declaration of interestsNone.

The Effects of Self-Management Interventions on the Health Outcomes of Individuals With Chronic Kidney Disease After Critical Illness: An Integrative Review

2019 ◽  
Vol 13 (3) ◽  
pp. 126-144
Author(s):  
Claudia Leung Ho Yau ◽  
Janita Chau Pak Chun
Keyword(s):  
Quality Of Life ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Health Outcomes ◽  
English Language ◽  
Well Being ◽  
Management Program ◽  
Self Management ◽  
Management Interventions

BackgroundSelf-management is a crucial step towards achieving better physical and mental well-being and a better health-related quality of life for individuals with chronic kidney disease (CKD). Despite the high prevalence of CKD and the significant burdens faced by the individuals with CKD, their caregivers, and healthcare systems, very few studies have explored CKD and its consequences compared to other chronic diseases.ObjectiveTo synthesize and present the best available evidence on the effectiveness of CKD self-management interventions in terms of the biomedical, psychosocial, and behavioral aspects of health outcomes.MethodsThree electronic English-language literature databases were searched from inceptions to March 2018. Two reviewers independently selected articles according to pre-specified criteria, critically appraised and extracted data from relevant research. Narrative summaries were presented because the interventions and study features of the included articles were heterogeneous.ResultsOf the five included articles, three were interventional and two were systematic reviews. Effective self-management interventions have beneficial effects on biomedical outcomes such as blood pressure, psychosocial outcomes such as quality of life and self-efficacy, and behavioral outcomes such as CKD knowledge, self-management techniques, and adherence to self-care regimens and treatments.ConclusionsA self-management program that could provide better education and guidance for individuals with CKD is needed, as this would improve the provision of resources and preparations for foreseeable and avoidable CKD complications. The findings from the included articles demonstrate that limited amount of research has focused on CKD management. Additional randomized controlled trials that compare interventions with usual care are needed to determine the efficacy of CKD self-management programs.

scholarly journals Malnutrition in Hospitalized Adults: A Systematic Review

2021 ◽  
Author(s):  
Stacey Uhl ◽  
Shazia Mehmood Siddique ◽  
Liam McKeever ◽  
Aaron Bloschichak ◽  
Kristen D’Anci ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Length Of Stay ◽  
Usual Care ◽  
Clinical Outcomes ◽  
Hospitalized Patients ◽  
Improve Quality ◽  
Inclusion Criteria ◽  
Strength Of Evidence ◽  
Measurement Tools

Objectives. To review the association between malnutrition and clinical outcomes among hospitalized patients, evaluate effectiveness of measurement tools for malnutrition on clinical outcomes, and assess effectiveness of hospital-initiated interventions for patients diagnosed with malnutrition. Data sources. We searched electronic databases (Embase®, MEDLINE®, PubMed®, and the Cochrane Library) from January 1, 2000, to June 3, 2021. We hand-searched reference lists of relevant studies and searched for unpublished studies in ClinicalTrials.gov. Review methods. Using predefined criteria and dual review, we selected (1) existing systematic reviews (SRs) to assess the association between malnutrition and clinical outcomes, (2) randomized and non-randomized studies to evaluate the effectiveness of malnutrition tools on clinical outcomes, and (3) randomized controlled trials (RCTs) to assess effectiveness of hospital-initiated treatments for malnutrition. Clinical outcomes of interest included mortality, length of stay, 30-day readmission, quality of life, functional status, activities of daily living, hospital acquired conditions, wound healing, and discharge disposition. When appropriate, we conducted meta-analysis to quantitatively summarize study findings; otherwise, data were narratively synthesized. When available, we used pooled estimates from existing SRs to determine the association between malnutrition and clinical outcomes, and assessed the strength of evidence. Results. Six existing SRs (including 43 unique studies) provided evidence on the association between malnutrition and clinical outcomes. Low to moderate strength of evidence (SOE) showed an association between malnutrition and increased hospital mortality and prolonged hospital length of stay. This association was observed across patients hospitalized for an acute medical event requiring intensive care unit care, heart failure, and cirrhosis. Literature searches found no studies that met inclusion criteria and assessed effectiveness of measurement tools. The primary reason studies did not meet inclusion criteria is because they lacked an appropriate control group. Moderate SOE from 11 RCTs found that hospital-initiated malnutrition interventions likely reduce mortality compared with usual care among hospitalized patients diagnosed with malnutrition. Low SOE indicated that hospital-initiated malnutrition interventions may also improve quality of life compared to usual care. Conclusions. Evidence shows an association between malnutrition and increased mortality and prolonged length of hospital stay among hospitalized patients identified as malnourished. However, the strength of this association varied depending on patient population and tool used to identify malnutrition. Evidence indicates malnutrition-focused hospital-initiated interventions likely reduce mortality and may improve quality of life compared to usual care among patients diagnosed with malnutrition. Research is needed to assess the clinical utility of measurement tools for malnutrition.

Exploring and Prioritization of Mobile-Based Self-Management Strategies for HIV Care

2019 ◽  
Vol 19 (3) ◽  
pp. 288-296
Author(s):  
Esmaeil Mehraeen ◽  
Reza Safdari ◽  
SeyedAhmad SeyedAlinaghi ◽  
Niloofar Mohammadzadeh
Keyword(s):  
Quality Of Life ◽  
Management Strategies ◽  
Healthcare Services ◽  
Point Of View ◽  
Hiv Care ◽  
Self Management ◽  
Second Phase ◽  
People Living With Hiv ◽  
Management Interventions

Background: Appropriate mobile-based self-management strategies can be as new approaches to decelerate the HIV infection progression and improve the quality of life. This study aims at (i) identifying in the literature mobile-based self-management strategies for HIV care and (ii) prioritizing those from the point of view of infectious diseases specialists. This study provides some clues to design useful mobile-based self-management tools for HIV patients, from the point of view of practitioners. Methods: This mixed methods study was done in two main phases. In the first phase, a review was conducted in: PubMed, Web of Science, Science Direct, Scopus, and Ovid. In this manner, related studies published between 2010 and 2017 and in the English language were reviewed. In the second phase, identified mobile-based self-management strategies were scored and prioritized by 23 participants. Frequency distribution and mean reports were calculated using SPSS statistical software. Results: By detailed reviewing of 24 related articles, the HIV mobile-based self-management strategies were identified in 47 categories and subcategories. According to the findings, "enhance the quality of life" was the main self-management strategy addressed by reviewed studies. However, "antiretroviral therapy and medication adherence" was reported at a higher rate to be a more helpful strategy than "enhance the quality of life". Conclusion: In this study, helpful HIV mobile-based self-management strategies were identified that can be used to guide self-management interventions which have the potential to improve the healthcare services for people living with HIV.

scholarly journals Fatigue predicts future reduced social participation, not reduced physical function or quality of life in people with systemic sclerosis

2020 ◽  
pp. 239719832096538
Author(s):  
Susan L Murphy ◽  
Daniel Whibley ◽  
Anna L Kratz ◽  
Janet L Poole ◽  
Dinesh Khanna
Keyword(s):  
Quality Of Life ◽  
Systemic Sclerosis ◽  
Physical Function ◽  
Social Participation ◽  
Self Efficacy ◽  
Self Management ◽  
Management Intervention ◽  
Management Interventions ◽  
Fatigue Severity

Objective: Although fatigue is one of the most problematic symptoms for people with systemic sclerosis, little is known about how fatigue impacts daily life over time. Such information is important when developing fatigue management interventions. This study was conducted to examine (1) if fatigue severity predicted outcomes of worse functioning (social participation, physical function), and quality of life and (2) if level of self-efficacy moderated significant relationships between fatigue and these outcomes. Methods: Data were utilized from a clinical trial in which an online self-management intervention was tested (N = 267). Fatigue, social participation, and physical function were assessed by PROMIS measures. Quality of life was assessed by the EuroQol 5-domain instrument. Linear regressions were performed to examine how baseline fatigue related to functioning and quality of life outcomes 16 weeks later controlling for relevant covariates. PROMIS measures were used to measure self-efficacy in managing symptoms, daily activities, medications and treatments, emotions, and social interactions. Results: Fatigue at baseline significantly predicted social participation 16 weeks later, but did not predict physical functioning or quality of life. Self-efficacy variables did not moderate the association between fatigue and social participation. Conclusion: Fatigue severity predicted decreased social participation in people with systemic sclerosis. Interventions targeting fatigue should include support to maintain participation of social roles and activities. The level of reported self-efficacy did not vary the strength of the association between fatigue and decline in social participation indicating that there may be other targets to treat fatigue intervention beyond self-management.

scholarly journals Development and evaluation of an eHealth self-management intervention for patients with chronic kidney disease in China: protocol for a mixed-method hybrid type 2 trial

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Hongxia Shen ◽  
Rianne van der Kleij ◽  
Paul J. M. van der Boog ◽  
Xiaoyue Song ◽  
Wenjiao Wang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mixed Method ◽  
Self Management ◽  
Evidence Based ◽  
Management Intervention ◽  
Management Interventions ◽  
Improve Health Status ◽  
Improve Health

Abstract Background Chronic kidney disease (CKD) is a significant public health concern. In patients with CKD, interventions that support disease self-management have shown to improve health status and quality of life. At the moment, the use of electronic health (eHealth) technology in self-management interventions is becoming more and more popular. Evidence suggests that eHealth-based self-management interventions can improve health-related outcomes of patients with CKD. However, knowledge of the implementation and effectiveness of such interventions in general, and in China in specific, is still limited. This study protocol aims to develop and tailor the evidence-based Dutch ‘Medical Dashboard’ eHealth self-management intervention for patients suffering from CKD in China and evaluate its implementation process and effectiveness. Methods To develop and tailor a Medical Dashboard intervention for the Chinese context, we will use an Intervention Mapping (IM) approach. A literature review and mixed-method study will first be conducted to examine the needs, beliefs, perceptions of patients with CKD and care providers towards disease (self-management) and eHealth (self-management) interventions (IM step 1). Based on the results of step 1, we will specify outcomes, performance objectives, and determinants, select theory-based methods and practical strategies. Knowledge obtained from prior results and insights from stakeholders will be combined to tailor the core interventions components of the ‘Medical Dashboard’ self-management intervention to the Chinese context (IM step 2–5). Then, an intervention and implementation plan will be developed. Finally, a 9-month hybrid type 2 trial design will be employed to investigate the effectiveness of the intervention using a cluster randomized controlled trial with two parallel arms, and the implementation integrity (fidelity) and determinants of implementation (IM step 6). Discussion Our study will result in the delivery of a culturally tailored, standardized eHealth self-management intervention for patients with CKD in China, which has the potential to optimize patients’ self-management skills and improve health status and quality of life. Moreover, it will inform future research on the tailoring and translation of evidence-based eHealth self-management interventions in various contexts. Trial registration Clinicaltrials.gov NCT04212923; Registered December 30, 2019.

scholarly journals A systematic review of the effectiveness of self-management interventions in people with multiple sclerosis at improving depression, anxiety and quality of life

PLoS ONE ◽  
2017 ◽  
Vol 12 (10) ◽  
pp. e0185931 ◽  
Author(s):  
Tara Kidd ◽  
Nicola Carey ◽  
Freda Mold ◽  
Sue Westwood ◽  
Maria Miklaucich ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Systematic Review ◽  
Self Management ◽  
Management Interventions
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