Self-management Activities Research Articles

Psychological flexibility, cognitive emotion regulation and mental health outcomes among patients with asthma in Pakistan.

Adults with asthma who experience difficulties in emotion regulation are prone to developing psychopathological symptoms that may affect their self-management activities and symptom control. The current research investigated the role of psychological flexibility and cognitive emotion regulation strategies in relation to mental health outcomes (psychological distress and quality of life) among patients with asthma in Pakistan. A sample of 200 adults, diagnosed with asthma (32% men, 68% women; Mage = 42.32, SDage = 16.99), completed the acceptance and action questionnaire (AAQ-II) cognitive emotion regulation questionnaire (CERQ), depression, anxiety, stress scale-21 (DASS-21), asthma-related quality of life questionnaire (AQLQ) and a self-structured demographic sheet. Results of Pearson product moment correlation showed that most of the adaptive cognitive emotion regulation strategies (positive refocusing, refocus on planning, and positive reappraisal) were positively correlated with psychological flexibility and quality of life, whereas negatively correlated with psychological distress. All the maladaptive strategies of cognitive emotion regulation had a significant inverse relationship with psychological flexibility and quality of life, while positively correlated with psychological distress. Results of serial mediation analysis through PROCESS MACRO showed that catastrophising and anxiety fully mediated the relationship between psychological flexibility and asthma-related quality of life. Evidence-based interventions should focus on developing psychological flexibility and identifying maladaptive patterns of cognitive emotion regulation strategies for improved mental health and quality of life outcomes for adults with asthma.

Barriers to Diabetes Self-Management in Grenada During the Covid-19 Pandemic: A Qualitative Study

During the COVID-19 lockdown, several countries implemented restrictions that affected how persons with diabetes managed their condition. While several studies exploring diabetes self-management during the pandemic was conducted, none was done in Grenada or the Caribbean region. Therefore, the aim of this study was to identify the barriers to diabetes self-management during the COVID-19 lockdown in Grenada. The study was a descriptive qualitative study with a phenomenological approach. Semi-structured interviews were conducted with 13 participants with type 2 diabetes in Grenada over two months. Two overarching themes emerged, reflecting external and internal barriers to diabetes self-management activities. The results indicated that these personal and environmental barriers significantly affected adherence across the five self-management behaviors. The findings may be used to develop a multidisciplinary approach to improve self-management skills and attitudes and promote appropriate diabetes disaster planning for a future pandemic. Addressing those barriers to diabetes self-management will improve health outcomes and quality of life.

DIMAS (Diabetes Management Support) Application: Mobile-Phone Based Intervention to Support Diabetes Self-Management Activities

Introduction: The self-management process in Diabetes Mellitus (DM) is essential to improve glycemic control. Currently, COVID-19 leading to a significant limitation in services and accessibility, especially regular support for diabetes patients. The utilization of DIMAS Mobile App is expected to be a support system to overcome these problems. This application has three menus such as health education containing information about diabetes, nutrition, medication, exercise, stress management, and foot care; self-care monitoring containing medication reminders, blood sugar and exercise records; and consultation with nurses. This study aimed to determine the effect of DIMAS (Diabetes Management Support) application on Diabetes Self-Management activities. Methods: Using an experimental study with One Group Pre-Posttest Design, the self-management activities were measured among 24 respondents after four weeks of intervention. The intervention was carried out with the DIMAS app and WhatsApp communication. Using the Summary of Diabetes Self-Care Activity (SDSCA) questionnaire, the data were analysed with one paired sample t-test using SPSS 22. Results: Statistically significant changes were observed between pre and post-intervention measures: DSM activities with SDSCA (p=0,000) and the level of knowledge (p=0,000). The results showed that the biggest change in self-care activity was foot care and exercise with the increase of scoring was 2.4 and 0.8 respectively. Respondents stated that the application was useful for reminding them to take medication and communicating with nurses. Conclusion: The application makes it easier for patients to keep connected with nurses despite being constrained by distance and provides practical benefits in nursing services at home.

Barriers and facilitators of self-management behaviors among patients with chronic obstructive pulmonary disease and chronic comorbidities: A mixed-methods investigation.

We investigated how individuals with chronic obstructive pulmonary disease (COPD) and multi-morbidity (MM) navigate barriers and facilitators to their health management. We conducted a mixed-methods study using semi-structured interviews and survey assessments of adults with COPD, hypertension, and/or diabetes. We recruited 18 participants with an average age of 65, with 39% being male, 50% Black, and 22% Hispanic/Latino/a. Five investigators used an iterative, hybrid-coding process combining a priori and emergent codes to analyze transcripts and compare quantitative and qualitative data for themes. Participants reported a generalized approach to their health rather than managing MMs separately. Individuals with good or mixed adherence found daily routines facilitated regular medication use, while those with poor adherence experienced complex prescriptions and life stressors as barriers. Walking was viewed as beneficial but challenging due to limited mobility. Most participants viewed diet as important to their MMs, but only two reported high diet quality and many held inaccurate beliefs about healthy diet choices. Participants with MM were highly motivated to engage in self-management activities, but some individuals experienced barriers to maintaining them. Emphasizing an individualized clinical approach to assessing and solving patient barriers may improve self-management outcomes in this complex population.

Emotional Intelligence: Practices to Manage and Develop It

Emotional intelligence (EI) describes the ability to recognize, understand, and manage emotions, both in oneself and in others. It has strongly emerged as a game changer, playing crucial roles in various aspects of human development, including interpersonal relationships, academic and professional success, and overall well-being. Despite the unprecedented impact of emotional intelligence in human development, happiness and survival, it seems to have been given inadequate attention or ignored entirely by some people. Worse still, in some professional curricula, little or no attention has been given to it. This research paper explores the significance of emotional intelligence and presents strategies for enhancing emotional intelligence through strengthening self-management, self-awareness, relationship management and social awareness activities.

Improving disease management of patients with inflammatory bowel disease: the potential role of self-concordant health goals.

Inflammatory bowel diseases (IBD) are chronic gastrointestinal conditions that significantly impact patients' quality of life. Previous research indicates that patients with IBD have a higher prevalence of anxiety compared to the general population and other chronic diseases. This pilot study aimed to investigate the relationships between goal integration, positive and negative emotions, goal self-efficacy, and trait anxiety as the outcome variable, focusing on patients' self-management strategies. Drawing from the Self-Concordance Model (SCM) of Self-Determination Theory (SDT), the study explored how goal integration is associated with more fulfilling and enjoyable experiences and fewer negative emotions, ultimately improving psychological well-being. Health-related goals were evaluated using the Personal Project Analysis technique, while the State-Trait Anxiety Inventory was utilized to measure general anxiety levels. Among the 141 participants with inflammatory bowel disease, 96 reported having health-related goals. Of these, 66 were female (68.75%), and 30 were male participants (31.25%). Path analysis revealed a moderate negative association between self-concordance (SC) and negative emotions, which, in turn, predicted higher levels of trait anxiety. Furthermore, the alternative model tested indicated that trait anxiety predicted a lower level of self-concordance. Setting well-integrated health goals involves an internal capacity, enabling patients to experience less negative emotions during self-management activities. Anxiety can hinder individuals from accessing their inner needs, resulting in less self-concordant aspirations and more negative emotions. These findings may contribute to developing prevention and intervention programs to enhance IBD patients' adherence to lifestyle changes, ultimately improving their overall well-being.

중학생의 스포츠활동 참여 재미요인과 자기관리 및 건강성의 구조적 관계

This study was conducted with the purpose of establishing a foothold for lifelong sports by encouraging middle school students to participate in sports activities continuously by identifying the structural relationship between the fun factor of sports activity participation and self-management and health of middle school students. To achieve the purpose of this study, frequency analysis, reliability analysis, exploratory factor analysis, confirmatory factor analysis, and correlation analysis were conducted using SPSS 18.0 for Windows and AMOS 18.0. Through this, the causal relationship between the factors was identified. The results of the above research method and research model verification are as follows. First, it was found that the enjoyment of middle school students' participation in sports activities had an effect on self-management. Second, self-management was found to have an effect on health. Third, the enjoyment was found to have an effect on health. Fourth, in the relationship between the enjoyment and health, self-management was found to mediate. Therefore, in order to improve the overall health of middle school students, various teaching methods should be sought to improve the fun factor of participation in sports activities and self-management.

ANALYSIS OF FACTORS AFFECTING SELF MANAGEMENT IN TYPE 2 DIABETES MELLITUS PATIENTS

Background: Diabetes mellitus type 2 is a common problem that occurs in people who have metabolic disorders characterized by increased blood sugar due to decreased secretion by pancreatic beta cells or impaired insulin function. Objectives: This study aims to determine what factors are associated with self-management in Type 2 DM patients at the Buduran Health Center.Design: This study was a quantitative research. The design in this study was a cross-sectional analytic with a sample of 80 people who were carried out at the endocrine polyclinic Puskesmas Buduran Sidoarjo. Research instrument used the Diabetes Self-Management Questionnaire (DSMQ) developed by Schmitt et al (2013) to determine the self-management of type 2 DM patients and to measure the level of knowledge using the Diabetes Knoeledge Test (DKT) instrument developed by Burrough et al (2008), measure to physical activity using the Summary of Diabetes Self Care Activities (SDSCA), measure to family support using Family Support Questionairre, and measure to self efficacy using Diabetes management Self Efficacy Scale (DMSES). The sample siza with simple random sampling method, and data analysis using spearman rank test. Results: The results showed that there was a significant relationship between the level of knowledge and self-management with a coefficient value (r=0.576), a significant relationship between activity ability and self-management with a coefficient value (r=0.612), a significant relationship between family support and self-management with a value of coefficient (r=0.592) and there is a significant relationship between self-efficacy and self-management with a coefficient value (r=0.660). Conclusion: Patients DM Type 2 can be overcome by providing education in every prolanis activity program which is expected to increase knowledge, activity abilities, family support and self-efficacy, so that patients are able to improve self-management well. This intervention is highly recommended for people with Type 2 DM by increasing the frequency of health education and involving the family of diabetes mellitus patients so that patients are able to carry out self-management well.

Effects of Messaging Framing on the Self-Management Activities and Self-Efficacies of Patients with Type 2 Diabetes Mellitus.

Message framing is a low-cost and effective intervention method to improve diabetics' health behaviors. The study aimed to investigate the impacts of positive and negative message framing interventions on the self-management activities and self-efficacy of patients with type 2 diabetes mellitus (T2DM). Overall, 102 T2DM patients from Jinhua People's Hospital of China were recruited and divided into three groups: positive and negative message framing intervention groups and a control group. A 12-week experiment was implemented on the first two groups. Then, the differences of the patients' self-management activities and self-efficacies were analyzed between the experimental and control groups. Finally, the mediating effect of self-efficacy between two types of message framing interventions and patients' self-management activities was investigated. Both positive and negative message framing interventions could significantly improve the T2DM patients' self-management activities in diet, blood glucose testing, foot care, and medication taking (P<0.05), meanwhile significantly improving their self-efficacies along the nutrition, physical exercise and weight, medical treatment, blood sugar, and feet check (P<0.05). Results of the difference analysis for both within-group and inter-group showed that, compared with the positive messaging framing intervention, the negative one had more significant effects on enhancing the patients' self-management activities and self-efficacy. Self-efficacy had only a mediating effect between negative messaging framing intervention and self-management activities (β = 0.94, 95% CI: 0.0934 - 0.456). Negative messaging framing intervention could better enrich T2DM patients' diabetes knowledge through offering threatening information, thereby enhancing their self-efficacies, and ultimately improve their self-management activities.

A randomized controlled trial for evaluating an occupational therapy self management intervention in adults with type 2 diabetes

This study evaluated the efficacy of the Occupational Therapy Diabetes Self-Management intervention (OTDSM) to enhance glycemic stability and self-management skills in people with diabetes type-2. Based on this single-blind randomized trial, 30 subjects with diabetes type-2 were assigned to two groups of intervention and control. The intervention group received a 10-week program, consisting of four group visits and six individualized sessions. The control group received an individual session and three weekly phone calls. The primary study outcome, blood hemoglobin A1C, was measured before and three months after the study. The secondary outcome was assessed in terms of the participants’ self-management behaviors, self-efficacy, diabetes distress, depressive symptoms, and performance and satisfaction with daily activities. These outcomes were evaluated three times: before, one month into, and three months after the study. The study findings demonstrated significant differences between the two groups in the hemoglobin A1C levels, self-management behaviors, self-efficacy, and performance and satisfaction with daily routines after the intervention (P < 0.05). No significant differences existed between the groups for the extent of diabetes distress and depressive symptoms. Inclusion of occupational therapy protocol into the plan of care for people with diabetes can improve health outcomes by promoting their routine participation in self-management activities.

Impact of COVID-19 on Disease Self-management Among Patients With Advanced CKD: A Qualitative Study

Patients with advanced chronic kidney disease (CKD) and their care partners experienced decreased access to care, and worse physical and emotional health during the Coronavirus Disease-19 (COVID-19) pandemic. Few studies have explored how COVID-19-related challenges affected disease self-management among those with advanced chronic kidney disease (CKD) and their care partners. Leventhal's self-regulation model offers a comprehensive framework for understanding disease self-management through the interplay of cognitive beliefs, emotional reactions and social influences. The study aims to examine the impact of COVID-19 on self-management activities among patients with CKD and care partners. Qualitative study. Adults with advanced CKD, including dialysis and transplant recipients, and their carepartners. Thematic Analysis. Among 42 participants, 12 had stage 4 CKD, 5 had stage 5 CKD, 6 were receiving in-center hemodialysis, 5 had a kidney transplant, and 14 were care partners. We identified 4 patient-related themes with corresponding subthemes related to the impact of COVID-19 on self-management: 1) cognitive understanding that COVID-19 is an additional health threat to existing kidney disease, 2) heightened anxiety and vulnerability driven by perceived risk, 3) coping with isolation through virtual interactions with healthcare services and social circles, 4) increased protective behaviors to maximize survival. Three care partner-related themes emerged: 1) hypervigilance in family care and protection, 2) interaction with health system and adaptations to self-management, and 3) increased intensity in caregiving role to facilitate patient self-management. The qualitative study design limits the ability to generate generalizable data. Grouping patients with Stage 3 and 4 CKD, in-center hemodialysis, and kidney transplants together limited our ability to examine self-management challenges specific to each treatment requirement. When faced with the COVID-19 pandemic, patients with CKD and their care partners experienced heightened vulnerability and thus increased cautionary activities to maximize survival. Our study provides the groundwork for future interventions to help patients and care partners live with kidney disease during future crises.

Living with type 1 diabetes in Neno, Malawi: a qualitative study of self-management and experiences in care

BackgroundThe prevalence of type 1 diabetes (T1D) is increasing in low-income countries including Malawi. In this setting, care is frequently impacted by challenges in diagnosis and management. Access to high-quality T1D care remains limited in Malawi, with fairly low availability and high cost of insulin and other supplies and diagnostics, lack of T1D knowledge, and absence of readily accessible guidelines. In the Neno district, Partners In Health established advanced care clinics at district hospitals to provide comprehensive, free care for T1D and other noncommunicable diseases. Prior to this study, experiences in care for people living with T1D (PLWT1D) at these clinics remained unexplored. Here we examine the impact of living with T1D, knowledge and self-management of, and facilitators and barriers to T1D care in Neno District, Malawi.MethodsWe conducted a qualitative study utilizing behavior change theory that consisted of twenty-three semi-structured interviews conducted in Neno, Malawi in January 2021 with PLWT1D, their families, providers, and civil society members to explore the psychosocial and economic impact of living with T1D, T1D knowledge and self-management, and facilitators and barriers to accessing care. Interviews were analyzed thematically using a deductive approach.ResultsWe found that PLWT1D had good knowledge and practice of self-management activities for T1D. Key facilitators to care identified by informants included extensive patient education and availability and provision of free insulin and supplies. Significant barriers included distance from health facilities, food insecurity, and low literacy/numeracy. Informants described T1D as having a notable psychosocial and economic impact on PWLT1D and their families, notably worrying about having a lifelong condition, high transportation costs, and reduced working ability. While home visits and transport refunds helped facilitate access to the clinic, informants reported the refunds as inadequate given high transport costs faced by patients.ConclusionsT1D was found to have a significant impact on PLWT1D and their families. Our findings represent important areas of consideration in design and implementation of effective programs for treating PLWT1D in resource-limited settings. Facilitators to care identified by informants may be applicable and beneficial in similar settings, while persisting barriers represent areas for continued improvement in Neno.

Web-based Acceptance and Commitment Therapy (ACT) for adults with type 1 diabetes: A single case experimental design (SCED)

A randomised multiple-baseline single case experimental design (SCED) was used to examine feasibility, acceptability, and preliminary effectiveness of an online Acceptance and Commitment Therapy (ACT) intervention for adults with Type 1 diabetes (T1D). Consenting participants reporting diabetes-specific distress (n = 25) were randomised to baseline length (1–3 weeks) before completing a six-week online ACT intervention, followed by one-month follow-up (FU). The primary outcome assessed generic and diabetes-specific well-being, measured at pre, post, and FU using the Well-Being Questionnaire. Secondary outcomes were: diabetes-dependent quality of life (Audit of Diabetes-Dependent Quality of Life at pre, post, FU); mood and anxiety measured daily using visual analogue scales (VAS); diabetes self-management (daily self-management activities VAS, and pre, post, FU measurements using the Diabetes Self-Management Questionnaire); glycaemic control (information from continuous glucose monitoring devices and daily self-monitoring of blood glucose); and psychological flexibility (Multidimensional Psychological Flexibility Inventory at pre, post, FU). Nine participants completed all phases of the study, rating the intervention as highly acceptable. Most participants showed clinically significant improvements in generic well-being (n = 5) and diabetes-specific well-being (n = 7) at follow-up. Diabetes-dependent QoL reliably improved at follow-up for three participants. Improvements in mood (n = 7) and anxiety (n = 6) were observed across phase comparisons. Most participants reported a significant increase in physical activity (n = 5) across phases. A positive trend of increased time in blood glucose range from baseline to intervention was observed for four participants. Psychological flexibility significantly increased from baseline to follow-up for seven participants. Interpretation of the findings was considered in the context of limitations including high rates of attrition (55%).

Introducing Australia's clinical care standard for low back pain.

Introducing Australia's clinical care standard for low back pain.

Self-Management of Diabetes and Associated Factors among Patients Seeking Chronic Care in Tshwane, South Africa: A Facility-Based Study.

The burden of diabetes continues to increase in South Africa and a significant number of diabetes patients present at public primary healthcare facilities with uncontrolled glucose. We conducted a facility-based cross-sectional study to determine the diabetes self-management practices and associated factors among out-patients in Tshwane, South Africa. An adapted validated questionnaire was used to collect data on sociodemography, diabetes knowledge, and summaries of diabetes self-management activities measured in the previous seven days, and over the last eight weeks. Data were analysed using STATA 17. A final sample of 402 diabetes out-patients was obtained (mean age: 43 ± 12 years) and over half of them were living in poor households. The mean total diabetes self-management of score was 41.5 ± 8.2, with a range of 21 to 71. Almost two thirds of patients had average self-management of diabetes, and 55% had average diabetes knowledge. Twenty-two percent of patients had uncontrolled glucose, hypertension (24%) was the common comorbidity, and diabetic neuropathy (22%) was the most common complication. Sex [male: AOR = 0.55, 95% CI: 0.34-0.90], race [Coloured: AOR = 2.84, 95% CI: 1.69-4.77 and White: AOR = 3.84, 95% CI: 1.46-10.1], marital status [divorced: AOR = 3.41, 95% CI: 1.13-10.29], social support [average: AOR = 2.51, 95% CI: 1.05-6.00 and good: AOR = 4.49, 95% CI: 1.61-7.57], body mass index [obesity: AOR = 0.31, 95% CI: 0.10-0.95], diabetes knowledge [average: AOR = 0.58, 95% CI: 0.33-0.10 and good: AOR = 1.86, 95% CI: 0.71-4.91], and uncontrolled glucose [AOR = 2.97, 95% CI: 1.47-5.98] were factors independently predictive of diabetes self-management. This study emphasizes that the self-management of diabetes was mostly on average among patients and was associated with the aforementioned factors. Innovative approaches are perhaps needed to make diabetes education more effective. Face-to-face sessions delivered generally during clinic visits should be better tailored to the individual circumstances of diabetes patients. Considerations should be given to the options of leveraging information technology to ensure the continuity of diabetes education beyond clinic visits. Additional effort is also needed to meet the self-care needs of all patients.

Elizabeth Usher memorial lecture: Beyond our practice borders—using a biopsychosocial framework to improve long-term outcomes for people living with aphasia

Purpose: Over 140 000 Australians live with aphasia after stroke, with this number of people living with aphasia increasing significantly when aphasia arising from traumatic brain injury, neoplasm, and infectious and progressive neurological diseases is also included. The resulting communication disability frequently compromises every aspect of daily life, significantly impacting everyday activity, employment, social participation, mental health, identity, and family functioning. Rehabilitation services rarely meet the needs of this group who have, for example, poorer healthcare outcomes than stroke peers without aphasia, nor address long-term recovery and support needs. Method: In this discussion paper, I argue that given the broad impacts of aphasia, a biopsychosocial approach to aphasia rehabilitation is required. Rehabilitation must include: interventions to improve the communication environment; programs that directly target identity, wellbeing, and mental health; and therapies focusing on functional activity, communication participation, and long-term self-management. Result: The evidence for these approaches is mounting and includes strongly stated consumer needs. I discuss the need for multidisciplinary involvement and argue that for speech-language pathologists to achieve such comprehensive service provision, an expanded scope of practice is required. Conclusion: There is a need to rethink standard therapy approaches, timeframes, and funding mechanisms. It is time to reflect on our practice borders to ask what must change and define how change can be achieved.

The effect of a novel, digital physical activity and emotional well-being intervention on health-related quality of life in people with chronic kidney disease: trial design and baseline data from a multicentre prospective, wait-list randomised controlled trial (kidney BEAM)

BackgroundPhysical activity and emotional self-management has the potential to enhance health-related quality of life (HRQoL), but few people with chronic kidney disease (CKD) have access to resources and support. The Kidney BEAM trial aims to evaluate whether an evidence-based physical activity and emotional wellbeing self-management programme (Kidney BEAM) leads to improvements in HRQoL in people with CKD.MethodsThis was a prospective, multicentre, randomised waitlist-controlled trial, with health economic analysis and nested qualitative studies. In total, three hundred and four adults with established CKD were recruited from 11 UK kidney units. Participants were randomly assigned to the intervention (Kidney BEAM) or a wait list control group (1:1). The primary outcome was the between-group difference in Kidney Disease Quality of Life (KDQoL) mental component summary score (MCS) at 12 weeks. Secondary outcomes included the KDQoL physical component summary score, kidney-specific scores, fatigue, life participation, depression and anxiety, physical function, clinical chemistry, healthcare utilisation and harms. All outcomes were measured at baseline and 12 weeks, with long-term HRQoL and adherence also collected at six months follow-up. A nested qualitative study explored experience and impact of using Kidney BEAM.Results340 participants were randomised to Kidney BEAM (n = 173) and waiting list (n = 167) groups. There were 96 (55%) and 89 (53%) males in the intervention and waiting list groups respectively, and the mean (SD) age was 53 (14) years in both groups. Ethnicity, body mass, CKD stage, and history of diabetes and hypertension were comparable across groups. The mean (SD) of the MCS was similar in both groups, 44.7 (10.8) and 45.9 (10.6) in the intervention and waiting list groups respectively.ConclusionResults from this trial will establish whether the Kidney BEAM self management programme is a cost-effective method of enhancing mental and physical wellbeing of people with CKD.Trial RegistrationNCT04872933. Registered 5th May 2021.

Демократизация управления персоналом как фактор развития творческой активности работников

The basic approaches of analysis are identified, generalized definitions are developed, and the essence of the personnel management democratization process is clarified. Based on the authors' interviews of 12 expert managers (2022) the relationship between the democratization process of personnel management and the development of creative activity of employees is revealed. It is proved that democratization of management of the personnel is a process of introduction of democratic principles and norms in a control system of the personnel, formation of innovative culture, transfer of a part of traditional functions of management to direct structural divisions, social and labor groups, separate workers of organization. The authors propose to differentiate the objectives of democratization of management processes at the level of individual structural subdivisions, social professional groups of the organization: 1) implementation of the process of transferring management functions in relation to the set tactical work tasks; 2) ensuring relative social justice, optimization of professional adaptability; 3) motivation of rationalization proposals and innovative implementations; 4) formation of the mechanism of partnership interaction on the problems of creative innovations and rationalization proposals; 5) target design of educational, scientific, innovative self-management activities of professional teams. It was proved that management design of innovative organizational culture reflects not only the process of planned, purposeful formation of innovative values, norms, traditions and principles of both the organization as a whole and individual social professional groups, but also the achievement of democratic management transformation, regulation and resolution of labor conflicts, labor adaptation of organization members. In conditions of growing uncertainty of external and internal environment, managerial democracy should have specific manifestations in individual units and professional groups of the organisation.

A REVIEW OF EVIDENCE ON THE EFFECTIVENESS OF MOBILE HEALTH APPLICATIONS IN IMPROVING THE CLINICAL OUTCOMES AND SUPPORTING THE SELF-MANAGEMENT OF PATIENTS WITH TYPE 2 DIABETES MELLITUS

Various mobile health application for monitoring of diabetes outcomes and supporting the self-management is available in the market. However, the effectiveness of it is still unclear. This systematic literature review was conducted to determine the effectiveness of mobile health application compared to the conventional methods in managing blood glucose level, body weight, and self-management activities among patients with Type 2 Diabetes Mellitus. A literature search on relevant online databases was performed to identify the randomised controlled trials studies (RCTs) that evaluated the effectiveness of the mobile health application. The relevant studies were identified and appraised according to the review protocol from Joanna Briggs Institute. Six randomised controlled trial studies has been identified and included in the review. In this review, a total of 843 participants were enrolled, mean age of 53.9 years old and all of them were diagnosed with T2DM. All the studies are methodologically good however limitation was identified in their concealment technique. All the included studies reported on the improvement in the glucose control, decreased in body mass index (BMI) and improvement in the adherence to the self-management activities. Mobile health application is effective in improving the glucose control (HbA1c), BMI and self-management activities of patients with type 2 diabetes. It could be suggested that mobile health application is worth to be considered as a method in monitoring and supporting patients with T2DM, particularly in this pandemic situation.

“Sometimes Our Mob Don’t Really Take It Serious Until It’s Serious”: The Experiences of Western Australian Aboriginal Adolescents Living With Type 2 Diabetes, Their Parents, and Their Family Members

ObjectivesIn Australia, Aboriginal children experience disproportionate rates of type 2 diabetes (T2D) compared with non-Aboriginal children. The aim of this qualitative study was to explore the experiences of Aboriginal adolescents with T2D and their family members to better understand the influences of T2D on self-management, with findings used to inform an enhanced service model of care. MethodsSemistructured interviews were conducted with purposively selected Western Australian Aboriginal adolescents with T2D and their parents and guardians. Interviews were transcribed verbatim and analyzed with NVivo software using interpretative thematic analysis; overarching themes were generated. ResultsInterviews with 24 participants, including 8 adolescents aged 11 to 16 years, were conducted across 4 regions of Western Australia. A high proportion of these adolescents were diagnosed with T2D during an unrelated hospitalization or medical appointment. Most did not fully understand or were unaware of the long-term impact of T2D. Discussions about diabetes within families did not typically occur, and shame and concealment of the diagnosis was a common finding. The parents of the adolescents described the diagnosis of T2D as compounding an already challenging set of circumstances for the family; this impacted their capacity to promote self-management activities and attend hospital and outpatient appointments. ConclusionsThis study privileges the voices of Aboriginal adolescents and family members and offers insight into their personal narrative of living with T2D. Building family and community capacity to normalize preventive activities and manage T2D postdiagnosis is recommended to improve health outcomes.