Self-management Of Chronic Conditions Research Articles

Integrating Smartphone Sensor Technology to Enhance Fine Motor and Working Memory Skills in Pediatric Obesity: A Gamified Approach

Childhood obesity remains a pervasive global challenge, often accompanied by deficits in working memory and fine motor skills among affected children. These deficits detrimentally impact academic performance. Despite limited evidence, home-based interventions targeting both fine motor skills and working memory remain underexplored. Leveraging game-based approaches holds promise in behavior modification, self-management of chronic conditions, therapy adherence, and patient monitoring. In this study, a novel smartphone-based game was meticulously developed to target the enhancement of working memory and fine motor skills in a cohort of thirty-two obese or overweight children. Over two weeks, participants engaged in regular gameplay sessions within the comfort of their homes. Pretest and post-test assessments yielded compelling evidence of significant improvements, with statistical significance established at a robust 95% confidence level. Notably, participants exhibited a progressive trend of improvement in their gameplay performance. Recognizing the profound impact of academic achievement on future socioeconomic trajectories, regardless of weight management outcomes, the importance of bolstering cognitive skills cannot be overstated. This innovative intervention offers a pragmatic and cost-effective solution to empower children to cultivate essential cognitive abilities within their home environment. By fostering the development of working memory and fine motor skills, this intervention holds promise in facilitating improved academic performance and, consequently, enhancing long-term prospects for these children.

Implementation of a virtual community of practice to promote the empowerment of middle-aged people with multimorbidity: study protocol of a randomised controlled trial

IntroductionEmpowering people living with multimorbidity (multiple chronic conditions) to gain greater confidence in managing their health can enhance their quality of life. Education focused on self-management is a key tool...

An Umbrella Review of Self-Management Interventions for Health Conditions With Symptom Overlap With Traumatic Brain Injury.

To synthesize evidence for the effectiveness of self-management interventions for chronic health conditions that have symptom overlap with traumatic brain injury (TBI) in order to extract recommendations for self-management intervention in persons with TBI. An umbrella review of existing systematic reviews and/or meta-analyses of randomized controlled trials or nonrandomized studies targeting self-management of chronic conditions and specific outcomes relevant to persons with TBI. A comprehensive literature search of 5 databases was conducted using PRISMA guidelines. Two independent reviewers conducted screening and data extraction using the Covidence web-based review platform. Quality assessment was conducted using criteria adapted from the Assessing the Methodological Quality of Systematic Reviews-2 (AMSTAR-2). A total of 26 reviews met the inclusion criteria, covering a range of chronic conditions and a range of outcomes. Seven reviews were of moderate or high quality and focused on self-management in persons with stroke, chronic pain, and psychiatric disorders with psychotic features. Self-management interventions were found to have positive effects on quality of life, self-efficacy, hope, reduction of disability, pain, relapse and rehospitalization rates, psychiatric symptoms, and occupational and social functioning. Findings are encouraging with regard to the effectiveness of self-management interventions in patients with symptoms similar to those of TBI. However, reviews did not address adaptation of self-management interventions for those with cognitive deficits or for populations with greater vulnerabilities, such as low education and older adults. Adaptations for TBI and its intersection with these special groups may be needed.

The role of mobile health applications in improving patient engagement and health outcomes: A critical review

Mobile health applications (apps) have revolutionized healthcare delivery by enhancing patient engagement and improving health outcomes. This critical review examines the role of mobile health apps in improving patient engagement and health outcomes. The review discusses the benefits of mobile health apps in empowering patients to manage their health, facilitating communication between patients and healthcare providers, and promoting healthy behaviors. Mobile health apps have transformed the way patients engage with their healthcare by providing them with convenient access to health information and resources. These apps enable patients to track their health metrics, such as physical activity, diet, and medication adherence, allowing for better self-management of chronic conditions. By empowering patients to take control of their health, mobile health apps can lead to improved health outcomes and reduced healthcare costs. Furthermore, mobile health apps facilitate communication between patients and healthcare providers, enabling remote monitoring and virtual consultations. This improved communication can lead to more timely interventions and better coordination of care, ultimately improving patient outcomes. Mobile health apps also promote healthy behaviors by providing patients with personalized recommendations and reminders to engage in preventive care activities. Despite their potential benefits, mobile health apps also face challenges, such as ensuring data privacy and security, and addressing disparities in access to technology. Future research should focus on evaluating the effectiveness of mobile health apps in improving patient engagement and health outcomes, and on developing strategies to overcome these challenges. In conclusion, mobile health apps have the potential to significantly improve patient engagement and health outcomes. By empowering patients to manage their health, facilitating communication with healthcare providers, and promoting healthy behaviors, mobile health apps are transforming healthcare delivery and improving patient care.

A Digital Intervention to Promote Self-Management Self-Efficacy Among Community-Dwelling Individuals With Stroke: Pilot Randomized Controlled Trial.

Digital interventions provided through smartphones or the internet that are guided by a coach have been proposed as promising solutions to support the self-management of chronic conditions. However, digital intervention for poststroke self-management is limited; we developed the interactive Self-Management Augmented by Rehabilitation Technologies (iSMART) intervention to address this gap. This study aimed to examine the feasibility and initial effects of the iSMART intervention to improve self-management self-efficacy in people with stroke. A parallel, 2-arm, nonblinded, randomized controlled trial of 12-week duration was conducted. A total of 24 participants with mild-to-moderate chronic stroke were randomized to receive either the iSMART intervention or a manual of stroke rehabilitation (attention control). iSMART was a coach-guided, technology-supported self-management intervention designed to support people managing chronic conditions and maintaining active participation in daily life after stroke. Feasibility measures included retention and engagement rates in the iSMART group. For both the iSMART intervention and active control groups, we used the Feasibility of Intervention Measure, Acceptability of Intervention Measure, and Intervention Appropriateness Measure to assess the feasibility, acceptability, and appropriateness, respectively. Health measures included the Participation Strategies Self-Efficacy Scale and the Patient-Reported Outcomes Measurement Information System's Self-Efficacy for Managing Chronic Conditions. The retention rate was 82% (9/11), and the engagement (SMS text message response) rate was 78% for the iSMART group. Mean scores of the Feasibility of Intervention Measure, Acceptability of Intervention Measure, and Intervention Appropriateness Measure were 4.11 (SD 0.61), 4.44 (SD 0.73), and 4.36 (SD 0.70), respectively, which exceeded our benchmark (4 out of 5), suggesting high feasibility, acceptability, and appropriateness of iSMART. The iSMART group showed moderate-to-large effects in improving self-efficacy in managing emotions (r=0.494), symptoms (r=0.514), daily activities (r=0.593), and treatments and medications (r=0.870), but the control group showed negligible-to-small effects in decreasing self-efficacy in managing emotions (r=0.252), symptoms (r=0.262), daily activities (r=0.136), and treatments and medications (r=0.049). In addition, the iSMART group showed moderate-to-large effects of increasing the use of participation strategies for management in the home (r=0.554), work (r=0.633), community (r=0.673), and communication activities (r=0.476). In contrast, the control group showed small-to-large effects of decreasing the use of participation strategies for management in the home (r=0.567), work (r=0.342, community (r=0.215), and communication activities (r=0.379). Our findings support the idea that iSMART was feasible to improve poststroke self-management self-efficacy. Our results also support using a low-cost solution, such as SMS text messaging, to supplement traditional therapeutic patient education interventions. Further evaluation with a larger sample of participants is still needed. ClinicalTrials.gov 202004137; https://clinicaltrials.gov/study/NCT04743037?id=202004137&rank=1.

UMLS-Based Approach for Developing VoiS: Voice-Activated Conversational Agent for Self-Management of Multiple Chronic Conditions

This abstract proposes a system design for an ontology-based conversational agent (CA) for the self-management of chronic conditions. The proposed system plans to integrate the largest medical ontology, the Unified Medical Language System (UMLS) (Bodenreider, 2004), aiming to narrow the vocabulary gaps between health professionals and patients and to make the agent more responsive to the users.
 Recently, conversational agents (CAs) like ChatGPT, or computer dialog systems that simulate human-to-human communication in natural language, have risen and gained popularity in various health contexts (Bin Sawad et al., 2022; Montenegro et al., 2019) including self-management of chronic conditions (Griffin et al., 2020). Despite their potential, the currently available CAs are often criticized for lacking the capability to understand natural language inputs (Montenegro et al., 2019). This limitation can be highlighted in medical areas due to the known vocabulary gaps between health professionals and health consumers. The knowledge-grounded dialog flow for CAs presents the potential to lift this limitation, making CAs naturally converse with their users.
 In the proposed voice-activated self-monitoring support (VoiS) application, the research team plans to integrate the UMLS to make the agent better understand lay terms from patients and properly map those terms to medical concepts. This automated process is expected to improve the user experience in two folds: a) promote the quality of communication between the patients and health providers and b) make the VoiS app more responsive to user inputs, overcoming accepting only constrained user inputs (e.g., multiple choice of utterance).

How to achieve delivery of a cardiovascular health intervention in community mental health settings: a process evaluation of Flinders Program using RE-AIM framework

Background, research problem & context: Globally, it is well recorded that adults with severe mental illness (SMI) die 10-20 years earlier than the general population, with cardiovascular disease being recorded as the key contributor to this health inequity. To address this health gap, the Flinders Chronic Condition Self-Management Program (will be referred to as Flinders Programme from here onward) was delivered within an NHMRC-funded randomised controlled trial (RCT) during 2018-2020 among 130 South Australian community-living adults diagnosed with SMI and CVD risk factors. Intervention design: The Flinders Programme is a person-centred care planning approach designed by Flinders University Behavioural Health Unit’s researchers. For this study, the programme aimed to improve the heart health and quality of life of the study participants. Intervention evaluation methods: This study sat alongside the RCT research and employed a longitudinal qualitative methodology underpinned by Roy Bhaskar’s Critical Realism philosophy and ontology. The aim was to understand why, how, and under which contexts the Flinders Program worked (or not). Alongside an outcome evaluation, this study also investigated how the Flinders Programme was delivered. Reach (R), Effectiveness/Efficacy (E), Adoption (A), Implementation/Delivery (I), Maintenance (M) or RE-AIM framework was used to conduct this qualitative process evaluation. Data were collected from 19 trial team members at multiple time points using multiple methods. In total, ten in-depth interviews, two focus group discussions, ten meeting minutes, and five reflective journals were analysed. Data analysis involved a Critical Realist Analysis (CRA) approach. Results & impact: The key findings were organised within the RE-AIM framework: Reach (low recruitment, strategies taken to increase recruitment), Effectiveness (non-specific effects, ‘invisible’ changes such as enhanced awareness, motivation, hope), Adoption (model of care, work atmosphere, the physical structure of the setting), Implementation (preparation, pilot survey, revising study design, actual trial and adaptations, fidelity), Maintenance (self-management capacity, resources, care continuity). Learning for the international audience: This study described the steps taken in delivering the Flinders Programme within a few South Australian metropolitan community mental health settings between the period November 2017 – September 2020. The trial team faced difficulties in fulfilling the recruitment target for the trial. There were a few critical reasons identified- the South Australian community mental health system went through a significant restructuring during the same time, resulting in enormous workload increases in an already resource-scarce sector. Health system-level politics had a direct negative effect on the trial. Besides, improving the cardiovascular health of SMI was not deemed a priority in a system that was struggling to deal with acute mentally ill patients within a crisis-driven system. There was a clear indication that most sites did not have enough clear communication from the trial team before recruitment and throughout the trial period. The next steps: In the future, more preparation, including education sessions among clinicians, are required before delivering such physical health interventions within mental health settings. 

SELF-MANAGEMENT SUPPORT STRATEGIES BASED ON THE RNAO GUIDELINES IN AECOPD PATIENTS: A RANDOMISED CONTROLLED TRIAL

Abstract Abstract Chronic disease management is a key intervention for the management of AECOPD patients. We conducted a Chinese-based trial according to RNAO’s chronic disease management guidelines.The aim of this study was topply an evidence-based guideline practice protocol for self-management in patients with chronic disease to improve the clinical outcomes, as well as reduce the economic costs for patients discharged with AECOPD.In this study, the “Strategies to Support Self-Management in Chronic Conditions: Collaboration with Clients”, published by RNAO, was used as a practice guideline to be applied in the follow-up of patients discharged from COPD to understand patients’ post-discharge self-management ability, pulmonary function, and readmission within one year, and to compare the cost-effectiveness for patients after discharge. The follow-up of both groups was conducted over time, and the patients’ self-management ability and pulmonary function in the observation group were effectively improved at month 6 and month 12 and was significantly different in comparison with the control group (P< 0.05). The observation group showed significant differences in readmission rates and economic costs at month 12 as compared to the control group (P< 0.05).Application of the guideline’s chronic disease self-management support strategies could stabilize patients’ blood oxygenation levels, better maintain pulmonary function, significantly improve patients’ self-management ability, and reduce patients’ medication costs. Keywords: COPD;Chronic disease self-management; RCT; economic analysis

Diabetes self-management and social support during the COVID-19 pandemic: Perspectives of older adults living in Barbados.

Diabetes mellitus (diabetes) is a major health concern in Barbados. In 2013, the reported prevalence (18.7%) was double global levels, with diabetes accounting for 10.4% of total deaths in 2016. Barbados has a rapidly aging population and older adults living with diabetes are more at risk of developing complications. Poorly managed diabetes represents a high burden for individuals and society due to direct healthcare costs for treatment, and to indirect costs due to loss of productivity from disability and premature mortality. Good diabetes self-management promotes glycemic control. Self-management is enhanced by social support and challenged by external shocks. This study explored the role of social support in diabetes self-management among older people in Barbados during the COVID-19 pandemic. Qualitative secondary thematic analysis of semi-structured individual telephone interviews with adults aged 65-84 years living with diabetes in Barbados during a partial COVID-19 lockdown period. Sampling was purposive, aided by gatekeepers who provide services to elderly people. Verbatim interview transcripts coded using an inductive method were subjected to thematic analysis by three qualitative researchers using NVIVO software. Four organising themes: "Balance", "Social Capital", "Resilience", and "Adaptations to COVID-19", informed the global theme "Adaptive Diabetes Self-Management Response", which captures resilience mechanisms of older adults who balanced facilitators including self-reliance and religious faith, and barriers such as perceived ageist discrimination in workplace policies designed to reduce COVID-19 exposure. Accordingly, elderly Barbadians living with diabetes were resilient, selectively incorporating available social support mechanisms to maintain self-management and overall well-being during the COVID-19 pandemic. The emergent evidence for resilience among older persons in this setting is important for informing health system interventions to improve quality of life for PLWD. The views of the elderly should be explicitly considered in policies designed to enhance the self-management of chronic health conditions.

Peer advice for women living with HIV in the Southern USA

Peer advice can provide emotional, social and practical assistance for the sustained self-management of chronic conditions. For stigmatised diseases such as HIV, finding support can be challenging. Women living with HIV in the Southern USA are additionally impacted upon by region-specific barriers such as stigma, poverty and limited access to services. The effectiveness of peer advice has been studied, yet little is known about the advice shared amongst women living with HIV. Therefore, we aimed to qualitatively explore the context and content of the advice participants offered to other women. With the assistance of a Community Clinician Advisory Board, women were recruited from across the US Centers for Disease Control and Prevention South Census Region. In-depth interviews were conducted with (N = 40) participants, aged 23 to 72 years (M = 51.2). Qualitative inductive thematic analysis was used to explore both the solicited and unprompted advice shared during individual interviews. Analysis of interview transcripts revealed three advice themes: Consistency in disease management Practical, non-medical advice; and Emotional and social support. The findings are valuable in shaping future peer-delivered programmes and interventions to enhance HIV care engagement, medication adherence, and the well-being of women living with HIV in the Southern USA.

Long-term impact of the COVID-19 pandemic on self-management of chronic conditions among high-risk adults in the USA: protocol for the C3 observational cohort study

IntroductionCOVID-19 is an unprecedented public health threat in modern times, especially for older adults or those with chronic illness. Beyond the threat of infection, the pandemic may also have longer-term...

The effect of mHealth program on behavior modification and health outcomes among patients with diabetes: A randomized controlled trial study.

Mobile health presents a promising alternative in the digital era. Mobile health apps (mHealth), when combined with the concept of self-management, are considered one of the methods for incorporating technology-based interventions into the healthcare system. This study aimed to determine the effect of mHealth (specifically, the Diabetic Care App) on foot care behavior, dietary behavior, foot condition, and fasting blood glucose levels among patients with uncontrolled diabetes mellitus. A single randomized controlled trial was conducted at a government-run primary clinic in Northern Malaysia, involving 58 patients with uncontrolled diabetes who were assigned to two groups. The intervention group received the Diabetic Care App, attended a 2-hour face-to-face session, and was included in a WhatsApp group, while the control group received standard care. Relevant assessments were conducted for both groups in Week 1 and Week 5. The study was conducted from February 2020 to November 2020, and parametric and non-parametric statistics were used for data analysis. Pretest-posttest comparisons in both groups revealed significant findings for foot care behavior (p <0.01), dietary behavior (p <0.01), and foot condition (p <0.01), except for fasting blood glucose levels. In inter-group comparisons, a significant difference was observed only in foot care behavior (p <0.01) and dietary behavior (p <0.01). The results indicate that technology-based interventions are beneficial for modifying behavior, specifically in terms of foot care and dietary behavior, in this study. The study highlights the applicability of mHealth for nurses in patient education and self-management of chronic conditions. Future research should explore app utilization among patients with chronic conditions. NCT04260100 (registered at https://clinicaltrials.gov/ct2/show/NCT04260100).

An Integrative Review of the Use of the Individual and Family Self-Management Theory in Research.

The extent of the application of the Individual and Family Self-Management Theory (IFSMT) in research has yet to be determined. The purpose of this analysis was to review the use of the IFSMT in published research and evaluate posited constructs and relationships. Dimensions and categories of the IFSMT and the interrelationships were generally supported in the 77 articles reviewed. A majority focused on self-management of chronic conditions in the adult population. More research on the strength, direction, and interaction of relationships is needed. Defining and exploring social constructs, including race, ethnicity, and gender, should be prioritized in future IFSMT research.

Use of telemonitoring in patient self-management of chronic disease: a qualitative meta-synthesis

BackgroundTelemonitoring for the remote patient self-management of chronic conditions can be a cost-effective method for delivering care in chronic disease; nonetheless, its implementation in clinical practice remains low. The aim of this meta-synthesis is to explore barriers and facilitators associated with the use of remote patient monitoring of chronic disease, drawing on qualitative research, and assessing participant interactions with this technology.MethodA meta-synthesis of qualitative studies was performed. MEDLINE, SCOPUS and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched from database date of inception to 5 February 2021. The Critical Appraisal Skills Programme (CASP) was used to critically appraise each study. Thematic synthesis was performed to identify user (patients, carers and healthcare professionals) perspectives and experiences of patient remote monitoring of chronic disease (Type 2 diabetes mellitus, chronic obstructive pulmonary disease, and cardiovascular disease).ResultsSearches returned 10,401 studies and following independent screening by two reviewers, nine studies were included in this meta-synthesis. Data were synthesised and categorised into four key themes: (1) Improved care; (2) Communication; (3) Technology feasibility & acceptability; and (4) Intervention concerns. Most patients using patient remote devices felt motivated in managing their own lifestyles and felt reassured by the close monitoring and increased communication. Barriers identified involved generational differences and difficulties with the technology used.ConclusionMost studies showed a positive attitude to telemonitoring, with patients preferring the convenience of telemonitoring in comparison to attending regular clinics. Further research is required to assess the most effective technology for chronic disease management, how to maintain long-term patient adherence, and identify effective approaches to address generational variation in telemonitoring up-take.

Telenursing and Remote Patient Monitoring in Cardiovascular Health.

Background: Since the decline in death rates from cardiovascular diseases has slowed down recently, promoting cardiovascular health in patients and the general public has become more important than ever, particularly for elder and rural patients. This study is a collaborative effort between a regional health network in Virginia and associated organizations to implement and assess telenursing and remote patient monitoring (RPM) to help home care patients better manage their own cardiovascular related diseases and promote sustainable health delivery options. Method: Eighty cardiovascular patients with diabetes, congestive heart failure, or both who had a recent disease-related hospital stay were enrolled in the RPM program to receive services, including care coordination, coaching, referral for behavioral health, and aging-related services for 90+ days. The program used telenursing and RPM through home care monitoring equipment to coach patients on effective measures to stay compliant with posthospitalization regimens, track and evaluate readmissions, and assess physiological status and mental health. Result: There was a decline in hospital admissions of 65%, 85% for observations and related inpatient services for enrolled CVD patients in the RPM program. In addition, the longer the patient was enrolled the less likely they were to readmit. The program saved ∼$615,127 in patient claims costs and had net savings of $390,296, ∼173% of the total program expenses. Discussion: Evidence showed that 90+ day enrollments are sufficient for realization of readmissions and Emergency Department reductions, increased health care access, and lower costs. This resulted from consistent monitoring using the technology to alert nurses and care coordinators who were able to respond and facilitate patients accessing care in the most helpful and generally less costly care environment. Conclusion: The study has confirmed that care coordination and RPM are effective in supporting self-management of chronic conditions and cost reductions through telenursing and RPM.

The Impact of Cybervictimization on the Self-Management of Chronic Conditions: Lived Experiences.

Cybervictimization of people with long-term conditions is a disturbing phenomenon with a documented impact on health and well-being. These experiences are primarily examined using quantitative methods, focusing on children and young people. However, research centered on the cybervictimization of adults with chronic conditions is scarce, with limited qualitative input from the victims as experts in their own experiences. This study aims to understand the impact of cybervictimization on the self-management of long-term conditions among adults with chronic conditions and disabilities in the United Kingdom. This paper reports the findings from the qualitative phase of a phenomenologically informed mixed methods study. The biographical disruption concept was used to conceptualize the study. In-depth semistructured interviews were conducted with 13 participants with chronic conditions who experienced cybervictimization. A codebook was developed, and a zigzag approach to thematic analysis was used to define and refine themes. Ethical considerations and risk assessment were ongoing during the research process because of the sensitivity of the topic and cases of harassment. Cybervictimization has direct and indirect impacts on the self-management of chronic conditions. This impact was verified across 6 overarching themes that emerged from this study. First, biomedical events included overall health deterioration because of existing conditions, new diagnoses, and subjective physical complaints. Second, the impact on mental health was perceived through psychological consequences and psychiatric disorders that developed after or during this traumatic experience. Third, the multilevel impact theme focused on disrupting the strategies for coping with health conditions and involved unplanned changes to victims' health management priorities. Fourth, the impact of complexity reflected the perceived uniqueness in each case, intersectionality, struggle to obtain formal support, and subsequent health complications. Fifth, social network involvement comprised the effects of social isolation, victim blaming, and deception. Finally, the disability discrimination theme focused on prejudice, issues on inclusion, and hostility in society, with subsequent effects on well-being. People with long-term conditions experienced different forms of cybervictimization, all disruptive with various effects on health. Disability discrimination was a prominent finding to be further investigated. This paper reports the impact as themes to guide further research and practice, with the recognition that long-term conditions and impairments are not a homogeneous group. Despite the devastating consequences, there are positive points that strengthen potential interventions. Awareness-raising campaigns, training of support channels, and multidisciplinary research are recommended to tackle this issue and initiate change.

Self-efficacy, resilience and healthy ageing among older people who have an acute hospital admission: A cross-sectional study.

To examine the associations between self-efficacy, resilience and healthy ageing among older people who have an acute hospital admission. A cross-sectional study. Survey and medical record data were collected from older people on discharge from hospital. The survey measured self-efficacy with the 6-item General Self-Efficacy scale (GSE-6), resilience with the Brief Resilience Scale (BRS), and healthy ageing with the Selfie Ageing Index (SAI). Medical record data included potential confounders: co-morbidities, frailty items, previous falls and previous admission in the last 28 days. Multi-linear regression and Spearman's rank correlation coefficient were used to examine the independent associations between self-efficacy, resilience and healthy ageing. Responses were received from 143 older people (mean age 79). After adjusting for potential confounders, co-morbidities (ß = -0.08, p = 0.001) remained negatively associated with healthy ageing, while self-efficacy (ß = 0.03, p = 0.005) and resilience (ß = 0.05, p < 0.001) remained positively associated with healthy ageing (R2 = 0.243). Positive correlations were found between self-efficacy (ρ = 0.33, p < 0.01), resilience (ρ = 0.38, p < 0.001) and healthy ageing. Positive correlations were also found between self-efficacy and resilience (ρ = 0.38, p < 0.01). Those with lower self-efficacy and resilience were more likely to report reduced activities of daily living, mobility, physical activity and mood. Findings indicate that while the number of co-morbidities have negative consequences for healthy ageing among older people who are hospitalised, the promotion of self-efficacy and resilience can potentially contribute to healthy ageing within the physical and psychological domains. Nurses can promote self-efficacy, which can potentially increase resilience and help to improve self-management of chronic conditions, functional ability in daily activities, mobility and physical activity and reduce both anxiety and depressive symptoms. Participant feedback throughout the data collection process assisted in the evaluation of study methods and data interpretation. This included processes such as assessing selected tools and clarifying the meanings of healthy ageing factors.

Health Social Networks of Black Women With Hypertension.

The prevalence of hypertension is 55% among African American/Black women, who have a higher risk for poor health outcomes compared to women from other racial and ethnic groups, in part because of uncontrolled blood pressure. Previous research results suggest that peers may positively influence self-management of chronic conditions like hypertension. However, few studies have described the personal characteristics of peers in the health social networks of Black women. This substudy aimed to examine health social networks and describe the peers' characteristics, as reported by a convenience sample of Black women with hypertension. In this analysis of data from a larger study, 94 Black women with hypertension attending a church conference participated in a cross-sectional, descriptive study. Their mean age was 59 years, and their mean systolic blood pressure was 143 mm Hg. All participants completed a survey to gather data about (a) the characteristics of individuals they discussed health matters with (their peers or health social network) and (b) their perceptions about hypertension status and knowledge of hypertension among the peers in their health social network. Collectively, participants from the larger study named a total of 658 peers who were part of their health social networks; the mean health social network size was six peers. The peers were mostly women, Black, family members, and, on average, 54 years old. The participants discussed hypertension with 71% of the peers, reported that 36% had hypertension, and felt that 67% were somewhat or very knowledgeable about the condition. A small, positive correlation existed between the participants' health social network size (number of peers named) and their systolic blood pressure levels. The health social network peers were similar to those in the larger study, with most of the same gender, race, and age. The findings of this analysis may be used to help practitioners and scientists guide patients in building health social networks for support in self-managing hypertension and conducting future studies to examine the best strategies for developing and using health social networks to improve health outcomes and reduce health disparities.

A Survey of Conversational Agents and Their Applications for Self-Management of Chronic Conditions.

Conversational agents have gained their ground in our daily life and various domains including healthcare. Chronic condition self-management is one of the promising healthcare areas in which conversational agents demonstrate significant potential to contribute to alleviating healthcare burdens from chronic conditions. This survey paper introduces and outlines types of conversational agents, their generic architecture and workflow, the implemented technologies, and their application to chronic condition self-management.

Cybervictimization of Adults With Long-term Conditions: Cross-sectional Study.

People living with chronic conditions and disabilities experience harassment both offline and on the web. Cybervictimization is an umbrella term for negative web-based experiences. It has distressing consequences on physical health, mental well-being, and social relationships. These experiences have mostly been documented among children and adolescents. However, the scope of such experiences is not well documented among adults with long-term conditions, and the potential impact has not been examined from a public health perspective. This study aimed to examine the scope of cybervictimization among adults living with long-term conditions in the United Kingdom and the perceived impact on self-management of chronic conditions. This paper reports the findings of the quantitative phase of a mixed methods study in the United Kingdom. This cross-sectional study targeted adults aged ≥18 years with long-term conditions. Using a web-based link, the survey was shared on the web via 55 victim support groups, health support organizations, and social media accounts of nongovernmental organizations and activists such as journalists and disability campaigners. People with long-term conditions were asked about their health conditions, comorbidities, self-management, negative web-based experiences, their impact on them, and support sought to mitigate the experiences. The perceived impact of cybervictimization was measured using a set of questions on a Likert scale, frequency tables, and the Stanford Self-Efficacy for Managing Chronic Diseases Scale. Demographic data and the impact on self-management were cross-tabulated to identify the demographic characteristics of the targeted individuals and potential conditions with complications and highlight directions for future research. Data from 152 participants showed that almost 1 in every 2 adults with chronic conditions was cybervictimized (69/152, 45.4%). Most victims (53/69, 77%) had disabilities; the relationship between cybervictimization and disability was statistically significant (P=.03). The most common means of contacting the victims was Facebook (43/68, 63%), followed by personal email or SMS text messaging, each accounting for 40% (27/68). Some participants (9/68, 13%) were victimized in web-based health forums. Furthermore, 61% (33/54) of victims reported that experiencing cybervictimization had affected their health condition self-management plan. The highest impact was on lifestyle changes such as exercise, diet, avoiding triggers, and avoiding excessive smoking and alcohol consumption. This was followed by changes to medications and follow-ups with health care professionals. Most victims (38/55, 69%) perceived a worsened self-efficacy on the Self-Efficacy for Managing Chronic Diseases Scale. Formal support was generally rated as poor, with only 25% (13/53) of victims having disclosed this experience to their physicians. Cybervictimization of people with chronic conditions is a public health issue with worrying consequences. This triggered considerable fear and negatively influenced the self-management of different health conditions. Further context- and condition-specific research is needed. Global collaborations to address inconsistencies in research are recommended.