Illness Self-management Skills Research Articles

The impact of the COVID-19 pandemic on peer specialists.

Individuals with mental health challenges are at particularly high risk of experiencing negative outcomes (e.g., worsening of mental health, increased risk of mortality) due to the coronavirus disease (COVID-19) pandemic. Peer specialists may have the benefit of several protective factors, including higher levels of social support and better illness self-management skills that buffer against negative effects of the pandemic. In this study, we compared the differences in the impact of COVID-19 on those trained as peer specialists (e.g., certified peer specialists, recovery coaches) to those not trained in this role. Participants with self-reported mental health and/or substance use challenges completed an online survey to collect information on their experiences during COVID-19 (Epidemic-Pandemic Impacts Inventory [EPII]), loneliness (3-item Loneliness Scale), and access to and satisfaction with mental health support. Respondents self-identified as peer specialists or not. One hundred seventy-three U.S. resident participants from 23 states were included in the final analysis: 109 were peer specialists and 64 were nonpeer specialists. Those who were trained as peer specialists reported fewer negative outcomes during the pandemic, including less disruption in employment, less loneliness, and less worsening of mental health, while reporting more positive attitudes in the face of difficulties. Peer specialists were also likely to report more access to and satisfaction with mental health services. Possibly as a function of their role, peer specialists reported better mental health outcomes during COVID-19, providing key, empirical evidence to support the benefits of helping others. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

58210 Perspectives and Guidance for Mobile Health Self-Management Intervention Developers from Adolescents and Young Adults with Chronic Illnesses: A Qualitative Study

ABSTRACT IMPACT: The perspectives and guidance from adolescents and young adults (AYA) reported in this study could inform the evidence-based development and delivery of mobile health (mHealth) interventions to improve the health of AYA with chronic diseases. OBJECTIVES/GOALS: To elicit advice from AYA with chronic healthcare needs regarding if and how mHealth interventions could effectively promote illness self-management skills. We selected this goal because including the user perspective from the beginning of the design process could lead to greater future adoption. METHODS/STUDY POPULATION: We purposively recruited AYA patients from a pediatric hospital with heterogeneous chronic illnesses to identify universal chronic disease views rather than condition-specific perspectives. We conducted qualitative face-to-face semi-structured interviews with (N = 19) AYA between 16 and 20 years old (63.2% Latinx; 21.1% Black; 10.5% White; 5.3% Multiracial). Using ATLAS.ti, three coders completed thematic analysis to inform a conceptual framework on how AYA believe mHealth interventions could promote the development and maintenance of self-management skills. Member checking was conducted over the phone to obtain participant feedback on themes to enhance the validity of qualitative results. RESULTS/ANTICIPATED RESULTS: Results suggest that AYA develop self-management skills through several strategies, including 1) getting organized, 2) ‘making it work for me’ and 3) keeping the ‘right’ mentality. AYA described developing these strategies through: 1) receiving social support, 2) accessing helpful tools and technologies, and 3) going through a maturation process. They provided recommendations for how mHealth interventions could improve this process, including: 1) ‘what’ recommendations, describing the content or active ingredients that should be included in mHealth interventions, and 2) ‘how’ recommendations, describing the technological aspects or style in which the interventions should be delivered. DISCUSSION/SIGNIFICANCE OF FINDINGS: The results suggest that an appealing mHealth intervention could increase the support for AYA patients to proactively acquire self-management skills, avoiding trial-and-error or uneven access to guidance. Improving self-management could prevent poor health outcomes and increase quality of life.

The adaptation of everyday practices in the adoption of chronic illness.

This article uses social practice theory to examine the role of information-seeking in the maintenance of existing lifestyle and illness-related adjustments in the context of chronic illnesses. The research findings are derived from a thematic analysis of 16 semi-structured in-depth interviews with Estonian Parkinson's disease patients. The coding scheme bases on the four practice elements outlined by Schatzki (practical understandings, rules, teleological structures and general understandings) and other categories related to chronic illness self-management skills, bodily movements, daily routines and information-seeking practices. The findings reveal that people with chronic illness value maintaining their existing lifestyles as long as possible and the willingness to seek out illness-related information is related to the severity and duration of the disease. These findings suggest that effective illness-related communication that supports self-management should provide patients with possibilities to adjust and switch between practices in a time and a pace that is natural and acceptable to them.

Neurocognitive functioning and outcome of the Illness Management and Recovery Program for clients with schizophrenia and schizoaffective disorder

The relationship between psychosocial programming and neurocognition has been established in previous research, but has not been explored in the context of the Illness Management and Recovery Program (IMR). This study examined associations between neurocognition and illness self-management skills acquisition, based on two previous trials of IMR. Neurocognitive functioning was assessed at baseline and post-treatment in 53 participants with schizophrenia or schizoaffective disorder who completed the IMR. Illness self-management was measured by the client and clinician versions of the Illness Management and Recovery Scale. Statistical analyses investigated improvements in neurocognitive functioning and possible association between illness self-management skills acquisition and neurocognitive functioning. Speed of processing as measured by the Trail Making Test A, was related to client-reported acquisition of illness self-management skills, before and after controlling for psychiatric symptoms and medication, but did not predict improvement in clinician ratings of client illness self-management skills. However, when controlling for client session attendance rates, the association between speed of processing and client-reported illness self-management skills acquisition ceased to be statistically significant, which suggests that compromised neurocognitive functioning does not reduce response to training in illness self-management in itself. The association between the frequency of attended IMR sessions and outcome of the IMR seems to decrease the negative impact of compromised neurocognition on illness self-management skills acquisition. Also, clients with slower speed of processing may experience less benefit from the IMR and may attend fewer sessions.

Individual Resiliency Training: An Early Intervention Approach to Enhance Well-Being in People with First-Episode Psychosis

Early intervention treatment programs have begun to play an increasingly important role in improving long-term outcomes for people with psychosis. These programs focus on helping people achieve recovery through reducing the risk of relapse, improving illness self-management skills, and making progress toward a meaningful life. This article describes Individual Resiliency Training (IRT), the individual therapy component of the Recovery After Initial Schizophrenia Episode Early Treatment Program (RAISE-ETP). As part of a comprehensive specialty care program for people with first-episode psychosis (FEP), IRT uses a strengths-based approach that focuses on progress toward individual recovery goals, as well as improving social functioning and overall well-being. IRT addresses recovery by engaging in illness self-management, Cognitive Behavior Therapy for Psychosis, and psychiatric rehabilitation skills. Two illustrative cases show how people can use information and skills within the IRT modules to make progress toward recovery and learn individualized skills to address common challenges. Within a coordinated specialty care program, IRT provides strategies and skills that promote recovery and resiliency, and shows promise toward improved illness outcomes for people with FEP. [ Psychiatr Ann . 2015;45(11):554–560.]

Wellness and Illness Self-Management Skills in Community Corrections

Community corrections provide a readjustment venue for re-entry between incarceration and home for inmates in the US corrections system. Our goal was to determine how self-management skills, an important predictor of re-entry success, varied by demographic and risk factors. In this cross-sectional study, we analyzed responses of 675 clients from 57 community corrections programs run by the regional division of the Federal Bureau of Prisons. A self-administered survey collected data on self-management skills, demographics, and risk factors; significant associations were applied in four regression models: the overall self-management score and three self-management subscales: coping skills, goals, and drug use. Over one-quarter (27.2%/146) of participants had a mental health history. White race, no mental health history and high school education were associated with better overall self-management scores; mental health history and drug use in the past year were associated with lower coping scores; female gender and high school education were associated with better self-management goals; female gender was associated with better self-management drug use scores. Self-management programs may need to be individualized for different groups of clients. Lower scores for those with less education suggest an area for targeted, nurse-led interventions.

Automated telehealth for managing psychiatric instability in people with serious mental illness

Background: Serious mental illness (SMI) with psychiatric instability accounts for disproportionately high use of emergency room visits and hospitalizations.Aim: To evaluate the effectiveness of an automated telehealth intervention supported by nurse health care management for improving psychiatric illness management and reducing acute service use among individuals with SMI and psychiatric instability.Methods: Thirty-eight individuals with SMI received the automated telehealth intervention for 6 months. Psychiatric symptoms, illness self-management, and self-reported service use (emergency room visits and hospital admissions) were collected at baseline, 3- and 6-months. Measures of quality of life, health indicators, and subjective health status were also collected.Results: Participants demonstrated improvements in self-reported psychiatric symptoms and illness self-management skills, an 82% decrease in hospital admissions (from 76 to 14 hospitalizations, p < 0.001) and a 75% decrease in emergency room visits (from 63 to 16 visits, p < 0.001). Improvements were also observed in quality of life, severity of depressive symptoms, and mental health status.Conclusion: These highly promising findings support the use of an automated telehealth device monitored by a nurse care manager for people with SMI, and highlight the potential for cost savings through reductions in acute health care utilization.

Computer Intervention: Illness Self-Management/Quality of Life of Rural Women.

The Women To Women project, a computer-based support and educational research intervention, was designed to help rural women better understand and manage their chronic illnesses. Its impact on psychosocial adaptation has been reported elsewhere. This article reports on the effect of a computer intervention on chronic illness self-management skills and quality of life. Using a parallel 2-group study design, the researchers randomized 309 middle-aged rural women with chronic conditions to either a computer-based intervention or a control group. They collected data on self-management of chronic illness and quality of life indicators at baseline and at the end of the intervention. Women in the intervention group reported significantly more self-efficacy in managing their chronic disease than those in the control group and the observed effect was of moderate size. Women in the intervention group also reported statistically significant gains in quality of life; effect sizes were small but consistent. Select chronic illness self-management skills and quality of life can be positively influenced by a well-designed computer intervention.

Integrated Illness Management and Recovery: A Program for Integrating Physical and Psychiatric Illness Self-Management in Older Persons with Severe Mental Illness

Older persons with severe mental illness (SMI) are prone to the development of multiple physical illnesses, which are often poorly recognized and treated and which can threaten the quality of their lives, diminish their ability to live in the community, and lead to premature mortality. To address this issue, the Illness Management and Recovery (IMR) program, a standardized program for teaching psychiatric illness self-management skills, was modified to develop the Integrated IMR (I-IMR) program to include the teaching of physical illness self-management by an I-IMR specialist, and medical needs assessment and monitoring provided by an on-site nurse health case manager. A group of 8 older clients with SMI and a comorbid medical condition participated in an open clinical trial to evaluate the feasibility of the program and to explore potential clinical benefits. Participation in the program was high, with 71% of the clients who participated in at least one session completing a total of at least 10 I-IMR ses...

Communication Commentary: Psychiatric Advance Directives

Communication Commentary: Psychiatric Advance Directives

Supported medical care: a multi-faceted approach to helping HIV/hepatitis C virus co-infected adults with serious mental illness

This paper presents a multi-faceted supported rehabilitation and health management model to inform the development of interventions for mentally ill adults who are HIV/hepatitis C virus co-infected. The model, referred to as 'supported medical care' (SMC), calls for the combination of chronic illness self-management skills training and enhanced case management. Illustrative examples of each SMC intervention component are provided. Integrated delivery of these intervention components shows promise for improving the coordination of psychiatric and medical care. Research and related policy challenges regarding ongoing quality improvement efforts are also discussed.

Psychoeducation in first-episode psychosis: a therapeutic process.

THE importance of psychoeducational work with the relatives of patients with psychotic illness has been increasingly emphasized in recent years (Anderson et al. 1986). This has resulted partly from research showing that providing support and information for families is of value in reducing relapse rates as well as assisting relatives directly, and partly from the emergence of highly effective organizations of relatives advocating on behalf of the families of the severely mentally ill (Sokas 1986). A puzzling aspect of this development is the relative lack of interest in the psychoeducational needs of the patients themselves. As Smith et al. (1992) point out, few researches or clinicians have focused on this issue and only one controlled study has been carried out (Goldman and Quinn 1988). Eckman et al. (1992) reported the results of a controlled trial of modularized illness self-management skills training versus supportive group psychotherapy and found some advantage for the former intervention, which involved some elements of psychoeducation. However, the patients were suffering from well-established schizophrenia and had been ill for many years, so the timing of the interventions was less than optimal.

Psychological and educational interventions to reduce arthritis disability

The extent of disability attributable to arthritis is briefly summarized and the World Health Organization's (WHO) classification scheme for progression from pathology to disability described. The types of outcomes that have been examined in evaluations of psychological and educational interventions aimed at preventing arthritis disability are described and classified according to the WHO scheme where appropriate. Next, the most common components included in psychological and educational interventions for arthritis are reviewed. These are (1) providing general information, (2) teaching illness self-management skills, (3) training in biofeedback, (4) applying cognitive-behavioural techniques, (5) using other psychotherapeutic techniques, and (6) enhancing social support. This is followed by a discussion of issues pertinent to assessing the efficacy of various intervention components, citing specific examples of intervention research. Finally, the conclusion that certain types of psychological interventions appear to be effective in mitigating arthritis disability is drawn and the contribution of social science theory to intervention efficacy acknowledged.