Integration Of Self-management Research Articles

Self-Management Among People Living With Endometriosis: A Qualitative Study.

Self-management is pivotal for effective chronic disease management. However, this concept remains unexplored among people with endometriosis, who often experience chronic pain and significant impacts on their quality of life. This research explored participants' experience managing endometriosis and their understanding and integration of self-management into their lives. Inductive reflexive thematic analysis was used to analyze transcripts from 15 semi-structured interviews among people with endometriosis. The themes captured many aspects of self-management and included (1) perceptions of control, (2) engaging in self-management behaviors, (3) active decision-makers versus recipients of care, (4) establishing a patient-provider partnership, and (5) support is vital. The extent to which participants engaged in self-management varied, however, is consistent with self-management literature for other chronic conditions suggesting that there is a role for self-management among people living with endometriosis.

PAINSTORIES – Exploring the Temporal Developments in the Challenges, Barriers, and Self-Management Needs of Adolescents with Longstanding Knee Pain: A Qualitative, Retrospective Interview Study with Young Adults Experiencing Knee Pain Since Adolescence

Patient education is essential to enable rehabilitation and self-management of longstanding knee pain in adolescents. Currently, a lack of insights into the socio-cognitive processes governing adolescents' self-management remains an obstacle for enhancing treatment efficacy. This study developed a conceptual model for integrating adolescents' challenges and barriers into future treatments. We conducted semi-structured retrospective interviews with 14 young adults (age 21-25 years) with knee pain since adolescence (9 years mean duration). Temporal developments in participants' knee pain were captured through a memorization exercise. Data was analyzed via the General Inductive Approach. Themes were organized into a matrix, extracting a conceptual model, which was tested with eight new participants. The analysis identified seven themes. Further interpretation, via the matrix, organized these within a four-stage trajectory of; gaining awareness, knowledgeability, contextual application and reconceptualization, each with different challenges and dilemmas, participants had to overcome to progress their self-management. Testing the conceptual model, confirmed stages and highlighted acceptance as key to overcoming barriers. The study described adolescents' integration of self-management as proximal and inquiry-based, with acceptance, driving increasingly complex management behaviors. We hypothesize future interventions may benefit from exploring supporting adolescents' inquiries into their knee pain at different stages of the trajectory. PERSPECTIVE: This study presents a conceptual model and vocabulary for optimizing patient education concepts, to target the challenges, barriers and needs of adolescents with knee pain at different stages of their mastery journey. We believe our findings may inform reflections among clinicians and researchers, and development of more effective education interventions.

A self-management application “pain-housekeeper” to control cancer pain: a randomized controlled trial study protocol†

Abstract Objective Pain is a prevalent and distressing symptom in patients with cancer which has a significant impact on patients’ physical health, psychological well-being, and quality of life (QOL). Deficiency of pain care, inadequate pain communication, and reluctance toward pain medication contribute to the difficulties in improving the situation of patients with cancer pain. Fortunately, the integration of self-management and professional healthcare provides new opportunities for patients with cancer pain. Methods A two-arm randomized controlled trial will be conducted to assess the effectiveness of self-management application compared with routine care among patients with cancer pain. Based on Orem's self-care theory and Naylor's transitional care theory, cancer pain self-management application “Pain-housekeeper” was developed with dual client: patient client and medical client. A total of 120 patients with cancer pain are recruited from two university-affiliated tertiary public hospitals in China. They are randomly assigned to the control group and the intervention group. The patients in the control group get routine care while the patients in the intervention group get routine care and Pain-housekeeper App. The intervention is delivered by registered doctors, nurses, and postgraduate nursing students specialized in pain care. Effect measurements for both groups are carried out with questionnaires at baseline (T0), after 4 weeks (T1) and after 12 weeks (T2). The primary outcomes include pain condition, self-efficacy, and QOL. The secondary outcomes include pain medication adherence, satisfaction, anxiety, and depression. Compliance of data submission, economic evaluation, usage, and clinical data are also considered in the test. Data for the evaluation are gathered continuously during the study period. Discussion This article provides insight into the effectiveness of a theory-based self-management mobile application intervention delivered to patients with uncontrolled cancer pain. The results are used to help patients to improve cancer pain control, self-efficacy, and QOL. Conclusions The findings of this article provide evidence to support the implementation of an innovative and easily accessible intervention that enhances health outcomes. Trial registration ChiCTR: ChiCTR1800020295, Registered 22 December, 2018.

An Individual Focused Approach in Oncology:Motivational Interview

Integration of self-management into patient care has a place in patient-centered approach which is encouraging in achieving self-care and determinant of personal requirements. Individual focused approach is mentioned to result in better findings in directing patients to behavior changes. Efficiency of motivational interview on oncology has been shown in other studies which suggested that motivational interview can be applied in life style changes such as diet and exercise during cancer treatment process, that it is a cost-effective method for increasing the efficacy of monitorization programs, preventing and controlling cancer and may also be used as a “give up smoking” attempt for patients with cancer. The motivational interview method may be used in early diagnosis and treatment of cancer, in providing life style changes and in strengthening self-management of the patient.

A Patient‐Focused Framework Integrating Self‐Management and Informatics

This article introduces a framework to (a) guide chronic illness self-management interventions through the integration of self-management and nursing informatics, (b) focus self-management research, and (c) promote ethical, patient-empowering technology use by practicing nurses. Existing theory and research focusing on chronic illness, self-management, health-enabling technology, and nursing informatics were reviewed and examined and key concepts were identified. A care paradigm focusing on concordance, rather than compliance, served as the overall guiding principle. This framework identifies key relationships among self-management (patient behaviors), health force (patient characteristics), and patient-defined goals. The role of health-enabling technology supporting these relationships is explored in the context of nursing informatics. The Empowerment Informatics framework can guide intervention design and evaluation and support practicing nurses' ethical use of technology as part of self-management support. Nurses worldwide provide support to patients who are living with chronic illnesses. As pressures related to cost and access to care increase, technology-enabled self-management interventions will become increasingly common. This patient-focused framework can guide nursing practice using technology that prioritizes patient needs.