Patient Engagement In Self-care Research Articles

The impact of lifestyles on the periodontal health among 35–44 years old adult population in Lucknow district: A cross-sectional study

Background: Periodontal disorder continues to be a major issue worldwide. It is closely related to lifestyles and strongly determined by behavioral factors. Aim: To assess the different lifestyle factors and overall lifestyle variables affecting the periodontal health among 35–44 years old adult population in Lucknow district. Objectives: (1) To determine the influence of various lifestyle factors on adult periodontal health among urban and rural population. (2) To measure the effect on periodontal adult health of the overall lifestyle variables measured by the health practice index (HPI). Materials and Methods: A cross-sectional research w as performed on 400 participants aged 35–44 years, consisting of a standardized questionnaire on HPI, oral health-related behavior, and personal behaviors, as well as sociodemographic variables. Clinical examination for periodontal status was done by recording the loss of attachment (LOA) scores using the community periodontal index (WHO-2013). Statistical Analysis: Statistical Package for the Social Sciences (SPSS) software version 21.0 was used for statistical analysis. Statistical analysis was done using the Chi-square test and multivariate regression analysis. Results: The variables that showed an independent association with periodontitis were location, smoking, sleeping hours, physical exercise, eating breakfast, nutritional balance, mental stress with LOA of periodontal tissues; the results of multivariate regression analysis are statistically significant (P < 0.001). Conclusions: This study supports an overall management of chronic periodontitis using different lifestyles. Vital public health action is needed on factors that define unhealthy lifestyle habits across the community, which is achievable through promoting healthy lifestyles through patient engagement in self-care.

The shared decision-making model: Providers' and patients' knowledge and understanding in clinical practice.

Shared decision making (SDM) is a collaborative approach to patient care that facilitates patient engagement in self-care by upholding the patient's values and perspectives. The Affordable Care Act (2010) offers provisions for using SDM in clinical practice to improve care outcomes; however, inconsistent evidence exists about the provider-patient satisfaction and effectiveness of using SDM in Federally Qualified Health Centers (FQHCs), which offer care predominantly to the underserved. This study assessed providers' and patients' knowledge and understanding of SDM in two FQHC in the Pacific Northwest. Descriptive phenomenological approach guided the investigation. Data were gathered through in-person interviews. Interviews were analyzed using the method discussed by Colaizzi (1978). A purposive sample of 13 providers and 6 patients. Although providers and patients had divergent understandings of SDM, they highly valued this approach to care. An overarching theme "We use SDM as a Cornerstone of Patient Centered Care" and two subthemes: "We are partners in care" and "Being in the driver seat may not be comfortable but necessary" captured the providers' experiences. "They tell you what's up and we do it together" was a key theme that emerged from the patients' narratives. Several processes further described provider and patient experiences with SDM in the FQHC. Findings suggest that the use of SDM in FQHC contributes to provider and patient satisfaction and improved patient engagement in self-care. Providers should therefore strongly consider using SDM model when working with the underserved.

Frequency of In-Home Internet Use Among Prekidney and Postkidney Transplant Patients-Facilitators and Barriers to Use and Trends Over Time.

BackgroundAs health-related communications become digitized, strategies to increase adoption of these Web-based platforms are needed. The purpose of this study was to assess facilitators and barriers to in-home Internet use among prekidney and postkidney transplant patients.MethodsA single center, cross-sectional survey of 240 consecutive patients of all levels of technological proficiency who presented to an urban transplant center in the United States. The Patient Information and Technology Assessment consists of 6 demographic questions, 3 disease-related questions, and 8 technology-related questions.ResultsMuch of the sample was African American, male with a mean age of 51 years, and median income of $53 800/year. Logistic regression analysis was undertaken, and after adjusting for covariates, we found Smartphone ownership (odds ratio [OR], 4.94; 95% confidence interval [CI], 2.32-10.52), a higher number of Internet users in the home (OR, 2.00; 95% CI, 1.11-3.62), and having college education and beyond (OR, 4.88; 95% CI, 2.03-11.74) increased the likelihood of being a frequent Internet user. African American or Hispanic/Latino patients were less likely to be frequent Internet users compared with white patients (OR, 0.26 and 0.24, respectively, compared with whites, all P < 0.05). As the total number of people in the household increased, frequent Internet use decreased (OR, 0.52; 95% CI, 0.29-0.92). As age increased, reports of frequent Internet use decreased.ConclusionsLower rates of Internet use among African Americans and Hispanic/Latinos in urban areas in the United States remains a problem despite a significant increase in access to the Internet and Smartphone ownership. The finding that Internet use increases as the number of Internet users in the household increases indicates that leveraging the patient’s social support network and/or the development of patient information champion programs may aid with patient’s adoption of health technology and patient engagement in self-care.

Detecting and Managing Cognitive Impairment to Improve Engagement in Heart Failure Self-Care

The purpose of this review was to examine the recent literature on detecting cognitive impairment in patients with heart failure (HF) and the evidence indicating any ramifications of cognitive impairment on patient engagement in HF self-care. Mild cognitive impairment (MCI) is common in HF and impacts on patients' engagement in self-care, yet it is frequently not detected. The use of screening tools, even when brief, improves detection of MCI. However, the most sensitive, specific and feasible screening measure to use in practice is yet to be identified. A full neuropsychological assessment is required to determine a diagnosis of cognitive impairment and to identify the specific areas of cognitive deficit. In patients with HF, there appears to be differing clusters of cognitive deficits. Identification of these deficits may help inform the application of specific cognitive training strategies to ameliorating cognitive changes in HF patients and potentially enhance engagement in self-care. Screening for cognitive impairment is crucial in the management of HF patients to ensure that potential self-care deficits are prevented. The optimal screening tool is yet to be identified.

A Role for Patients: The Argument for Self-Care

This article discusses the role of patients and self-care enabled through the use of technology. Patients have shown interest in healthcare tools that are artfully designed and based on their wants and personal habits. The expectation is that, as these tools evolve, patients will find sufficient motivation and capability to join with their providers to co-manage their health. Review of research published between 2001 and 2012 was conducted in 2011. The areas where research still needs to be conducted include our gaps in understanding about the relationship between self-care and engagement with technology (that might facilitate self-care), and the issues that determine why and when consumers engage with technology. Evidence increasingly suggests that patient engagement in self-care, particularly with respect to coping with chronic disease, can improve medical outcomes. Technology platforms are important to patient self-care. But a more-important need is to change workflows/incentive structures to support long-term behavioral change.