Patient Self-management Practices Research Articles

Experiences of Patients With Type 2 Diabetes Who Recovered From COVID-19 in the Pandemic Period: A Qualitative Study.

Coronavirus disease 2019 (COVID-19) infection can induce acute and chronic complications by affecting the self-management behaviors of individuals with diabetes. The objective of this study is to examine the physical, psychosocial health, and self-management experiences of type 2 diabetes patients who have recovered from COVID-19, 1 year after the infection. The study adopted a qualitative research design, specifically content analysis. In all, 14 patients with type 2 diabetes who presented to the diabetes outpatient clinic were interviewed by teleconferencing, which lasted approximately 25 to 30 minutes. The Standards for Reporting Qualitative Research guidelines were used. Based on the participants' responses, four main themes were determined: obstacles in activities of daily living, feeling of psychosocial problems, changes in health and treatment management, and patient self-management practices. Amid the pandemic, diabetes nurses should strive to recognize the issues that diabetes patients encounter. To assist patients, telemedicine should be leveraged, and evidence-based practices must be developed.

Effect of Health Educational Guidelines on Self-Management Practices among Patients with Chronic Obstructive Pulmonary Disease: A Scoping Review

Context: Chronic obstructive pulmonary disease (COPD) is a type of lung disease characterized as chronic lung airflow obstruction that interferes with normal respiration. The World Health Organization ranked it as the third leading cause of death. The evidence indicates that health education may improve patients' outcomes.
 Aim: This scoping review aimed to identify empirical evidence related to the effect of health educational guidelines on self-management practices among patients with chronic obstructive pulmonary disease improve self-management practices.
 Methods: Studies published between 2015-2021 and recruited from authentic databases, including MEDLINE, PubMed, CINAHL, and EBSCO, were reviewed critically to explore the effect of health educational guidelines on patient self-management practices.
 Results: There are four themes generated from this scoping review. In this scoping review, 14.700 articles were searched. After checking for duplicates, 1344 articles were left to evaluate titles and abstracts. This evaluation left 301 articles for reading of full texts. Of these, 238 articles did not meet the aim of this review. Ten studies were included in the current review.
 Conclusion: This scoping review found that health educational guidelines consider an important need to improve self-management practices. Health education can improve patients' health outcomes and thus should be considered an essential component of the overall management of COPD.

Factors associated with self-management practices and self-efficacy among adults with cancer under treatment in Saudi Arabia.

To discover the current state of self-management practices and levels of self-efficacy among adults with cancer under treatment in Jeddah City, Saudi Arabia, and to identify their associated factors. The prevalence of cancer and cancer treatment-related problems is increasing in Saudi Arabia. However, effective cancer care programmes are not provided in this country. Cross-sectional correlational study. This study was conducted with a convenience sample of 130 adults with cancer under treatment from May 2020-August 2020 at the largest tertiary care hospital providing cancer care in the western region, Saudi Arabia. The study methods were compliant with the STROBE checklist. Data were collected by Self-Care Inventory, Strategies Used by People to Promote Health, and sociodemographic and clinical surveys. Descriptive statistics and stepwise linear regression analysis were performed. The total score for self-management practices was 84.38 (SD=13.66) and self-efficacy, as a strong associated factor of self-management, earned a total score of 104.24 (SD=15.87). Stepwise regression analysis identified self-efficacy, age and education level as important associated variables, explaining 57.6% of the total variance in self-management practices. Significant effects of age, gender, marital status and duration of cancer on patients' self-efficacy were also found. The levels of self-management practices and self-efficacy to manage cancer treatment-related problems demonstrated by patients with cancer in this study were rated as a medium. Self-efficacy, age and education level were the significant factors associated with self-management practices of patients in Saudi Arabia. Age, gender, marital status and duration of cancer were identified as associated factors of self-efficacy. Enhancing patient's adherence to self-management practices and increase patient's self-efficacy through adopting educational intervention programmes, considering patient's sociodemographic and disease-related characteristics, and continuous patient education must be taken into consideration in the cancer management plan.

Acceptability and practicability of self-management for patients with Parkinson\u2019s disease based on smartphone applications in China

BackgroundChina has had about 1.2 billion mobile-phone users, and this number continues to grow. However, mobile-health services (mHealth) are currently in the initial stage, and have not yet prevailed in China. Additionally, the prevalence of Parkinson’s disease (PD) in China is 1700/100,000 (≥65 years). Indeed, these PD patients would benefit from mHealth to manage their disease. Therefore, we designed a study to determine attitudes toward smartphone applications (apps) for chronic condition self-management, and to discover the practicality of these apps among PD patients in China.MethodsWe selected 204 participants with PD between 52 and 87 years old and surveyed their attitudes concerning the use of smartphone apps for chronic condition management via questionnaires.ResultsAmong the participants, 65.19% had smartphones. Among these smartphone users, 82.84% expressed a preference for using apps for PD management. This group tended to be younger and more frequent web users with higher education and better medication compliance, and they tended to have a longer PD course and worse conditions (P < 0.001, P = 0.001, P < 0.001, P = 0.041, P < 0.001, P = 0.013). Additionally, the willingness to apply apps for PD self-management was positively related to education (P < 0.001) and negatively related to age and PD course (P = 0.017, P < 0.001).ConclusionIn China, patients with PD have a generally positive attitude towards self-management through smartphone apps. Consequently, improving the coverage of smartphones with practical and handy apps is a promising strategy for PD self-management.

Patients experiences of self-management and strategies for dealing with chronic conditions in rural Malawi

Background: The high burden of chronic communicable diseases such as HIV/AIDS, and an escalating rise of non-communicable diseases (NCDs) in Malawi and other African countries, calls for a shift in how healthcare services are designed and delivered. Patient-centred care and patient self-management are critical elements in chronic care, and advocated as global strategies. Further evidence is needed around patient self-management practices, and how to best support patients with chronic conditions in the African context. Our study explored self-management practices of patients with different chronic conditions, and their strategies to overcome care challenges in a resource constrained setting in Malawi. To further unpack self-management mechanisms and patient adjustment processes, we make use of Bandura’s social cognitive theory. Methods: We conducted a mixed methods study, involving patients with different chronic conditions from a rural district in Malawi. Data included a longitudinal survey with 129 patients, 14 in-depth interviews, and four focus-group discussions with patients. We used a framework approach for qualitative data analysis and survey data analysed using descriptive statistics. Results: Patients demonstrated ability to self-manage their conditions, though this varied between conditions, and was influenced by individual and environmental factors. Factors included: ability to acquire appropriate disease-specific knowledge; poverty level; the presence of support from family caregivers and community-based support initiatives; the nature of one's social relations; and the ability to deal with stressors and stigma. NCD and HIV comorbid patients were more disadvantaged in their access to healthcare, as they experienced frequent drug stock-outs and incurred additional out of pocket costs when referred. These barriers contributed to delayed care, poorer treatment adherence and likelihood of poorer treatment outcomes. Patients proved resourceful and made adjustments in the face of (multiple) care challenges. Discussion and conclusion: We found that patient adaptiveness is an individualised process and relies on how well a patient is able to cope with circumstances in their environment. Bandura’s social cognitive theory further elaborates adaptation as a process where patients develop different mechanisms. For instance, patients create internal models based on successful management of past experiences/events to deal with current challenges (symbolising); or choose to avoid situations that cause distress (self-regulation); or observe and learn complex skills from others such as peers in support groups (vicarious learning). We found evidence of the development of such mechanisms, but it proved difficult to delineate them from the broader patient environment, which was characterised by a heavy reliance on family support and restricted access to resources in their external environment. These in turn influenced patient experiences and strategies for self-management. As Malawi strives towards attaining universal healthcare, affordability and access to NCD services through the public sector presents a formidable challenge, particularly for the rural parts of the country. We recommend introducing peer-patient and support group initiatives for patients with NCDs, and further investments in the decentralisation of integrated health services. Limitation: Our research focused on one rural district in Malawi, hence transferability of our findings to contexts with different characteristics, such as urban setting(s), should be taken into consideration.

Knowledge, Attitude and Self-management Practices of Patients with Type 2 Diabetes in an Ambulatory Care Setting in Ibadan, Nigeria

Diabetes education is likely to be more effective if patients&#8217; characteristics and attitude toward diabetes is well understood. This study aims to assess knowledge and attitude of patients with type 2 diabetes about diabetes and its complications, self-care practices to recognize and manage diabetes crisis, as well as selfmonitoring of blood glucose with a view to identify the areas to focus for diabetes self management education and to improved diabetes care. A cross sectional study was conducted at Adeoyo General Hospital, a secondary care setting located in Ibadan, southwestern Nigeria. Pre-tested questionnaire was administered to 200 randomly selected type 2 diabetes patients between 2nd March and 31st May, 2009. Of these, 175 (87.5%) properly filled questionnaires were subsequently analyzed and descriptive statistics were used to summarize data. Chi-square was used for tests of proportions, while student t-test and ANOVA were used to compare continuous variables, with P &lt; 0.05 considered significant. Only 18 (10.3%) knew the most probable cause of diabetes, more than three fourth (77.7%) were not aware that poor control of blood glucose levels could result in complications. Only 24.1% could mention at least a symptom to recognize hypoglyacemic episode, while 75.9% were not aware of the self care approach to manage such crisis. Polyuria, 65 (37.4%) was the most commonly cited signal to recognize hyperglyacemic episode. Only 3.4% practice self monitoring of blood glucose. Overall, 47 (26.9%) had a good knowledge and attitude about diabetes. Knowledge, attitude and self management practices among type 2 diabetes patients is low. This knowledge gap about diabetes suggests the need for an institutionalized and effective standard for diabetes self management education so as to ensure improved diabetes care for the patient.Keywords: Type 2 diabetes, knowledge, attitude, self management practices, secondary care facility

Implementing Evidence-Based Patient Self-Management Programs in the Veterans Health Administration: Perspectives on Delivery System Design Considerations

While many patient self-management (PSM) programs have been developed and evaluated for effectiveness, less effort has been devoted to translating and systematically delivering PSM in primary and specialty care. Therefore, the purpose of this paper is to review delivery system design considerations for implementing self-management programs in practice. As lessons are learned about implementing PSM programs in Veterans Health Administration (VHA), resource allocation by healthcare organization for formatting PSM programs, providing patient access, facilitating PSM, and incorporating support tools to foster PSM among its consumers can be refined and tailored. Redesigning the system to deliver and support PSM will be important as implementation researchers translate evidence based PSM practices into routine care and evaluate its impact on the health-related quality of life of veterans living with chronic disease.