Patient Self-management Research Articles

Joint Action JACARDI: a context analysis on CVDs and diabetes policies and practices

Abstract Issue/problem Non-communicable diseases are the leading cause of death and disability in Europe, with 63 million people living with cardiovascular diseases (CVDs) and 32 million with diabetes (DM) in 2019. The EU-co-funded Joint Action on CVDs and diabetes (JACARDI), with 76 partners from 21 countries, aims to reduce CVDs and DM burden at European level through 142 pilot projects. Description of the problem For an effective and tailored pilots’ implementation, a preliminary step is to assess the current state of strategies and services for CVDs and DM prevention and management in Europe. We adopt the Gap Analysis methodology aiming to evaluate the gap between the current and the ideal state, the latter defined according to scientific evidence, best-practices, guidelines, and expert’s opinions. For this purpose, 12 questionnaires, one for CVDs and one for DM for six different thematic areas, were developed through a participatory approach that fostered the collaboration between the scientific coordination team and the project members. Results Questionnaires were sent to National Focal Points for health covering 29 European countries. We anticipate receiving responses from each country covering aspects related to the legal and strategic framework, the intersectoral and equity-oriented approaches, the funding and the service delivery and capacity for CVDs and DM. This information will be collected across each of the six thematic areas corresponding to six technical Work Packages (WP): health literacy, data, screening, integrated-care pathways, patients self-management, labour participation. The survey will be completed by June 2024, and results by WP and country will be presented. Lessons The context analysis, based on the Gap Analysis methodology, allows to identify gaps between the current and ideal state in CVDs and DM prevention and management. This will guide JACARDI’s pilots to address gaps and serve as a roadmap to inform European policy-makers. Key messages • The context analysis will provide an invaluable overview of the current European state of CVDs and DM prevention and management. • The context analysis will support JACARDI’s pilots in addressing identified gaps and policy-makers in shaping public health responses.

Minimum Dataset of Lung Cancer Patients: An Initial Step Towards Developing a Web-Based Personal Health Record

Background: Personal Health Records (PHR), which utilize advanced health information technology tools, play a crucial role in patient self-management and improving the control of chronic diseases such as lung cancer. To optimize the design of these systems, it is essential to determine the necessary data elements. Objectives: This study aims to identify the minimum dataset required for designing a web-based PHR for lung cancer patients. Methods: This descriptive, cross-sectional research was conducted in 2023. Initially, a lung cancer dataset was extracted through text analysis. In the next phase, a proposed minimum lung cancer dataset was formulated into a questionnaire containing 18 data groups, including 126 data elements. The dataset underwent expert validation in two phases using the Delphi technique. Data analysis was performed using SPSS version 26, with descriptive statistics employed. Results: The minimum web-based PHR dataset for lung cancer patients, consisting of 18 data groups (112 data elements), includes demographics, insurance information, emergency contact details, patient symptoms, tumor-related data, physician details, treatment information, patient-reported measurements, personal medical history, history of procedures and surgeries, visits, allergies, family history, medication information, test results, imaging data, dietary information, and educational materials. Conclusions: Based on the study findings, it is recommended that lung cancer data management encompass not only routine information but also additional dimensions such as allergies, tumor-related information, and dietary details. Collecting comprehensive and complete data can significantly enhance the treatment process and post-treatment follow-up.

Patient autonomy in self-managing their bronchial asthma exacerbation and its associated factors, 2024

IntroductionAsthma, a global chronic respiratory condition, varies in patient autonomy due to limited resources, health literacy, and cultural beliefs, emphasizing the importance of understanding this autonomy for improved asthma management.MethodsA cross-sectional study was conducted at Jimma University Comprehensive Specialized Hospital, involving face-to-face interviews with 175 patients. Data was collected on sociodemographic characteristics, clinical factors, and autonomy levels using a validated Patient Autonomy Preference Index. Descriptive statistics and binary logistic regression analysis were used.ResultsA total of 175 participants were recruited, out of them 41.7% (95% CI: 31.19, 40.41)) of participants were autonomous in managing their asthma exacerbation. 127 (72.6%) of study participants were female, with a mean age of 47.51 (SD ± 13.96), 101(57.7%) were live in urban areas, 54 (30.9%) had no formal education, 140 (80%) were married, 112 (64%) had health insurance, and 102(83.3%) obtained health information about their condition from healthcare workers. Reside in an urban area (AOR = 3.24; 95% CI: 1.40–7.49, p < 0.006), have health insurance (AOR = 4.30; 95% CI: 1.76–10.51, p < 0.001), those doing regular exercise (AOR = 4.79; 95% CI: 1.69–13.64, p < 0.003), have family history (AOR = 7.47; 95% CI: 1.61–34.60, p < 0.01), have a duration above five years since diagnosis (AOR = 0.44; 95% CI: 1.04–1.26, p < 0.003), and participants with a high level of health literacy (AOR = 1.10; 95% CI: 1.00–1.20, p < 0.042) become associated with being autonomous in managing asthma exacerbation.Conclusion and recommendationOnly around forty-two percent of study participants were autonomous in managing their asthma exacerbation. Thus healthcare providers should give due attention to those who reside in rural areas, are not insured, recently diagnosed with asthma, and with low health literacy to enhance patient autonomy and self-management practices, ultimately improving health outcomes for individuals with asthma.

The Determinants of Mental Illness Self-Management for Patients With Schizophrenia and Type 2 Diabetes: A Self-Determination Theory Approach.

This study based on self-determination theory aimed to assess the relationship between motivation, competence in diabetes management and perceived autonomy support respectively and mental illness self-management; furthermore, the authors intended to explore the determinants of mental illness self-management for patients with schizophrenia and diabetes. This was a cross-sectional study. One hundred ten participants were recruited at the psychiatric hospital and assessed with the Illness Management and Recovery Scale, the Treatment Self-Regulation Questionnaire, the Perceived Competence Scale for Diabetes and the Health-Care Climate Questionnaire. Patients with lower educational levels, who were admitted to the chronic ward, were unemployed, had lower motivation in illness management, lower competence in diabetes management and perceived lower autonomy support all had lower mental illness self-management. Competence in diabetes management, employment status, autonomy support, educational levels and living alone were the determinants of mental illness self-management. Recovery from schizophrenia and comorbid diabetes is an enduring and complicated process requiring support from healthcare providers. Health professionals should assess the levels of illness self-management and provide integrated care interventions for patients with schizophrenia and diabetes, helping them manage both conditions. The illness management programme could apply to patients with schizophrenia and diabetes and address patients' characteristics such as low levels of education, living alone and being unemployed while additionally promoting motivation and competence, and providing supporting autonomy. The STROBE checklist was followed. Patients with schizophrenia and diabetes were recruited for this study and voluntarily completed the questionnaire.

Behavior Change Techniques Used in Self-Management Interventions Based on mHealth Apps for Adults With Hypertension: Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Hypertension has become an important global public health challenge. Mobile health (mHealth) intervention is a viable strategy to improve outcomes for patients with hypertension. However, evidence on the effect of mHealth app interventions on self-management in patients with hypertension is yet to be updated, and the active ingredients promoting behavior change in interventions remain unclear. We aimed to evaluate the effect of mHealth app self-management interventions on blood pressure (BP) management and investigate the use of behavior change techniques (BCTs) in mHealth app interventions. We conducted a literature search in 6 electronic databases from January 2009 to October 2023 for studies reporting the application of mHealth apps in self-management interventions. The Cochrane Risk of Bias (version 2) tool for randomized controlled trials was used to assess the quality of the studies. BCTs were coded according to the Taxonomy of BCTs (version 1). The extracted data were analyzed using RevMan5.4 software (Cochrane Collaboration). We reviewed 20 studies, of which 16 were included in the meta-analysis. In total, 21 different BCTs (mean 8.7, SD 3.8 BCTs) from 12 BCT categories were reported in mHealth app interventions. The most common BCTs were self-monitoring of outcomes of behavior, feedback on outcomes of behavior, instruction on how to perform the behavior, and pharmacological support. The mHealth app interventions resulted in a -5.78 mm Hg (95% CI -7.97 mm Hg to -3.59 mm Hg; P<.001) reduction in systolic BP and a -3.28 mm Hg (95% CI -4.39 mm Hg to -2.17 mm Hg; P<.001) reduction in diastolic BP. The effect of interventions on BP reduction was associated with risk factors, such as hypertension, that were addressed by the mHealth app intervention (multiple risk factors vs a single risk factor: -6.50 mm Hg, 95% CI -9.00 mm Hg to -3.99 mm Hg vs -1.54 mm Hg, 95% CI -4.15 mm Hg to 1.06 mm Hg; P=.007); the presence of a theoretical foundation (with vs without behavior change theory: -10.06 mm Hg, 95% CI -16.42 mm Hg to -3.70 mm Hg vs -4.13 mm Hg, 95% CI -5.50 to -2.75 mm Hg; P=.07); intervention duration (3 vs ≥6 months: -8.87 mm Hg, 95% CI -10.90 mm Hg to -6.83 mm Hg vs -5.76 mm Hg, 95% CI -8.74 mm Hg to -2.77 mm Hg; P=.09); and the number of BCTs (≥11 vs <11 BCTs: -9.68 mm Hg, 95% CI -13.49 mm Hg to -5.87 mm Hg vs -2.88 mm Hg, 95% CI -3.90 mm Hg to -1.86 mm Hg; P<.001). The self-management interventions based on mHealth apps were effective strategies for lowering BP in patients with hypertension. The effect of interventions was influenced by factors related to the study's intervention design and BCT.

Effectiveness of Mobile Application Disease Self-Management Programme on Mental Health and Self-Management of Patients With Hypertension: A Randomised Controlled Trial.

Hypertension is a chronic disease that consumes considerable medical resources. The aim of this study is to evaluate a model able to develop and assess the effectiveness of a mobile application disease self-management programme regarding mental health and self-management for patients with hypertension. A randomised controlled trial and single-blind random assignment was employed to group the participants. A total of 100 patients were collected from the cardiology clinic of a teaching hospital in Taiwan. There were 50 participants in each group: the mobile application group (experimental group) and the routine care (control group). The primary outcome measures were mental health and self-management. This study discovered that the intervention improved the mental health and self-management of the experimental group. The results for the experimental group revealed significantly improved effects and outcomes superior to those of the control group. The study results verified that a mobile application disease self-management programme could improve the mental health and disease self-management of patients with hypertension.

Nurse-Led Physical Screening of Patients With Substance Use Disorders: A Cross-Sectional Study.

Somatic comorbidity is the main cause of reduced life expectancy in patients with substance use disorders (SUDs). This study aims to investigate somatic health challenges in patients with SUDs using the USS. Patient self-management of somatic health and quality of life were also assessed. In our study, a stratified random sample of 136 clients who received treatment at a specialist addiction facility was drawn to investigate their physical health and lifestyle behaviours using the Utrecht Somatic Screening 2.0 (USS 2.0). The sample included three subgroups, that is, patients receiving outpatient treatment through Flexible Assertive Community Treatment (FACT), Heroin-Assisted Treatment (HAT) and Opioid Replacement Therapy (ORT). Pain, self-management and quality of life were also measured. Descriptive statistics were used to analyse the data. The findings indicate that many patients experience a large number of somatic health problems, including pain and exhaustion. The most prevalent conditions in this study are cardiovascular disease (25%) and COPD (20%), underweight and poor oral health. Tobacco smoking is prevalent among 88% of patients. Fifty percent of the patients expressed a need for support in managing their physical health. Somatic health care and lifestyle promotion should be tailored to the specific characteristics of patients. Patients with SUDs suffer from poor physical health and show unhealthy lifestyle behaviours, which demand the promotion of tailored somatic health.

A Study of Diabetes Correlated Emotional Distress among Patients with Type 2 Diabetes Mellitus: A cross Sectional Study

Background: Diabetes distress (DD) is a significant concern for individuals with type 2 diabetes, marked by emotional strain related to disease management and support, distinct from general psychological distress. Specific Background: Addressing DD can improve self-care practices and glycemic control, yet limited research exists on the relationship between emotional distress and sociodemographic factors in this population. Knowledge Gap: This study aims to fill this gap by exploring how sociodemographic traits influence emotional distress among type 2 diabetes patients. Aims: The primary objectives are to identify the correlation between emotional distress and diabetes and to determine the impact of sociodemographic characteristics on this distress. Results: A descriptive cross-sectional study conducted at the Endocrinology and Diabetes Center in Al-Basrah City included 150 patients aged 50–65 years, with a significant proportion of men (63.3%). The findings revealed a mean emotional distress score of 3.81, indicating high distress levels, with physician-associated distress at 3.32 and regimen-related distress at 3.48. Novelty: This research highlights the strong correlation between emotional and diabetes-related distress, particularly across different age and gender demographics, thus emphasizing the need for tailored interventions. Implications: The study emphasizes the importance of incorporating psychological assessments into diabetes management and policymakers' consideration of emotional dimensions in health program designs to improve patient self-management and quality of life. Highlights: Diabetes distress impacts self-care and glycemic control. Socio-demographics influence emotional distress levels in patients. Psychological assessments are crucial in diabetes management strategies. Keywords: diabetes distress, emotional distress, type 2 diabetes, sociodemographic factors, healthcare interventions

Effect of self-efficacy on self-management ability for colorectal cancer patients with stoma: a path analysis.

Colorectal cancer threatens health and causes heavy social burdens. The purpose of this study is to analyze the pathway model for the effect of self-efficacy on self-management ability in colorectal cancer patients with stoma. A cross-sectional study was conducted from December 2022 to April 2023, with a convenience sample of 422 colorectal cancer patients with stoma at six tertiary grade A hospitals in Shandong Province, China. Statistical analysis was undertaken using SPSS 26.0 and Amos 24.0 software. A pathway model based on individual and family self-management theories was developed and analyzed by collecting data through onsite survey and online survey. Chinese colorectal cancer patient's self-management ability score is 105.19 (17.19), which shows medium-level self-management ability. The self-efficacy of colorectal cancer patients with a stoma is influenced by social support, which ultimately leads to changes in their self-management ability. The findings may help healthcare professionals to identify the factors that influence self-management skills of colorectal cancer patients with stoma and provide a basis for developing interventions.

Algorithm-Based Mobile Texting Platform for the Self-Management of Interstitial Cystitis/Bladder Pain Syndrome: Pilot Study Evaluating Feasibility, Usability, and Potential Utility.

We developed an algorithm-based mobile texting platform for promoting self-management in patients with interstitial cystitis/bladder pain syndrome (IC/BPS). Our aim was to measure the feasibility, usability, and potential utility of the platform. A texting platform that delivered 4 treatment modules (education and behavioral modification, cognitive behavioral therapy, pelvic floor physical therapy, and guided mindfulness practices) and an automated weekly message over 6 weeks was developed. Feasibility and usability were determined using patient engagement (proportion of platform messages to which patients responded) and System Usability Scale. Satisfaction with patient-physician communication questionnaire, Pain Self-Efficacy Scale, and Interstitial Cystitis Symptom and Problem Index were administered before and after the intervention. Engagement with the platform in 52 female patients with IC/BPS [median age (IQR) 40 (30-48) years] was 76.9%. The commonest module selected by patients was pelvic floor physical therapy (50%) followed by cognitive behavioral therapy (34%) and guided mindfulness (15%). System usability score (median, IQR) was 87 (83-95), indicating high usability. Satisfaction with patient-physician communication improved significantly (median change, 4; IQR, 1-9; P < .001). Pain self-efficacy score improved from moderate impairment at baseline to minimal impairment at 6 weeks (median change, 10; IQR, 2-18; P < .001). Urinary symptoms scores also improved (median change Interstitial Cystitis Symptom Index, -3; IQR, -5 to -1.5; P < .001, Problem Index, -2; IQR, 5.5 to -0.5; P < .001). An automated mobile platform has the potential for improving access to self-management strategies and easing clinicians' challenge of counseling patients with IC/BPS during time-limited in-person visits. ClinicalTrials.gov Identifier: NCT05260112.

Demand Analysis of Self-Management Mobile Health Applications for Middle-Aged and older Patients with Chronic Kidney Disease Based on the Kano Model.

Middle-aged and older individuals often face significant challenges in adopting digital health solutions, leading to a digital divide that hinders their ability to benefit from mobile health (mHealth) interventions. This study aims to investigate the specific requirements of middle-aged and older patients with chronic kidney disease (CKD) for self-management through mobile health applications (mHealth apps), using the Kano model. A multicenter cross-sectional survey was conducted from April to September 2023 in five hospitals across Sichuan, Shandong, Guangdong, and Shaanxi provinces in China. The Kano model was employed to analyze participants' preferences regarding mHealth apps for self-management. Out of 359 participants (57.1% men, predominantly aged 45-54), the study identified essential and desirable features for mHealth apps. Essential attributes include comprehensive CKD information and robust privacy protection. Key to enhancing user satisfaction are features like symptom and medication management, access to medical insurance information, and app interface simplicity. Additional attractive features for increasing app appeal include diet management, exercise guidance, and customizable text size. This study identifies critical mHealth app features for self-management in middle-aged and older CKD patients, emphasizing the importance of user-centric design. The findings provide valuable insights for app developers to create tailored solutions that cater to the specific needs of this demographic, potentially enhancing their self-management capabilities.

Relationships Between Quality of Discharge Teaching, Readiness for Hospital Discharge, Self-Efficacy and Self-Management in Patients With First-Episode Stroke: A Cross-Sectional Study.

The study investigated the influence of quality of discharge teaching (QDT) on readiness for hospital discharge (RHD) and pathways involved in patients with first-episode stroke, aiming to provide a theoretical framework for enhancing RHD levels and reducing readmission rates. Cross-sectional study. A total of 372 inpatients completed the Quality of Discharge Teaching Scale, Readiness for Hospital Discharge Scale, Chronic Disease Self-efficacy Scale and Southampton Stroke Self-Management Questionnaire. Structural equation modelling and Pearson's correlation analysis were utilised to elucidate relationships and action pathways among these variables. The correlation analysis demonstrated significant positive pairwise correlations between QDT, RHD, self-efficacy and self-management (r = 0.376-0.678, p < 0.01). The final model exhibited a good fit with the following indices: χ2/df = 3.286, RMSEA = 0.078, SRMR = 0.0303, GFI = 0.984, AGFI = 0.926, CFI = 0.991 and TLI = 0.970. The impact of QDT on RHD in patients with first-episode stroke was observed through one direct and three indirect pathways: (1) QDT exerted a direct influence on RHD (p < 0.001); (2) QDT indirectly influenced RHD via self-efficacy (p < 0.001); (3) QDT indirectly affected RHD through self-management (p < 0.001); and (4) QDT had an indirect effect on RHD via both self-efficacy and self-management (p < 0.05). QDT was found to directly influence RHD in patients with first-episode stroke and also exerted indirect effects through self-efficacy and self-management, either independently or in combination. Early screening of RHD levels in patients before discharge is recommended, along with the enhancement of QDT through the development of tailored guidance plans according to different disease stages, ultimately improving RHD levels and facilitating a safer transition from hospital to home or community. Healthcare professionals should assess both QDT and RHD levels to provide targeted interventions. The establishment of transitional care teams and implementation of long-term poststroke management are essential for reducing stroke recurrence and mortality rates.

Self-management in young and middle-aged patients with hypertension: a systematic review and meta-synthesis of qualitative studies

BackgroundThere has been a sharp increase in the prevalence of hypertension in young and middle-aged people at high risk of the disease. Despite the fact that good self-management can be effective in controlling blood pressure, patients do not perform well in this area, resulting in poor blood pressure control. It is therefore particularly important to gain a thorough understanding of patients’ attitudes to self-management and the factors that influence them. The aim of this study was to synthesise the qualitative research on attitudes, motivations and challenges of self-management in young and middle-aged hypertensive patients, to analyse the synthesised results using the COM-B model and to propose appropriate improvement actions.MethodsFrom the time of construction until May 2023, the system searched PubMed, Web of Science, ProQuest, Embase, MEDLINE, CINAHL, PsyCINFO and CNKI databases. The analyses were carried out using a thematic synthesis approach to summarise the key findings. The findings were then mapped and analysed using the COM-B model.ResultsA total of 11 studies were included, involving 250 patients between the ages of 18 and 64. Four themes with ten sub-themes were identified: Poor disease recognition (low disease perception, fuzzy disease knowledge); Barriers to doctor-patient interactions (short communication time, unmet knowledge needs, incomplete guidance for disease management); Living in a hostile environment (heavy workload, lack of companionship, ignorance of families); Expectations for a healthy body (responsibility of family roles, witness the cruelty of illness). Analysis of the composite results based on the COM-B model showed that low disease perceptions, barriers to doctor-patient interactions and life circumstances with enemies on all sides were the main challenges faced by young and middle-aged hypertensive patients, whereas the expectation of a healthy body was a motivation to promote self-management of blood pressure in patients.ConclusionsThis study shows that family responsibilities are a particular motivator for self-management in young and middle-aged hypertensive patients. In response to the problems they face, we believe that meeting patients’ knowledge needs, improving healthcare professionals’ communication skills and valuing the role of community hospitals are effective ways to promote patient self-management. In the future, telemedicine, mobile healthcare and intelligent monitoring devices will provide a solution to reduce the burden on medical resources.Systematic review registrationPROSPERO CRD42018100810.

Impact of an SMS intervention to support type 2 diabetes self-management: DiabeText clinical trial.

Complications arising from uncontrolled Type 2 Diabetes Mellitus (T2DM) pose a significant burden on individuals' well-being and healthcare resources. Digital interventions may play a key role in mitigating such complications by supporting patients to adequately self-manage their condition. To assess the impact of DiabeText, a new theory-based, patient-centered, mobile health intervention integrated with electronic health records to send tailored short text messages to support T2DM self-management. Pragmatic, Phase III, 12-month, two-arm randomized clinical trial with T2DM primary care patients in Spain. 742 participants with suboptimal glycemic control (HbA1c>7.5) were randomly allocated to a control (usual care) or intervention (DiabeText) group. The DiabeText group received, in addition to usual care, 165 messages focused on healthy lifestyle and medication adherence. glycated hemoglobin (HbA1c). medication possession ratio, quality of life (EQ-5D-5L), diabetes self-efficacy (DSES); and self-reported adherence to medication, Mediterranean diet (MEDAS-14), and physical activity (IPAQ). Over the 12-month period, we observed no significant differences in HbA1c between the intervention and the control groups (Beta=-0.025 (-0.198 to 0.147; p=0.772)). In comparison with the control group, the DiabeText group showed significant (p<0.05) improvements in self-reported medication adherence (OR=1.4; 95%CI: 1.0 to 1.9), DSES (Cohen's d=0.35), and EQ5D-5L (Cohen's d=0.18) scores; but not in the rest of secondary outcomes. DiabeText successfully improved quality of life, diabetes self-management, and self-reported medication adherence in primary care patients with T2DM. Further research is needed to enhance its effects on physiological outcomes.

Impact of a care delivery intervention for patients with socioeconomic disadvantages, in their preferred language of English or Spanish.

97 Background: Sinai Health System’s oncology program serves Chicago’s inner city patients with substantial needs for social and primary care, many of whom prefer communication in Spanish. Sinai has implemented a care delivery intervention to address these needs, using the 4R Oncology Model for patient-facing care planning and patient self-management. 4R (Right Info/Care/Patient/Time) has shown significant improvements in the timeliness of care cancer delivery and referrals to cancer care (1). Herein, we implemented the 4R intervention to improve the timeliness of care delivery and referrals to care, focusing on the social and primary care needs of Sinai patients. Methods: Evaluation was conducted by surveying historical control and intervention (4R) cohorts of patients in their preferred language of Spanish or English. The 4R cohort received care at a Sinai medical oncology clinic Apr 2023 - Jan 2024. Control cohort received care Jan 2023 – March 2023. Analyses were conducted using Fisher’s exact test. Results: Survey response rates: 76% (38/50) in control and 75% (33/44) in 4R cohorts. Participant characteristics were comparable between control and 4R cohorts, respectively: 55%, 58% Hispanic, 42%, 39% Black; 76%, 82% high school education or less; 87%, 97% &lt; 30k income; 50%, 55% preferred language Spanish; 47%, 45% English. For the total cohorts, all 5 metrics improved between control and 4R, and 4 of the 5 metrics improved significantly (Table). Among Spanish-preferred patients, 3 of the 5 metrics improved significantly, while improvements among English-preferred patients were not statistically significant. Both language groups saw numerical, but not statistically significant improvement in receiving referrals to primary care and meeting all their practical and family needs. Conclusions: The 4R Oncology intervention resulted in significant improvement in time to treatment and referrals to social and primary care in our population of socioeconomically disadvantaged patients with high needs for these services. Patients preferring Spanish benefited at a higher rate than English-preferring patients, indicating that 4R may be an effective method to address the needs of this important patient group. Future efforts will further optimize 4R to address remaining gaps for this group, as well as to improve the delivery of this care for the English-preferred patients. 1. Trosman JCO OP 2021. Metric Control Total %N=38 4R Total %N=33 Control Spanish %n=19 4R Spanish %n=18 Control English %n=19 4R English %n=15 Started treatment within 6 weeks of diagnosis 61 88* 53 94* 68 80 Received referral to primary care 66 82* 74 83 58 80 Received referral to support for transportation, food, and other needs 68 85* 63 89* 74 80 Referred to help and resources to help pay for care 50 67* 47 78* 53 53 All of my practical and family needs were addressed 86 89 84 89 87 87 *p&lt;0.1 comparing control and 4R cohorts.

Effects of Illness Perception and Coping Style on Self-Management in Peritoneal Dialysis Patients: A Cross-Sectional Study.

Chronic disease self-management is critical to disease prognosis and patient quality of life. Several psychological factors influence this process of self-management. In this background, the present study investigated the impact of illness perceptions and coping style on self-management in people with peritoneal dialysis (PD). The study is a cross-sectional study. From May 2022 to January 2023, a convenience sampling method was used to recruit 246 peritoneal dialysis patients. General information questionnaire, brief illness perception questionnaire, medical coping style modes questionnaire and the self-management scale for peritoneal dialysis patients were used in this study. We used SPSS 24.0 to analyze the data, and the statistical methods included descriptive analysis, single factor analysis, Pearson correlation analysis and multiple linear regression analysis. A total of 246 patients were included in this study (93.89% response rate). Cognitive representations and emotional representations were 30.40, 14.18, respectively. However, illness comprehensibility was 2.87. Illness perceptions were negative significantly correlated with self-management. With regard to coping style, our patients were more likely to adopt avoidance and resignation coping style. Confrontation and avoidance were positively related to self-management, while acceptance-resignation was negatively related. Self-management of peritoneal dialysis patients needs to be improved. Age, female sex, monthly income, illness perceptions and coping style were independently associated with self-management. These findings suggest that interventions that improve illness perceptions and coping style should be explored to ultimately improve their self-management. For example, patients can be provided with psychological counseling so that they can face the disease correctly, and we should pay attention to the positive role of social support.

Knowledge of self-management and asthma control among asthma patients attending a polyclinic in Western part of Singapore

BACKGROUND: Self-management is important for asthma control, yet it is unclear whether asthmatic patients have sufficient knowledge to optimally manage their disease. We examined the associations between the knowledge of self-management in adult patients attending a polyclinic in Singapore, sociodemographic factors, and asthma control. MATERIALS AND METHODS: A cross-sectional survey was conducted among adult asthmatic patients in a public primary care clinic (polyclinic) using convenience sampling. A a structured and validated self-administered questionnaire solicited the responses of study participants. Questionnaire comprised three sections: (1) Sociodemographic and asthma-related variables, (2) Modified Asthma Self-Management Questionnaire (ASMQ), and (3) The GINA assessment of asthma control. Participants completed the questionnaire in the clinic waiting area and returned them into a sealed box in the same area. Data were analyzed using SPSS version 29.0. Summary statistics were used to describe the study sample; t-test or analysis of variance (ANOVA), as appropriate, tested the differences in self-management knowledge by sociodemographic characteristics. Logistic regression was used to determine the association between asthma control and self-management knowledge controlling for sociodemographic characteristics. RESULTS: The sample comprised 141 asthma patients; Out of a total of 100 points, the mean ASMQ score was 46.8 (standard deviation 21.7). The scores for the knowledge of self-management of Asthma differed by age, level of education, and having been taught about asthma on bivariate analyses (P &lt; 0.05). Linear regression showed a significant association of asthma self-management knowledge with educational level only. No association was observed between ASMQ scores and asthma control. CONCLUSION: There were gaps in patients’ knowledge about asthma self-management, although they were generally knowledgeable about the inhaler technique. Higher education levels were associated with higher levels of knowledge beyond the effect of age and having been instructed about asthma, suggest that it is crucial that educational programs on asthma are made accessible to patients with lower levels of education. Further research needs to determine whether asthma educational programs targeting the knowledge gaps found in this study can improve knowledge of self-management and asthma control.

Using a Mobile Application to Promote Patient Education for Patients With Liver Cirrhosis.

Patient education and self-management are essential for patients with liver cirrhosis. Based on Fisher and Fisher's Information-Motivation-Behavior Skills model, a Cirrhosis Care App was developed to support the education and self-management of these patients. To evaluate the effectiveness of the application, a randomized controlled trial was conducted with patients having liver cirrhosis who were being followed up in the outpatient area of ​​a medical center in Taiwan. The experimental group used the app for 1 month, whereas a control group continued to receive conventional patient education. A pretest and posttest questionnaire was used to evaluate the app's effectiveness in improving the knowledge and practice of self-care. In addition, a questionnaire was developed based on the Technology Acceptance Model to understand satisfaction with the app. Results showed that following the implementation of the Cirrhosis Care App, patients' self-care knowledge and ability to promote self-care practice improved. User satisfaction with the app was measured and reflected in its frequency of use. This study confirmed that the Cirrhosis Care App, based on the Information-Motivation-Behavior Skills model, can improve patient knowledge and self-care practice and be actively promoted to benefit patients with cirrhosis.

Effectiveness of Dialysis Transition Unit to Improve Patients' Decision-Making and Self-Management Skills

Effectiveness of Dialysis Transition Unit to Improve Patients' Decision-Making and Self-Management Skills

Healthcare professionals beliefs and priorities for the rehabilitation of patients after ankle fracture surgery: A qualitative study

ObjectiveThe study aims to understand healthcare professionals’ (HCPs) beliefs and practices in the treatment and rehabilitation of patients after ankle fracture surgery, with the goal of informing new rehabilitation interventions based on these insights. BackgroundThere is considerable variation in postoperative rehabilitation advice given to patients with ankle fractures, leading to inconsistent care. Prior studies have primarily focused on patients' experiences, making it crucial to explore HCPs' perspectives to identify areas for intervention. MethodsThe study utilised semi-structured interviews with HCPs involved in the multicentre randomised controlled Weightbearing in Ankle Fractures (WAX) trial. Interviewees included physiotherapists, consultant trauma and orthopaedic surgeons, and trainee surgeons. Interviews were conducted between February 2020 and December 2021. Data were analysed using a mixed deductive and inductive approach, aligning with the Behavioural Change Wheel framework to translate findings into potential intervention strategies. Results18 Interviews were conducted, revealing discrepancies between patient and HCP beliefs about recovery, particularly regarding weight-bearing and managing physical symptoms like swelling and numbness. HCPs expressed varying beliefs on the safety of early weight-bearing and recognised historical practice and medicolegal concerns influencing rehabilitation advice. Themes highlighted the need for clearer communication, standardised advice, and the impact of HCPs' remarks on patients' recovery confidence. ConclusionsFindings underscore the mismatch between patient expectations and HCP guidance, emphasising the need for consensus on rehabilitation protocols. The study advocates for tailored rehabilitation pathways that address individual patient recovery trajectories, reduce dependency on HCPs, and encourage patient self-management.