Self-management Model Research Articles

Abstract 1301: Comparing VA and safety-net hospital patient-reported care metrics and provider recommendations to address social determinants of health and demographics

Abstract Background: The Jesse Brown Department of Veterans Affairs Medical Center (JBVA) and Sinai Chicago, a safety-net hospital nearby, serve veterans and patients with significant social needs on Chicago's South and West sides. Both institutions are adopting the 4R Oncology Model (Right Info/Care/Patient/Time) for patient-facing care planning and self-management, proven to enhance supportive and health maintenance care delivery (Trosman JCOOP 2021). This abstract depicts a baseline survey of JBVA veterans’ and Sinai Chicago patients' experiences in planning and delivering guideline-directed supportive and health maintenance care for new cancer diagnoses, informing 4R implementations. Methods: Patients at JBVA and Sinai Chicago were surveyed from February to September 2023 with participants receiving a $25 gift card. An analysis was conducted using Fisher’s two-tailed exact test. Results: The two institutions yielded a 67% survey response rate. Key patient demographics and oncologic and supportive care metrics are outlined in the table below. At JBVA, fewer than 50% of veterans knew their cancer stage at diagnosis, and 63% were aware of their care goals. Furthermore, only 17% of veterans received recommendations for support services offered by JBVA. “Emotional distress or worry” support recommendations were received by < 50% of patients at both institutions. Conclusions: The baseline survey uncovered gaps in care planning, supportive services, and health maintenance care in both institutions, catering to patients with challenging social determinants of health. The implementation of the 4R Oncology Model is designed to address these gaps, providing a personalized care sequence that establishes a clear roadmap through the patient's care trajectory, ultimately enhancing patient-centered care. Further results will be shared when available. Metric Combined% of pts(n=60) JBVA% of pts (n=30) SINAI% of pts(n=30) PVALUE Patient knew stage of their cancer 67 43 86 0.0005 Patient knew goal of their care 77 63 86 0.0442 Cancer care provider recommended to: Get Nutrition consult about how to eat during cancer treatment 35 27 42 0.2997 Talk to your primary care provider about staying as healthy as possible during care treatment 62 57 67 0.4523 Get support for transportation, food, housing, insurance, or other practical needs 44 17 67 0.0001 Get help to stop smoking or vaping* 29 28 31 1.0 Get help for emotional distress or worry* 37 24 46 0.1078 Demographics Age 59 66 53 0.0001 Male 69 93 39 0.0004 Black 59 83 39 0.0001 Hispanic 32 0 58 0.1103 High School education or less 68 57 78 0.1854 Household income less than $30,000 ** 70 59 81 0.1305 Live Alone 37 47 29 0.0001 *of those who reported needing help, **of those who shared income level Citation Format: Neha Hippalgaonkar, Michael Weinfeld, Christine Weldon, Julia Trosman, Cindy Chan, Sarah Khan, Swetha Paduri, Vijay Reddy, Auradha Sakhuja, Paramjeet Khosla, Mary Pasquinelli, Lawrence Feldman. Comparing VA and safety-net hospital patient-reported care metrics and provider recommendations to address social determinants of health and demographics [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 1301.

The Role of Self-Efficacy in Coping With the Psychological Challenges of Job Loss: Application of the Social Cognitive Career Self-Management Model

There is substantial evidence that involuntary job loss can have major implications for workers’ well-being. Yet research on coping with unemployment has most often focused on the job search process and progress toward re-employment, with less emphasis on the process of coping with the myriad psychological challenges of job loss. This study adapted the social cognitive model of career self-management as a framework for understanding well-being and psychological distress during unemployment. Participants were 602 unemployed workers who completed social cognitive measures representing two coping sub-domains, job searching and psychological coping. Within each sub-domain, measures included coping behaviors, self-efficacy, and support. Measures of proactive personality, financial strain, and two psychological functioning criteria (emotional well-being and distress) were also completed. The findings provided initial psychometric support for a novel measure of psychological coping self-efficacy and suggested the utility of the psychological coping variables as predictors of well-being and distress above and beyond job search coping in the context of unemployment. The study’s implications for practice and future research on coping with unemployment are discussed.

Vicarious learning and graduates' adaptive career behaviours: the case of graduates on clinical internships

PurposeThe effect of vicarious learning during clinical or medical internships on graduates' adaptive career behaviours has attracted scant attention from healthcare researchers, particularly, in the developing world context. Drawing upon the social cognitive career theory model of career self-management (SCCT-CSM), the current study examines how vicarious learning influences the clinical graduates' adaptive career behaviours (i.e. career exploration and decision-making) via career exploration and decision-making self-efficacy (CEDSE) and career intention.Design/methodology/approachData were collected from 293 nursing graduates undertaking clinical internships in 25 hospitals across Nigeria who willingly participated in this study as they were also assured of confidentiality at two-waves. The proposed hypotheses were tested using a path analysis.FindingsThe findings showed that vicarious learning during clinical internship had a direct effect on career exploration, decision-making and career decision self-efficacy among graduate trainees. Also, the findings revealed that the effects of vicarious learning on the graduates' career exploration and career decision-making were significantly mediated by career decision self-efficacy and career intentions.Practical implicationsThe findings of this study have important practical implications for higher education institutions and industries that send and receive clinical graduates for clinical internships to gain more skills. More emphasis should be on encouraging learners to learn vicariously in addition to other forms of learning experiences available during clinical internships.Originality/valueThe study explains that the graduates' higher engagement in clinical career exploration and decision-making was based on a higher level of vicarious learning during internships. The results suggest that higher education institutions and healthcare service providers can derive greater benefits from more emphasis on promoting vicarious learning during clinical internships.

Pediatrician perspectives on barriers and facilitators to discharge instruction comprehension and adherence for parents of children with medical complexity.

High rates of posthospitalization errors are observed in children with medical complexity (CMC). Poor parent comprehension of and adherence to complex discharge instructions can contribute to errors. Pediatrician views on common barriers and facilitators to parent comprehension and adherence are understudied. To examine pediatrician perspectives on barriers and facilitators experienced by parents in comprehension of and adherence to inpatient discharge instructions for CMC. We conducted a qualitative, descriptive study of attending pediatricians (n = 20) caring for CMC in inpatient settings (United States and Canada) and belonging to listservs for pediatric hospitalists/complex care providers. We used purposive/maximum variation sampling to ensure heterogeneity (e.g., hospital, region). A multidisciplinary team designed and piloted a semistructured interview guide with pediatricians who care for CMC. Team members conducted semistructured interviews via phone or video call. Interviews were audiorecorded and transcribed. We analyzed transcripts using content analysis; codes were derived a priori from a conceptual framework (based on the Pediatric Self-Management Model) and a preliminary transcript analysis. We applied codes and identified emerging themes. Pediatricians identified three themes as barriers and facilitators to discharge instruction comprehension and adherence: (1) regimen complexity, (2) access to the healthcare team (e.g., inpatient team, outpatient pediatrician, home nursing) and resources (e.g., medications, medical equipment), and (3) need for a family centered and health literacy-informed approach to discharge planning and education. Next steps include the assessment of parent perspectives on barriers and facilitators to discharge instruction comprehension and adherence for prents of CMC and the development of intervention strategies.

The self-management model can increase the immunity of people with HIV and AIDS during the COVID-19 pandemic

Cases of people living with HIV and AIDS continue to increase from year to year, necessitating a focus on maintaining their health. To ensure their well-being, individuals with HIV/AIDS must be vigilant in preserving their immunity, especially during COVID-19 pandemic. This research aimed to enhance the immunity of people with HIV and AIDS during the COVID-19 pandemic utilizing a self-management model approach. The research employed a quasi-experimental design with pretest and posttest measurements, involving a sample of 30 HIV and AIDS patients in Sorong City, selected through purposive sampling technique. Independent variable in this research was the self-management model, which measured using Self-Management Model Guidebook and dependent variable was increasing the immunity of people with HIV and AIDS, which was measured using Self Reporting Questionnaire (SRQ) and CD4 cell observation. Data were analyzed using Wilcoxon test with significance level for these tests was set at 95%, with α ≤ 0.05. Analyzing the SRQ results of HIV/AIDS patients before and after the intervention, indicated a significant difference with a Sig. (2-tailed) of 0.044 < 0.05. This suggests a notable change in the SRQ results of HIV/AIDS patients. Additionally, the analysis of CD4 cell values before and after the intervention, yielded a Sig. (2-tailed) of 0.000 < 0.05, signifying a difference in the CD4 cell results of HIV/AIDS patients. In conclusion, implementing the self-management model with the four management functions from Planning, Organizing, Actuating, and Controlling (POAC) over a period of 30 days for HIV and AIDS patients during the COVID-19 pandemic can enhance both mental and psychosocial immunity, as well as physical immunity. The findings of this research provide valuable information to health workers, recommending the adoption of the Self-Management Model Guide intervention to enhance the immunity of individuals with HIV and AIDS.

How Career and Non-Work Goal Progress Affect Dual Earners’ Satisfaction: A Whole-Life Perspective

Many career self-management models assume that career goal progress promotes satisfaction, but research on the topic has yielded mixed results. Adopting a whole-life perspective, this study examines how career and non-work goal progress relate to career, non-work, and life satisfaction and explores crossover effects and gender differences between dual-earner partners. We tested our research model using Actor-Partner Interdependence Modeling on a two-wave dataset of 190 heterosexual dual earners (i.e., 95 couples). Career goal progress was not related to any of the satisfaction indicators. For men, non-work goal progress was marginally positively related to career and non-work satisfaction and positively related to life satisfaction. For women, non-work goal progress was not related to any satisfaction indicator. Between partners, men’s non-work goal progress was positively related to women’s non-work and life satisfaction, whereas women’s career goal progress was negatively related to men’s life satisfaction. Implications for research and career practice are discussed.

The risk prediction of intergenerational transmission of overweight and obesity between mothers and infants during pregnancy.

Overweight and obesity in mothers before pregnancy lead to overweight and obesity in their offspring, which is the main form of intergenerational transmission of overweight and obesity in early life. Many factors, especially non-genetic factors, may influence intergenerational transmission, but little prediction research has been conducted. Therefore, we analyzed the status of intergenerational transmission in maternal and infant overweight and obesity. Second, we explored the factors during the pregnancy that might affect the the intergenerational transmission; According to the two application scenarios of pregnancy screen and self-management, risk prediction models for pregnant women were carried out. Based on a prospective birth cohort, a total of 908 mothers and offspring were followed up during early life. Follow-up visits were performed at the first trimester, second trimester, third trimester, delivery, 42 days after delivery, and 6 months and 12 months of age. The investigation methods included questionnaire survey, physical examination, biological sample collection and clinical data collection. In terms of risk prediction, univariate analysis was used to screen candidate predictors. Second, multivariable Cox proportional hazard regression models were used to determine the final selected predictors. Third, the corresponding histogram models were drawn, and then the 10-fold cross-validation methods were used for internal verification. Regarding intergenerational transmission of overweight and obesity between mothers and infants during pregnancy, the risk prediction model for pregnancy screen was constructed. The model established: h(t|X) = h0(t)exp.(- 0.95 × (Bachelor Degree or above) + 0.75 × (Fasting blood glucose in the second trimester) + 0.89 × (Blood pressure in the third trimester) + 0.80 × (Cholesterol in third trimester) + 0.55 × (Abdominal circumference in third trimester))., with good discrimination (AUC = 0.82) and calibration (Hosmer-Lemeshow2 = 4.17). The risk prediction model for self-management was constructed. The model established: h(t|X) = h0(t)exp. (0.98 × (Sedentary >18METs) + 0.88 × (Sleep index≥8) + 0.81 × (Unhealthy eating patterns Q3/Q4) + 0.90 × (Unhealthy eating patterns Q4/Q4) + 0.85 × (Depression)), with good discrimination (AUC = 0.75) and calibration (Hosmer-Lemeshow2 = 3.81). The risk predictions of intergenerational transmission of overweight and obesity between mothers and infants were performed for two populations and two application scenarios (pregnancy screening and home self-management). Further research needs to focus on infants and long-term risk prediction models.

Development and Preliminary Validation of Self-management Scale for Breast Cancer Patients in a tertiary hospital in southeastern Nigeria

Background: Self-management process of diseases aims to equip patients with specific information that will improve adherence with prescribed medication and develop strategies that will help to maintain good quality of life. This study developed and validated a self-management scale for breast cancer patients in two tertiary hospitals in southeastern, Nigeria.
 Methods: A set of 35-potential self-management model was developed for the breast cancer patients in 2 domains from extensive literature search. The Instrument was validated using Delphi technique, item-total correlation analysis, factor analysis, construct validity and reliability analysis. Consensus was reached on the content validation of the self-management scale with mean score > 3.5, median > 3.5, absolute value between the median and mode < 1.00.
 Results: Forty-three items emerged after content validation in 2 domains: demographic characteristics of patients, and self-management content. Construct validity for selected items of the instrument showed values above 0.5. Item-total correlation analysis resulted in 31-items of the instrument. Factor analysis revealed a multi-dimensional instrument. The internal consistency of the instrument was determined with values between 0.5 - 0.8. The Cronbach’s alpha for the reliability of the items of the instrument were : Items 1 to 11: 0.60; Items 12 to 17: 0.60; Items 18 and 19: 0.80; Items 20 to 30: 0.50; and Items 31 to 33: 0.60.
 Conclusion: Preliminary validation of the instrument showed the instrument is valid but the internal consistency needs to be evaluated further with larger population size. The self-management scale revealed level of self-management among the breast cancer patients. This instrument should form a reliable tool for evaluating self-management in breast cancer patients in Nigeria.

How knowledge sharing affects career adaptability: roles of knowledge depth, self-efficacy and reflective thinking

PurposeDrawing on the social cognitive model of career self-management (CSM model) and deep learning theory, the authors' study aims to investigate the effect of knowledge sharing on career adaptability and explore how and when this effect occurs. The authors proposed a moderated sequential-mediation model linking knowledge sharing, knowledge depth, self-efficacy and career adaptability, moderated by reflective thinking.Design/methodology/approachThe authors used a field survey involving 611 employees working in different enterprises in China to test the authors' predictions. For supplementary validation, the authors conducted a scenario-based experiment with a distinct sample of 148 employees from Chinese enterprises. The authors used hierarchical regression analysis, ANOVA analysis and moderated sequential-mediation analysis to test the hypotheses.FindingsThe results indicated a positive effect of knowledge sharing on career adaptability, sequentially mediated through knowledge depth and self-efficacy. Additionally, reflective thinking strengthened the positive effect of knowledge sharing on knowledge depth and further moderated the sequential mediating effect.Originality/valuePrevious research has predominantly focused on the perspective that individuals act as “recipients” from the environment in developing career adaptability. Instead, the authors adopt a “giving” perspective by investigating the influence of knowledge sharing on career adaptability, which advances the existing knowledge on the predictors of career adaptability.

Care models for patients with heart failure at home: A systematic review.

The aim of this study is to evaluate the relative merits of various heart failure models of care with regard to a variety of outcomes. Systematic review. Five databases including PubMed, Web of Science, Medline, Embase and Science Direct were searched from the inception date of databases to August 20, 2022. This review used the Cochrane Collaboration's 'Risk of Bias' tool to assess quality. Only randomised controlled trails were included in this review that assessed all care models in the management of adults with heart failure. A categorical summary of the pattern of the papers was found, followed by extraction of outcome indicators. Twenty articles (19 studies) were included. Seven examined nurse-led care, two examined multidisciplinary specialist care, nine (10 articles) examined patient self-management, and one examined nurse and physiotherapist co-led care. Regarding outcomes, this review examined how well the four models performed with regard to quality of life, health services use, HF self-care, and anxiety and depression for heart failure patients. The model of patient self-management showed more beneficial results than nurse-led care, multidisciplinary specialist care, and nurse and physiotherapist co-led care in reducing hospital days, improving symptoms, promoting self-care behaviours of HF patients, enhancing the quality of life, and strengthening self-care ability. This systematic review synthesises the different care models and their relative effectiveness. Four different models of care were summarised. Of these models, the self-management model demonstrated better outcomes. The self-management model is more effective in increasing self-management behaviours and self-management abilities, lowering the risk of hospitalisation and death, improving quality of life, and relieving anxiety and depression than other models. There was no funding to remunerate a patient/member of the public for this review.

Identity management processes, contextual supports and barriers, and substance use among sexual minority workers: A social cognitive lens.

Sexual minority people report substance use at higher rates than their heterosexual peers. Workplace sexual identity management, defined as the process by which sexual minority persons disclose or conceal their identities at work, may exacerbate substance use under stressful conditions, such as when faced with incivility. However, there is a paucity of research on the relation of the work environment to sexual minority workers' substance use. The present study used the social cognitive career self-management model as a conceptual framework to examine two aspects of the work environment (positive climate and harassment) in relation to the sexual identity management process and substance use of sexual minority workers. Because plurisexual employees (e.g., bisexual or pansexual) often face additional workplace stressors relative to their monosexual sexual minority peers, we also examined the links between plurisexual identity and each component of the self-management model. Participants were 418 full-time sexual minority workers residing in the United States. Results were largely consistent with the self-management model derived in terms of the prediction of sexual identity disclosure in the workplace. Workplace harassment moderated the relationship between identity disclosure and substance use, such that disclosure was linked more strongly to substance use in the context of more frequent harassment experiences. Plurisexuality was negatively related to disclosure self-efficacy, outcome expectations, and level of outness at work. Plurisexual workers also perceived their work climates as less identity-affirming. We consider implications for research and practice, including organizational interventions to minimize sexual minority workers' experience of workplace harassment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Shifting Responsibilities: Developing a Pan-European Service Model for an eHealth Technology Supporting Self-Management of People with Chronic Obstructive Pulmonary Disease and Comorbidities.

Active participation of patients in their care via self-management is an important pillar to manage chronic conditions. Self-management education and continuous support are needed to improve patients' confidence to take such active role. One way to do this is through eHealth technologies. However, those technologies can only be successful when actively used in daily practice and when integrated in overall care. Therefore, this study investigated how a self-management eHealth technology could be implemented that emphasises the active role of patients in their care. The service modelling method was utilized as implementation strategy. The design process consisted of five phases with salient stakeholders and consortium members of a European project to develop the service model. Studies with salient stakeholders were carried out in three different countries (Italy, Estonia, the Netherlands). A combination between face-to-face and online methods facilitated the participatory design process. Due to the pan-European context, different stakeholders in the three countries were identified. Research nurses and case managers were not yet established in practice but once implemented, expected to contribute to optimal implementation. During service modelling, a crucial step was revealed: providing self-management training before technology use to let patient familiarise with the concept of taking an active role. As HCPs felt that they were not necessarily equipped to guide patients in terms of self-management, they also should have access to such self-management training. By demonstrating a way for implementation while emphasising patients' active role, we also showed the complexity of the method in two ways. First, by demonstrating the fine line between the descriptive and prescriptive model. Thus, showcasing the need to recognize that prescriptive models may be hampered by the delay in changing work practices. Second, by highlighting the importance of identifying country-specific differences in the pan-European context, revealing that service modelling is not a one-size-fits-all approach.

Analysis of Behavioral Motivation in a Self-Management Model of Physical Activity Supported by Information Technology

Abstract In recent years, the topic of scientific exercise has attracted widespread attention, and people realize that participating in physical exercise requires the management of physical exercise behavior in order to reap the desired results. In this paper, we propose an exercise prescription recommendation based on the K-means clustering algorithm and a self-adjustment mechanism based on NLP sentiment analysis. We aim to provide the public with more professional and planned exercise programs. A sample of 1000 online user data from exercise software is taken for simulation experiments to verify the recommended method’s iterative effect and effectiveness. The data show that the optimal number of clusters for both male and female users is five, and the clustered body types are analyzed according to the mean of the Z-Score standard score, which shows that the five boys’ body types are obese, thin, lean, strong, and athletic, and the five girls’ body types are lean, agile, thin, obese, and fat, respectively. The confusing heatmap of the NLP affective tendency reflects its affective. The classification method is effective, and the overall correct rate of sentiment analysis reaches 94.5%, of which the classification of users with positive emotional tendencies is the best, with a correct rate of 97.8%, while the classification of users with no emotional tendencies is poor, with a correct rate of 87.6%. The model’s AUC value in the ROC curve is 0.82, which means it has a better classification effect. In addition, taking a sample in the first category of male physique as an example, the NLP sentiment analysis method derives an exercise prescription adjustment that increases the intensity of this user’s exercise by 40% through his exercise data and sentiment feedback text.

Why employees engage in proactive career behavior: examining the role of family motivation

PurposeThis study established and examined a moderated mediation model connecting family motivation with proactive career behavior (PCB). Drawing on social cognitive career theory model of career self-management and person-environment fit theory, the authors posit that the influence of family motivation on PCB is mediated by career goal setting (CGS) and moderated by career support climate (CSC).Design/methodology/approachUsing multilevel modeling techniques, data were collected from 98 leaders and 416 employees at two-time points.FindingsResults show that family motivation has a positive direct and indirect effect on PCB through CGS. Additionally, CSC strengthens the positive effect of family motivation on PCB through CGS.Practical implicationsFor employees, proactive career management and the establishment of clear career goals are vital for fulfilling family responsibilities. Simultaneously, for managers and organizations, creating a supportive work environment is crucial to encourage employees in career management.Originality/valueWhile existing research highlights the detrimental effect of fulfilling family caregiving responsibilities on employees' career development, the comprehension of this relationship remains limited. Taking a family motivation perspective, this study explores the mechanisms through which family motivation stimulates employees to engage in PCB, with a specific focus on the moderating influence of CSC. The findings offer fresh insights into the role of family motivation in career development, contributing significantly to the broader literature on the intersection of family and careers.

CAREER SELF-MANAGEMENT OF LATE LIFE WORK

Abstract The choice to retire can be gradual or sudden depending on the planning, the opportunities presented, and crises encountered. Issues of self-management will be examined focusing on the challenges faced by older faculty members seeking to continue working. Present and future older academics are increasingly pressed to take active involvement and responsibility for career management. A multidimensional model for self-management of career and retirement will be presented.

A Study on the Model of College English Self-managed Learning Based on the Flipped Classroom

With the rapid development of the information society, the traditional college English teaching model has become inadequate to meet the needs of social development. A new teaching model, the flipped classroom, has emerged. Based on blended learning theory and humanistic theory, this study focuses on the college English teaching model within the context of the flipped classroom, outlines the relationship between the flipped classroom and self-managed learning, analyzes the current situation of college students’ self-managed learning, and explores the construction of college English self-managed learning model. The experimental results indicate that the model of college English self-managed learning based on flipped classroom not only improves the quality of college English teaching and students’ self-managed learning abilities, but also has a positive impact on students’ attitudes toward study, which benefits the improvement of college students’ comprehensive abilities.

PSYCHOLOGICAL FEATURES OF PERSONAL ATTITUDE TO DIABETES DISEASE

The peculiarities of the attitude of the individual to the disease and treatment in diabetes mellitus are analyzed in the article. The research is conducted in the frames of a biopsychosocialapproach towards health and disease (G.Engel), V.N.Myasischev’s theory of attitudes. The tutorial “Attitude type towards disease” (L.Vasserman) was used as a research method. At all stages of the development of medical science, there was a violation of the therapeutic order. As early as the Hippocratic era, the problem of loyalty and the patient's lying about taking the drug was an urgent issue. Despite the changes in medical practice and in-depth reforms, the problem of adherence to doctor's recommendations remains relevant even in the current period, over the past decade this direction has become the subject of independent scientific research not only in medical practice but also in clinical psychology.The phenomenon of treatment adherence is consideredin the science of psychology from the side of various approaches, theories, structures, and factors. Hence, there are loyalty models of biomedical, behavioral, communicative, cognitive, and self-management (e.g., L. Myers, K. Evidence, 1998; M.X. Karamyan, 2010). I.E. Leppic gives a broad definition of compliance-basically: it represents the type of patient Hulk, the degree of complability, and the pursuit of purpose. In his views, the scientist includes the patient's taking the medicine on the Hulk, regular visits to the hospital, and proper adherence to the doctor's instructions. The absence of complacency can be explained in a narrow framework as follows: the patient takes the drug in the wrong dose (in very small quantities or overstates), how many times does not follow the procedure of administration and duration, or takes another drug that the doctor does not recommend at all. In particular, the issues of adherence to treatment in diabetes have not been studied by scientists from Uzbekistan. However,B.X. Shagazatova (2004) on the issue of improving the basics of medical social care and treatment-prevention measures, D.I. Ilkhamova (2003) –characteristics of the sex of the age of an individual in cardiovascular diseases, M.X. Karamyan-conducted research on the nature of the value relationship of the attitude to health.An analysis of the work devoted to the attitude to treatment and commitment to therapy shows that, in general, the question of its basis in diabetes mellitus, in the second –of the connection between the commitment to treatment and the motivational –values of the individual is little studied. In other words, despite our understanding of the importance of psychological factors in the constructive formation of the attitude to treatment, research on the dependence of loyalty on individual-motivational characteristics was found in patients with Type 1 and Type 2 sugar diabetes.

Medication self-management among older adults with cognitive frailty

BackgroundIndependent and safe medication self-management is essential for successful aging. Nevertheless, how older adults with cognitive frailty (CF) self-manage medications at their own homes remain elusive. ObjectiveThis study aimed at assessing the medication self-management capability of home-dwelling older adults with CF and exploring the ways, perceived challenges and barriers in medication self-management. MethodsA convergent mixed-method study design was used. The medication management capability of 16 CF individuals aged ≥ 60 years on ≥ 1 long-term prescription drugs were assessed using the Drug Regimen Unassisted Grading Scale (DRUGS). Virtual in-depth interviews were also performed between July–August 2022 using a semi-structured interview guide. All interviews were audio-recorded and transcribed verbatim. Qualitative data were analysed using a thematic analysis approach guided by Bailey and colleagues’ model of medication self-management. ResultsThe mean DRUGS summary score was 96.86 [standard deviation (SD) 3.74] with highest performance scores observed in medication access (100 %) and lowest performance score in medication identification (91.46 %). Informants were able to independently take their medications and they tended to organise their medication intakes according to mealtime even though some admitted missing medication doses due to forgetfulness. Informants had difficulties with recalling drug names, with little awareness of self-monitoring their own health conditions and the effects of medications. Misconceptions towards medications, difficulties in accessing medications, reduced mobility and worsening health conditions could potentially deter informants from safe and independent medication self-management. In contrast, trust in doctors and a desire to achieve treatment goal could motivate medication self-management. ConclusionThe findings revealed knowledge gaps among older adults with CF in identifying their medications and self-monitoring which warrant reinforcement by healthcare professionals to ensure chronic safe medication use. Future studies should evaluate strategies to enhance medication safety in terms of self-monitoring in individuals with CF.

Awareness of biomarker test timing and purpose in patients with non-small cell lung cancer (NSCLC).

138 Background: Biomarker testing is necessary for optimal 1st line treatment selection in advanced NSCLC. Patient understanding of timing and purpose of biomarker testing is imperative for patient engagement in care but is challenging to achieve (1). The 4R Oncology model of patient self-management and timely care delivery has been shown to improve patient knowledge of timing/sequence of care in breast cancer (2) but has not been studied in NCLSC in relation to biomarker testing. 4R is being implemented at 5 centers (3 community and 2 academic) in NSCLC. We report baseline assessment of patient awareness of biomarker testing timing and purpose to inform 4R implementation. Methods: Pre-implementation surveys of patients with advanced NSCLC at 5 centers Aug – Dec 2022. Metrics are listed in Table. Results: Survey response rate: 46% (65/142). Respondents were 65% White, 42% high school educated or less, 46% with annual income ≤$30K. While all patients were aware of receiving non-biomarker tests, >40% were not aware of receiving biomarker testing (Table). About half knew why or how long they need to wait for results, but only 29% received this information from providers. Of those tested, the majority reported provider discussions of biomarkers or therapy selection and were clear about results or therapy selection. Awareness (eg, knowing to wait for results before therapy) was associated with receiving printed NSCLC materials (45% vs 7%, p<.01), education above high school (69% vs 41%, p=.03) and income >$30K (67% vs 32%, p=.01). Willingness to wait for test results was associated with knowing how to prepare for treatment while waiting (89% vs 46%, p<.01). Race did not impact these metrics. Conclusions: Considerable gaps exist in patient awareness of timing and purpose of biomarker testing. We refined the 4R model to emphasize biomarker timing in printed visual material, facilitate patient-provider discussions and engage patients in health maintenance while waiting for results. We revised 4R to a lower literacy level. Results will be reported when available. (1) Martin, Oncol Issues, 2022. (2) Trosman JCOOP 2021.[Table: see text]

Predictive Contribution of Personality Traits in Career Decision-Making: A Test of the Social Cognitive Model of Career Self-Management

The current study sought to test hypotheses derived from the social cognitive model of career self-management (CSM; Lent & Brown, 2013) applied to the process of career exploration and decision-making. We examined how well personality traits, contextual factors, and social cognitive predictors, collectively, account for exploration behavior and career decision-making outcomes. Specifically, we determine the relationships between personality traits with career decision self-efficacy, career goals, and decisional criteria in a sample of 302 high school students. The participants completed domain-specific measures of four personality traits (conscientiousness, intellect/openness, extraversion, and neuroticism), social support, self-efficacy, outcome expectations, goals, level of career indecision, and decisional anxiety. The model fit the data well overall, though certain predictors were linked to the criterion variables only indirectly via mediated pathways. The structural equation model analysis suggested, consistent with previous studies, that the contribution of personality on career exploration and decision-making was mediated by sociocognitive mechanisms. Multiple group analysis suggests that neither sex nor the type of institution (state/private) that students attend determines the relationships among the variables of the proposed theoretical model. Limitations, further research, practical implications, and methodological implications for the CSM model are discussed.