Health Self-management Research Articles

Health Self-management Barriers and Facilitators in Long-term Care Facilities: A Qualitative Study

Objectives: Long-term care development has become a global demand. Nurse directors play a crucial role in managing a long-term care facility's quality and costs. Health self-management of nursing service quality managers, however, is relatively unknown. In this study, we aimed to assess determinants of long- term care facilities' (LTCF) quality care, including barriers and facilitators to health self-management as reported by service quality managers and their recommendations for further intervention in healthcare.Methods: An interview outline is developed based on the framework of theoretical domains. Using purposive sampling, we selected 17 managers in LTCFs engaged with the quality of nursing services for semi-structured interviews. We conducted thematic analysis using transcripts of interview recordings, interview notes, reflection diaries, and other materials. Results: Five major barriers were associated with the 10 domains of the theoretical domain framework: (1) negative emotional influence, (2) limited time resources, (3) fetters from professional roles, (4) lack of positive reinforcement, and (5) concerns about physical red flags. Six main facilitators were associated with the 10 domains of the theoretical domain framework: (1) highlight the benefits of good habits, (2) intention to balance life and work, (3) the impact of being considered a benchmark, (4) fragmented exercise management, (5) finding the team – for social support, and (6) wearing sports electronic equipment. Conclusion: A variety of factors impair self-health behaviors of nurse directors in LTCFs, and their mechanisms are complicated.

Implications of Inflammatory Processes on a Developing Central Nervous System in Childhood-Onset Systemic Lupus Erythematosus.

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that is increasingly affecting pediatric and adult populations. Neuropsychiatric manifestations (ie, cognitive dysfunction and mood disorders) appear to occur with greater severity and poorer prognosis in childhood-onset SLE (cSLE) versus adult-onset SLE, negatively impacting school function, self-management, and psychosocial health, as well as lifelong health-related quality of life. In this review, we describe pathogenic mechanisms active in cSLE, such as maladaptive inflammatory processes and ischemia, which are hypothesized to underpin central phenotypes in patients with cSLE, and the role of alterations in protective central nervous system (CNS) barriers (ie, the blood-brain barrier) are also discussed. Recent findings derived from novel neuroimaging approaches are highlighted because the methods employed in these studies hold potential for identifying CNS abnormalities that would otherwise remain undetected with conventional multiple resonance imaging studies (eg, T2-weighted or fluid-attenuated inversion recovery sequences). Furthermore, we propose that a more robust presentation of neuropsychiatric symptoms in cSLE is in part due to the harmful impact of a chronic inflammatory insult on a developing CNS. Although the immature status of the CNS may leave patients with cSLE more vulnerable to harboring neuropsychiatric manifestations, the same property may represent a greater urgency to reverse the maladaptive effects associated with a proneuroinflammatory state, provided that effective diagnostic tools and treatment strategies are available. Finally, considering the crosstalk among the CNS and other organ systems affected in cSLE, we postulate that a finer understanding of this interconnectivity and its role in the clinical presentation in cSLE is warranted.

Epilepsy self–management mobile health application: A needs assessment in people with epilepsy and caregivers in Viet Nam

ObjectivesThis study aimed to determine (1) the needsof Vietnamese people with epilepsy (PWE) and their caregivers for self-management mobile health applications and (2) the self-management features expected to be included in an application. MethodsThe survey consisted of an anonymous self-administered questionnaire that was distributed to PWE and caregivers from the age of 18 in Vietnam through online platforms and onsite at Nguyen Tri Phuong Hospital and University Medical Center, Ho Chi Minh City, from February 2022 to May 2022. The questionnaire assessed the participants’ attitudes toward epilepsy self-management mobile applications, their willingness to use applications, and their expectations of the contents of an application. ResultsResponses from 103 participants were submitted. Eighty-one participants (78.6%) reported using a smartphone, but only 50.6% of those claimed to know about self-management applications. Most respondents (70.9%) thought the applications would be useful for disease self-management, and 68.9% were willing to use epilepsy self-management applications. In addition, the most expected features to be included in self-management applications were epilepsy information, seizure first aid, connecting with medical professionals, and a seizure diary. ConclusionMost Vietnamese PWE and caregivers had a willingness to use epilepsy self-management applications.The expected features are related to all aspects of self-management, including information, seizure, medication, and safety management.

Prevalence, attitudes and concerns toward telepsychiatry and mobile health self-management tools among patients with mental disorders during and after the COVID-19 pandemic: a nationwide survey in Poland from 2020 to 2023.

Mobile Health (mHealth) is a rapidly growing field of medicine that has the potential to significantly change everyday clinical practice, including in psychiatry. The COVID-19 pandemic and technological developments have accelerated the adoption of telepsychiatry and mobile solutions, but patient perceptions and expectations of mHealth remain a key factor in its implementation. The aim of this study was to assess (1) the prevalence, (2) attitudes, preferences and (3) concerns about mobile mental health, including telepsychiatry and self-management tools, among patients with mental disorders over the period 2020-2023, i.e., at the onset, peak and after the expiration of the COVID-19 pandemic. A semi-structured survey was administrated to 354 patients with mental disorders in Poland. The questions were categorized into three section, addressing prevalence, attitudes, and concerns about telepsychiatry and mobile health self-management tools. The survey was conducted continuously from May 2020 to the end of May 2023. As many as 95.7% of patients with mental disorders used mobile devices at least once a week. Over the course of 3 years (from 2020 to 2023), there was a significant increase in the readiness of patients to embrace new technologies, with the percentage rising from 20% to 40%. In particular, a remarkable growth in patient preferences for telepsychiatry was observed, with a significant increase from 47% in 2020 to a substantial 96% in 2023. Similarly, mHealth self-management tools were of high interest to patients. In 2020, 62% of patients like the idea of using mobile apps and other mobile health tools to support the care and treatment process. This percentage also increased during the pandemic, reaching 66% in 2023. At the same time, the percentage of patients who have concerns about using m-health solutions has gradually decreased, reaching 35% and 28% in 2023 for telepsychiatry and for the reliability and safety of m-health self-management tools, respectively. This study highlights the growing acceptance of modern technologies in psychiatric care, with patients showing increased readiness to use telepsychiatry and mobile health self-management tools, in particular mobile applications, after the COVID-19 pandemic. This was triggered by the pandemic, but continues despite its expiry. In the face of patient readiness, the key issue now is to ensure the safety and efficacy of these tools, along with providing clear guidelines for clinicians. It is also necessary to draw the attention of health systems to the widespread implementation of these technologies to improve the care of patients with mental disorders.

Cancer Survivorship at Stanford Cancer Institute.

The Stanford Cancer Survivorship Program is a key initiative of Stanford Cancer Institute. The program's mission is to improve the experience and outcomes of patients and family caregivers throughout all phases of the cancer trajectory by advancing survivorship research, clinical care, and education. The four pillars of the program include clinical care delivery with a focus on primary care-survivorship collaboration and expanding specialty services, education and training of healthcare professionals, transdisciplinary patient-oriented research, and community engagement. Cross-cutting areas of expertise include the following: (a) adolescents and young adults (AYAs), (b) mental health and patient self-management, (c) integration of primary care, and (d) postgraduate medical education. The clinical care model includes embedded survivorship clinics within disease groups in outpatient clinics, novel clinics designed to address unmet needs such as sexual health for women, and primary care-based faculty-led survivorship clinics for patients undergoing active cancer care requiring co-management, those who have completed active therapy and those at high risk for cancer due to genetic risk. Educational initiatives developed to date include an online course and medical textbook for primary care clinicians, a lecture series, monthly research team meetings, and rotations for medical trainees. Patient-facing activities include webinars and a podcast series designed to promote awareness, thus expanding the provision of expert-vetted information. Ongoing research focuses on oncofertility and family building after cancer, improving communication for AYAs, changing mindsets to improve quality of life through targeted digital interventions, increasing capacity to care for cancer survivors, and strengthening collaboration with community partners. IMPLICATIONS FOR CANCER SURVIVORS: Stanford's Cancer Survivorship Program includes a robust transdisciplinary and interdisciplinary research, training and clinical platform that is committed to advancing access and improving care for people living with and beyond cancer, through innovation in design and care delivery.

The development and internal pilot trial of a digital physical activity and emotional well-being intervention (Kidney BEAM) for people with chronic kidney disease

This trial assessed the feasibility and acceptability of Kidney BEAM, a physical activity and emotional well-being self-management digital health intervention (DHI) for people with chronic kidney disease (CKD), which offers live and on-demand physical activity sessions, educational blogs and videos, and peer support. In this mixed-methods, multicentre randomised waitlist-controlled internal pilot, adults with established CKD were recruited from five NHS hospitals and randomised 1:1 to Kidney BEAM or waitlist control. Feasibility outcomes were based upon a priori progression criteria. Acceptability was primarily explored via individual semi-structured interviews (n = 15). Of 763 individuals screened, n = 519 (68%, 95% CI 65 to 71%) were eligible. Of those eligible, n = 303 (58%, 95% CI 54–63%) did not respond to an invitation to participate by the end of the pilot period. Of the 216 responders, 50 (23%, 95% CI 18–29%) consented. Of the 42 randomised, n = 22 (10 (45%) male; 49 ± 16 years; 14 (64%) White British) were allocated to Kidney BEAM and n = 20 (12 (55%) male; 56 ± 11 years; 15 (68%) White British) to the waitlist control group. Overall, n = 15 (30%, 95% CI 18–45%) withdrew during the pilot phase. Participants completed a median of 14 (IQR 5–21) sessions. At baseline, 90–100% of outcome data (patient reported outcome measures and a remotely conducted physical function test) were completed and 62–83% completed at 12 weeks follow-up. Interview data revealed that remote trial procedures were acceptable. Participants’ reported that Kidney BEAM increased their opportunity and motivation to be physically active, however, lack of time remained an ongoing barrier to engagement with the DHI. An randomised controlled trial of Kidney BEAM is feasible and acceptable, with adaptations to increase recruitment, retention and engagement.Trial registration NCT04872933. Date of first registration 05/05/2021.

Patient in health scale validation and self-management among Omani patients with mental health problems

The literature contains insufficient data relating to different approaches used by adults for managing their mental disorders, particularly in Oman. Most of the studies have been conducted in Western parts of the world, focusing on managing physical chronic illnesses. Therefore, this study aimed to assess adult Omani mentally ill patients' self-management behavior and to evaluate the validity and reliability of the Arabic version of the Partners in Health (PIH) Scale. Quantitative data were collected from 246 eligible adult participants who were diagnosed with different mental health illnesses from Oman's largest psychiatric and mental health hospital- Al Masarra Hospital. Data were collected using 12 items on the Arabic-translated PIH scale. While descriptive data analysis was used for quantitative data, content validity, and Cronbach's alpha coefficient were used to measure the validity and reliability of the PIH scale, respectively. Results showed that the Arabic version of PIH is valid (I-CVI was greater than 0.79 for all items, and S-CVI was found to be higher than 0.80) and reliable (0.92); Omani mentally ill patients have moderate self-management behavior in general, but specifically, they showed a lower level of knowledge and recognition of the symptoms and management of their mental illness. However, they also showed a moderate adherence to treatment and coping with the disease. It is concluded that the Arabic valid and reliable PIH can be used to measure self-management behavior among the mentally ill Arab population. Healthcare providers in Oman are recommended to integrate health literacy, self-management assessment, and education in their clinical care.
 Keywords: Partners in health; mental health; self-management; mental illness; instrumentation testing

Old age or cognitive decline? Examining the usability of a mobile health app for older Australians

ABSTRACT There is a growing literature on the role of mobile health applications (mHealth apps) in supporting older adults and the self-management of personal health. The purpose of this pilot study is to assess the usability of a government-funded mobile health app amongst older Australians and to evaluate whether cognitive function and demographic characteristics (i.e. age, gender, education) are associated with usability. A total of 28 older adults living in a regional city in Australia took part in the study. The participants were recruited using purposive sampling. Data collection instruments consisted of validated cognitive tests, task-based usability tests, and a questionnaire. The data was analyzed using non-parametric strategies. The findings of this study demonstrated that a government-funded, mHealth app was usable by older adults. Users were able to perform basic tasks in an effective and efficient manner. The hypothesis that elderly age would be significantly associated with performance on cognitive tests, as well as usability, was not supported. Performance on some cognitive tests was significantly and positively related to usability. Education and gender were not related to usability. The results suggest that traditional stereotypes surrounding aging and cognitive decline need to be reexamined.

Using FLO text-messages to enhance health behaviours and self-management of long-term conditions in South-Asian patients.

Cultural and communication differences faced by South-Asian (SA) ethnic minority groups have led to challenges in the delivery of health care and complex management of long-term conditions (LTCs). We aim to explore the use of text-messaging in SA communities, through the Florence (FLO) health messaging system utilised within U.K. health sectors, to enhance positive health behaviours and self-management. A mixed-methods approach was used for this study involving two phases. Phase 1 includes the administration of the patient activation measure to assess SA patient level of skills, knowledge, and confidence to self-manage their LTC; whilst in Phase 2 semi-structured interviews were conducted, exploring the experiences of users and non-users of FLO text messaging to promote self-management behaviours. Forty participants (Florence users (n = 20) and non-users (n = 20)) completed the patient activation survey once after using FLO, and took part in interviews. Differences were noted to exist between the two groups (p < .01). Users appeared to have higher activation levels and better self-management behaviours (p < .01 (p = .00). Interviews elicit participants' perceptions of the text messaging system, along with key themes relative to behavioural constructs: socio-demographical factors; influencing behaviour changes, self-management, and uptake of text messages amongst SA ethnic minorities. Text messaging and mHealth are being extensively used amongst general populations to monitor and enhance health. The study of SA patient experiences and their use of text messages within the United Kingdom (UK) remains scarce. Therefore, results from the study identify health beliefs that influence patient engagement with digital health interventions and their self-management. Developing policies and culturally appropriate education guidelines for healthcare practitioners can allow for the provision of culturally sensitive interventions tailored in terms of normative, cultural, and religious beliefs; which in turn will address crucial aspects including SA patient information and educational needs supporting their self-management journey.

Evaluation of the usability of the Quali+ mobile application for people with high blood pressure.

To evaluate the usability of the "Quali+" mobile application prototype for people with high blood pressure. Descriptive, cross-sectional study of heuristic evaluation of a mobile application prototype carried out between June and July 2021, in a university hospital. Participants were 22 people with arterial hypertension in the city of Campina Grande, PB, Brazil. To measure usability, the Smartphone Usability questionnaiRE instrument was applied. Levels (70 points have good usability. Descriptive statistics were used. The overall usability average was 105.8(7.44 points, with the lowest score being 83 and the highest being 113. Usability was at the highest level(80 points). The usability evaluation showed that, although it is a prototype, the application has good usability and can be considered for routine use in health self-management. Future research is needed to verify its effectiveness.

Impact of mindfulness-based and health self-management interventions on mindfulness, self-compassion, and physical activity in older adults with subjective cognitive decline: A secondary analysis of the SCD-Well randomized controlled trial.

Older adults experiencing subjective cognitive decline (SCD) have a higher risk of dementia. Reducing this risk through behavioral interventions, which can increase emotional well-being (mindfulness and compassion) and physical activity, is crucial in SCD. SCD-Well is a multicenter, observer-blind, randomized, controlled, superiority trial. Three hundred forty-seven participants (mean [standard deviation] age: 72.7 [6.9] years; 64.6% women) were recruited from memory clinics in four European sites to assess the impact of an 8-week caring mindfulness-based approach for seniors (CMBAS) and a health self-management program (HSMP) on mindfulness, self-compassion, and physical activity. CMBAS showed a significant within-group increase in self-compassion from baseline to post-intervention and both a within- and between-group increase to follow-up visit (24weeks). HSMP showed a significant within- and between-group increase in physical activity from baseline to post-intervention and to follow-up visit. Non-pharmacological interventions can differentially promote modifiable factors linked to healthy aging in older adults with SCD.

Effectiveness of Program for Older People’s Health Literacy on Drug and Health Products: Northeast of Thailand

Abstract Introduction: A health literacy promotion program in drugs and health products was collaboratively developed and evaluated for effectiveness by researchers and stakeholders. Methods: A Solomon four-group randomized study was conducted in 2022. The participants were people aged ≥60 years enrolled at senior schools in Northeast Thailand. One hundred and eighty older people were randomly selected using multistage sampling and allocated into four groups, 45 members. The designed program covers six skills: access to health information, cognition, communication, decision-making, media literacy, and self-management. ANOVA and t-test were used. Results: One hundred percent response rate, participants of the program (Group 1) showed a significant improvement (pre–post) of 62.2% in their health literacy in drugs and health products use (151.54 ± 37.88, 245.73 ± 9.33, P &lt; 0.001). Group 3, older people who joined the program with posttest only showed health literacy of 248.67 ± 11.54. In contrast, Group 2 and Group 4 with no program showed less health literacy of 149.02 ± 32.08 and 145.22 ± 34.14, respectively. On each item, the older people with the program consistently scored significantly higher across all domains (P &lt; 0.001). The average score was 247.20 ± 10.54, which showed a high level of health literacy (≥75%). Among areas, decision-making skills revealed the highest score of 45.97 ± 1.81 out of 50. The overall satisfaction score on the program was 47.60 ± 1.50. Conclusion: The program demonstrated its effectiveness in improving the older population’s health literacy regarding drug and health product use. It holds potential as a strategy to encourage older people to rational drug use. Participants expressed a significant satisfaction with the program, recommended for the broader Thai older people community.

Social Determinants of Health Factors and Self-Management of Care in Kidney Transplant Recipients: A Descriptive Cross-Sectional Study

Social Determinants of Health Factors and Self-Management of Care in Kidney Transplant Recipients: A Descriptive Cross-Sectional Study

Smartphone Addiction among Nursing and Health Students

Background:Smartphones are integral to human life and are in great demand by young people to communicate, use various applications, study, watch, and play games, browse the internet, and listen to music. However, for most people, the cumulative daily time spent on smartphones is quite long. This review aimed to analyze the risks of smartphone addiction among health students. Methods: This study was conducted by searching four electronic databases, ProQuest, CINAHLEBSCO, PubMed, and Science Direct, from 2016 to 2022. The keywords used were “Smartphone Addiction” AND “Medical” OR “Nursing” OR “Psychology” OR "Health." Results:Of the 923 articles screened, 25 met the inclusion criteria. The results showed that 15.6%–81.1% of nursing and health students were addicted to smartphones, having an average use of five hours daily. Conclusion:Nursing and health students have the potential to become addicted to smartphones, with an impact on psychology (e.g., stress, anxiety, depression, and neuroticism), sleep disorders, and general health. Therefore, the need for interventions from various parties, such as students, families, universities, and health workers, through psychoeducation and self-management for nursing and health students is necessary.

Relationships Among Health Literacy, Self-Efficacy, Self-Management, and HbA1c Levels in Older Adults with Diabetes in South Korea: A Cross-Sectional Study.

This study investigated the levels of health literacy, self-efficacy, self-management, and glycated hemoglobin (HbA1c) levels in older adults with diabetes to identify the relationships between these factors. This descriptive study consisted of 162 elderly outpatients with diabetes at the departments of endocrinology of three general hospitals in J Province, South Korea. Data were collected using a structured self-report questionnaire between October 21 and November 16, 2019. The data were analyzed using SPSS/WIN version 23.0. Health literacy was positively correlated with self-efficacy (rs=0.64, p<0.001) and self-management (rs=0.44, p<0.001) and significantly negatively correlated with HbA1c levels (rs=-.42, p<0.001). Self-efficacy showed a significantly positive correlation with self-management (rs=0.65, p<0.001) and a significantly negative correlation with HbA1c levels (rs=-.30, p<0.001). Moreover, a significant negative correlation was found between self-management and HbA1c levels (rs=-.35, p<0.001). Hence, health literacy and patient self-management levels were associated with HbA1c levels in older adults with DM. Health education for community-dwelling older adults with diabetes should consider their health literacy levels. Moreover, measures to improve self-management abilities may be needed when developing educational programs for older adults with diabetes.

Randomised controlled trial on the effect of social support on disease control, mental health and health-related quality of life in people with diabetes from Côte d’Ivoire: the SoDDiCo study protocol

IntroductionDiabetes mellitus (DM) and its severe complications contribute significantly to disability and, hence, burden of disease. Poor mental health, a frequent DM consequence, may hinder successful diabetes control in low-income...

Exploring adolescent and parent perspectives on facilitating health self-management in adolescents with autism spectrum disorder

BackgroundAs many as 95% of individuals across the lifespan with autism spectrum disorder (ASD) have at least one comorbidity. While research focused only on the health of autistic adolescents is limited, we do know that fewer than 14% of these youth receive appropriate transition services to self-manage their health. These limitations have resulted in poor outcomes and premature mortality. Little is known about how parents and their adolescent children address this health burden. ObjectiveThe objective of this study is twofold. First to compare the perceptions of adolescents with ASD and their parents regarding adolescents’ contextual and process variables (depressive symptoms, health knowledge, health communication/planning, self-efficacy, self-determination) and health self-management (HSM) behavior. The second is to examine social facilitation for HSM behaviors in adolescents with ASD and their parents. MethodsIn this community-based study, an online survey was used to compare the perspectives of 40 adolescents with ASD aged 12 to 22 years and their parents on the adolescents’ HSM behaviors. Contextual and process variable measures (PROMISE, Starx, General Self-efficacy Scale, AIR Self-determination Scale, Social Facilitation Questionnaire) were completed by both adolescents (adolescent/pediatric version) and parents (parent version). ResultsDescriptive analysis indicated that parents were teaching self-management to adolescents for monitoring and preventing illness, including medication knowledge and how to talk to their doctor. The largest differences were found between parents’ and adolescents’ perceptions regarding teaching and learning about independent management of existing health conditions. Additionally, adolescents rated their self-efficacy (t (38) = 3.62, p < .001) and self-determination (t (39) = 4.55, p < .001) significantly higher than their parents did. ConclusionsThis study contributes perspectives on what parents and adolescents are doing to enhance adolescents’ health self-management. Adolescence is a developmental period of social facilitation when parents may teach their adolescent children with ASD to self-manage their health and when those adolescents may learn to do so. During this period, providers should offer adequate planning and guided training to support parents and their adolescent children with ASD to improve adolescents’ self-management behaviors and improve health outcomes for this vulnerable population.

In action at work! Mental health self-management strategies for employees experiencing anxiety or depressive symptoms.

In action at work! Mental health self-management strategies for employees experiencing anxiety or depressive symptoms.

"Good life is to be in peace and harmony with everything around us": a qualitative study on good living among the Kankuamo Indigenous people of Colombia

The Kankuamo people are one of the 102 native peoples of Colombia, who are developing strategies for individual and collective health self-management. This article aims to investigate, identify and analyze, collaboratively and interculturally, the factors that influence the well-being of the Kankuamo people, using the Capabilities Approach proposed by Amartya Sen. To this end, three focus groups were conducted with the participation of 37 people from the 15 communities of the Kankuamo reservation. The transcripts were analyzed by means of a thematic analysis. Three central themes for the well-being of the Kankuamo emerged from the focus groups: (i) harmony between nature and human beings, (ii) social coexistence and (iii) self-determination. These themes reflect the fundamental principles and values that guide the community towards a good life, expansion of their capabilities, harmony and holistic development. The results suggest that material aspects play a secondary role in the Kankuamo community's concept of good life, and confirm that it is fundamental to consider a collective vision of capabilities, not only individual ones, in indigenous contexts. Studies such as this one can contribute to the development of more contextually appropriate approaches to assess and measure the quality of life and well-being of Indigenous communities, including the Kankuamo people.

Goal Ontology for Personalized Learning and Its Implementation in Child's Health Self-Management Support

Goal Ontology for Personalized Learning and Its Implementation in Child's Health Self-Management Support