Self-management Outcomes Research Articles

Effectiveness of an online self-management tool, OPERAS (an On-demand Program to EmpoweR Active Self-management), for people with rheumatoid arthritis: a research protocol

BackgroundActive self-management is a process where patients are fully engaged in managing their health in daily life by having access to contextualized health data and tailored guidance to support a healthy lifestyle. This study aims to determine whether an e-health intervention that incorporates symptom/disease activity monitoring and physical activity counselling can improve self-management ability in patients with rheumatoid arthritis (RA).MethodsThe ‘Empowering active self-management of arthritis: Raising the bar with OPERAS (an On-demand Program to EmpoweR Active Self-management)’ project is a randomized controlled trial that uses a delayed control design. One hundred thirty-four participants with RA will be randomly assigned to start the intervention either immediately (immediate group) or 6 months later (delayed group). The intervention involves (1) use of a Fitbit-compatible web app to record and monitor their RA disease activity, symptoms, and time spent on physical activity and a Fitbit; (2) group education and individual counselling by a physiotherapist (PT); and (3) six phone calls with a PT. The primary outcome measure is self-management ability measured by the Patient Activation Measure. Secondary outcome measures include disease status, fatigue, pain, depressive symptoms, and characteristics of habitual behavior and also time spent in physical activity and sedentary activity with a wearable multi-sensor device (SenseWear Mini). After the 6-month intervention, we will interview a sample of participants to examine their experiences with the intervention.DiscussionThe results of this study will help to determine whether this technology-enhanced self-management intervention improves self-management ability and health outcomes for people living with RA. A limitation of this study is that participants will need to self-report their symptoms, disease status, and treatment use through questionnaires on the OPERAS web app. The user-friendly interface, reminder emails from the research staff, and tailored guidance from PTs will encourage participants to actively engage with the app.Trial registrationDate of last update in ClinicalTrials.gov: January 2, 2019. ClinicalTrials.gov Identifier: NCT03404245.

Efek program manajemen diri pada pasien penyakit paru obstruktif kronik : Systematis review

ABSTRACTBackground: Self-management programs are very important in the care of patients with COPD as an independent intervention in an effort to improve health status. Aim: Of this systematic review is to find out the form of self-management intervention in COPD patients, an instrument to measure the outcomes of self-management and the effects of self-management programs in COPD patients. Methods: Used are electronic data bases from journals published through ProQuest, PubMed., And ScienceDirect. Results: Of a review of 9 selected journals stated that self-management programs had an influence on increasing lung capacity, exercise capacity and health-related quality of life compared to patients who experienced standard care. The research instrument was used to measure lung capacity using spirometry, Exercise capacity used a six-minute walking distance (6MWD), Incremental Shuttle Walk Test (ISWT) and the Endurance Shuttle Walk Test (ESWT), and health-related quality of life measured by St George Respiratory Questionnaire (SGRQ). The results showed that the effects of self-management programs benefited in the quality of care, reduced the number of days of hospital care and did not increase the number of deaths. Conclusion: Self-management programs in COPD patients provide the ability to manage disease so that it can increase lung capacity, exercise capacity and quality of life related to health. Keywords: Chronic obstructive pulmonary disease, exercise capasity, lung capacity self management program, quality of life

Ethnicity and health outcomes among people with epilepsy participating in an epilepsy self-management RCT

People with epilepsy (PWE) may experience negative health events (NHEs) such as seizures, emergency room visits, and hospitalizations, with ethnic and racial minorities disproportionately affected. Epilepsy self-management may reduce NHEs; however, few reports examine self-management outcomes in racial minorities. Using data from a longitudinal 6-month randomized controlled trial (RCT) of 120 PWE, this analysis compared African–American and Whites at baseline, 10 weeks and 24 weeks after receiving the “Self-management for people with epilepsy (SMART) and a history of NHEs” self-management program. The primary RCT outcome was number of NHEs. At baseline, compared to Whites, African–Americans had less education (p = 0.02) and greater depressive severity (p = 0.04). Both African–American and Whites generally improved with SMART, and there were no racial differences in NHE counts or other outcomes' responses. Given known racial disparities in epilepsy care, it may be particularly important to reach out to minority PWE with self-management programs.

Smartphone app for asthma self-management – a literature review of contents and functions

A self-management is an important thing in achieving optimum health outcomes. One of the many effective ways that help improve the outcomes of self-management in asthma is through the use of smartphone applications or popularly known as apps. The apps have been designed to help patients in controlling asthma complaints. This study aimed to examine contents and functions featured in the reviewed studies as well as to suggest what functions and contents should be featured in an asthma self-management smartphone app. This study used a systematic approach to examine and review the contents and functions of asthma management apps from selected studies. Inclusion criteria of the study included studies related to the use of asthma control or asthma self-management apps, providing information about contents and features of asthma apps, apps in the reviewed studies designed for laypersons or patients, studies published in peer-reviewed scientific journals in English, and original articles. All the studies had been taken from 2013 to 2018 from three databases, namely Pubmed, Science Direct, and ProQuest. Exclusion criteria included full text unable to be accessed and unable to obtain complete full statistical data. Results of this study showed that the most popular functions and contents featured in the asthma apps involved asthma education, medication use monitor, medication reminder, asthma control test, peak flow meter, asthma symptom monitor, and asthma action plan. Less popular functions and contents included a chat with others, Air Quality Health Index, and Quality of Life Questionnaires.

Examining the Association between Item Specific Treatment Burden and Adherence in People Living with HIV.

For the 1.1 million people with HIV (PWH) in the United States, adherence to a HIV anti-retroviral medication regimen, engagement in regular physical activity, and eating a healthy diet are essential for maintaining optimal health. However, treatment burden can increase the risk for self-management non-adherence. We analyzed data of 103 men and women diagnosed with HIV to examine the relationship between medication, physical activity, and diet-related treatment burden to corresponding measures of self-management adherence. Multivariate analysis demonstrated that one medication treatment burden item explained 11% (p=.01) of self-reported 30-day HIV anti-retroviral medication adherence; physical activity treatment burden, along with physical functioning, explained 25% (p<.001) of physical activity, measured by daily average steps; and diet-specific treatment burden was non-significant in maintaining a healthy diet, measured by a total Healthy Eating Index-2010 score. Findings demonstrate that specific treatment burden items can predict specific self-management outcome behavior in PWH.

35 - Improved Self-Management and Glycemic Outcomes in Refractory Patients Using an Individualized Self-Management Education Strategy

35 - Improved Self-Management and Glycemic Outcomes in Refractory Patients Using an Individualized Self-Management Education Strategy

Improving Patient Experience and Treatment Adherence in the Adult, Outpatient Hemodialysis Population.

The commonly employed medication reconciliation process leaves room for mismanagement of medications in the complex end-stage renal disease patient population. The purpose of this quality improvement project was to implement and evaluate a multidisciplinary education and feedback intervention designed to improve self-management for adults with end-stage renal disease. A pre-post, same subject repeated measures design was used to evaluate the intervention. Laboratory values, vital signs, interdialytic weight gains, dialysis attendance, and questionnaires were used to assess regimen adherence. We observed improvements in patient outcomes including laboratory values, vital signs, and interdialytic weight gains. Significant improvements in process outcomes were also seen, including accuracy of medication lists, dialysis attendance, and use of remote pharmacy services. A comprehensive medication review, with concurrent pharmacist access, represents a time-effective approach to improved self-management and end-stage renal disease outcomes.

What drives users’ participation in online social Q&amp;A communities? An empirical study based on social cognitive theory

Purpose The purpose of this paper is to examine some drivers of users’ participation in online social question-and-answer (Q&amp;A) communities based on social cognitive theory and then identify the underlying mechanism of this process. Design/methodology/approach This study developed a research model to test the proposed hypotheses, and an online survey was employed to collected data. Totally, 313 valid responses were collected, and partial least squares structural equation modeling was adopted to analyze these data. Findings This study empirically finds that the outcome expectations (personal outcome expectations and knowledge self-management outcome expectations) are positively related to participation in online social Q&amp;A communities. At the same time, users’ self-efficacy positively influences their participation behaviors. It can not only directly motivate users’ participation, but also indirectly promote participation behaviors through the two dimensions of outcome expectations. Besides, perceived expertise and perceived similarity are two positive and significant environmental elements affecting users’ participation. Originality/value This study extends the understanding about how participation behaviors will be motivated in the context of online social Q&amp;A communities. Drawing on the social cognitive theory, constructs were established based on the features of these communities. Meanwhile, some mediating effects in the motivating process were also discussed.

“You Have to Control It However You Can”: Type 2 Diabetes Management in a Hispanic Farmworker Community in Rural Florida

Latino farmworkers carry a disproportionate burden of type 2 diabetes and face numerous challenges to accessing health care. This research explores beliefs about disease causality, self-management practices, and barriers to diabetes care among diabetics in a Mexican farmworking community in Florida. Thirty semi-structured interviews were conducted utilizing free list elicitation, open-ended questions, and closed-ended demographic questions. Participants' most recent hemoglobin A1C blood test results and Body Mass Index were obtained. Most participants were knowledgeable about recommended behavioral modifications and attempted to incorporate them into their daily routine, yet the majority had poor A1C levels and were overweight. Participants held dual cultural belief models about diabetes and used various complementary and alternative medicines to account for the political and economic barriers to diabetes management. Barriers to self-management include high cost of glucometer test strips and difficulty adhering to a diabetic diet. Addressing barriers to care, such as limited income and high cost of diabetic supplies, is integral to improving diabetes self-management and health outcomes. Anthropologically informed research, such as this study, is particularly well-positioned to make visible how social and healthcare policies are embodied.

Improving IBD Transition, Self-management, and Disease Outcomes With an In-clinic Transition Coordinator.

Deficits in the preparation of patients with inflammatory bowel disease (IBD) who are transitioning to adult care are known yet studies presenting outcome data of transition interventions in IBD are lacking. We present data evaluating the impact of a transition coordinator on behavioral and clinical transition outcomes. A retrospective chart review identified 135 patients who had met with our transition coordinator and completed the Transition Readiness Assessment Questionnaire before, and 1 year after, the intervention. Changes in transition readiness, self-management skill acquisition, and clinical outcomes (eg, number of patients transferred vs "bounced back" to pediatrics, percentage of patients over age 21, changes in disease remission) were examined and compared with patients who received no intervention. Intervention participants demonstrated a significant increase in transition readiness, F(1, 134) = 24.34, P < 0.001, and self-management skill acquisition, F(1, 134) = 5.61, P < 0.05. The percentage of patients in remission significantly increased from pre- to post-intervention, χ(134) = 9.03, P < 0.01. There were no significant changes in the comparison population (Ps > 0.05). Following implementation of our programming, the percentage of patients over age 21 decreased by 33.07%. A 1-time transition coordinator-led intervention improved adolescent transition readiness and acquisition of self-management skills. The proportion of young adult patients retained in pediatric care was reduced. Benefits of hiring a transition coordinator are discussed.

Association of functional and structural social support with chronic kidney disease among African Americans: the Jackson Heart Study

BackgroundThere is limited evidence on the relationship between social support and renal outcomes in African Americans. We sought to determine the association of social support with prevalent chronic kidney disease (CKD) and kidney function decline in an African American cohort. We also examined whether age modifies the association between social support and kidney function decline.MethodsWe identified Jackson Heart Study (JHS) participants with baseline (Exam in 2000–2004) functional and structural social support data via the Interpersonal Support Evaluation List (ISEL) and social network size questions, respectively. With ISEL as our primary exposure variable, we performed multivariable regression models to evaluate the association between social support and prevalent CKD [estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2 or urine albumin-creatinine ratio (ACR) ≥30 mg/g], eGFR decline, and rapid renal function decline (RRFD) (> 30% decrease in eGFR over approximately 10 years). All models were adjusted for baseline sociodemographics, diabetes, hypertension, smoking status, and body mass index; models for eGFR decline and RRFD were additionally adjusted for eGFR and ACR. In models for eGFR decline, we assessed for interaction between age and social support. For secondary analyses, we replaced ISEL with its individual domains (appraisal, belonging, self-esteem, and tangible) and social network size in separate models as exposure variables.ResultsOf 5301 JHS participants, 4015 (76%) completed the ISEL at baseline. 843 (21%) had low functional social support (ISEL score < 32). Participants with low (vs. higher) functional social support were more likely to have lower income (47% vs. 28%), be current or former tobacco users (39% vs. 30%), have diabetes (25% vs. 21%) or CKD (14% vs. 12%). After multivariable adjustment, neither ISEL or social network size were independently associated with prevalent CKD, eGFR decline, or RRFD. Of the ISEL domains, only higher self-esteem was associated with lower odds of prevalent CKD [OR 0.94 (95% CI 0.89–0.99)]. The associations between social support measures and eGFR decline were not modified by age.ConclusionsIn this African-American cohort, social support was not associated with prevalent CKD or kidney function decline. Further inquiry of self-esteem’s role in CKD self-management and renal outcomes is warranted.

Effect of a Self-management Support Intervention on Asthma Outcomes in Older Adults

Older adults with asthma have worse control and outcomes than younger adults. Interventions to address suboptimal self-management among older adults with asthma are typically not tailored to the specific needs of the patient. To test the effect of a comprehensive, patient-tailored asthma self-management support intervention for older adults on clinical and self-management outcomes. Three-arm randomized clinical trial conducted between February 2014 and December 2017 at primary care practices and personal residences in New York City. Adults 60 years and older with persistent, uncontrolled asthma were identified from electronic medical records at an academic medical center and a federally qualified health center. Of 1349 patients assessed for eligibility, 406 met eligibility criteria, consented to participate, and were randomized to 1 of 3 groups: home-based intervention, clinic-based intervention, or control (usual care). A total of 391 patients received the allocated treatment. Screening for psychosocial, physical, cognitive, and environmental barriers to asthma control and self-management with actions to address identified barriers. The intervention was delivered in the home or primary care practices by asthma care coaches. Primary outcomes were the Asthma Control Test, Mini Asthma Quality of Life Questionnaire, Medication Adherence Rating Scale, metered dose inhaler technique, and emergency department visits for asthma care. Primary analyses compared intervention (home or clinic based) with usual care. Of the 391 patients who received treatment, 58 (15.1%) were men, and the mean (SD) age was 67.8 (7.4) years. After accounting for baseline scores, scores on the asthma control test were better in the intervention groups vs the control group (difference-in-differences at 3 months, 1.2; 95% CI, 0.2-2.2; P = .02; 6 months, 1.0; 95% CI, 0.0-2.1; P = .049; 12 months, 0.6; 95% CI, -0.5 to 1.8; P = .28; and overall, χ2 = 13.4, with 4 degrees of freedom; P = .01). Emergency department visits were lower at 12 months for the intervention groups vs the control group (16 [6.2%] vs 17 [12.7%]; P = .03; adjusted odds ratio, 0.8; 95% CI, 0.6-0.99; P = .03). Statistically significant improvements were observed for the intervention vs control patients in quality of life (overall effect: χ2 = 10.5, with 4 degrees of freedom; P = .01), medication adherence (overall effect: χ2 = 9.5, with 4 degrees of freedom; P = .049), and inhaler technique (metered-dose inhaler technique, correctly completed steps at 12 months, median [range]: 75% [0%-100%] vs 58% [0%-100%]). No significant differences in outcomes were observed between patients receiving the intervention in home vs practice settings. An intervention directed by patients' needs and barriers improved asthma outcomes and self-management behaviors among older adults. ClinicalTrials.gov identifier: NCT02316223.

339-OR: Yo Puedo! A Self-Management Group and mHealth Program for Low-Income Adults with Type 2 Diabetes in Mexico City

The purpose of this study was to evaluate the preliminary efficacy of a self-management group + mHealth program (Yo Puedo!) on clinical (A1C, BP, BMI), self-management (diet, exercise, blood glucose monitoring), depressive symptom, and self-efficacy outcomes in adults with type 2 diabetes (T2D) at Seguro Popular clinics in Mexico City. Participants were randomly assigned to treatment (n=26) or wait-list control groups (n=21) with data collected at 3 and 6 months. The Yo Puedo! Program included 7 weekly sessions and 6 months of daily text messages. Descriptive statistics and generalized linear mixed model (GLMM) with random intercept were calculated. Adults with T2D were 55.5 years of age (±8.6), 68% female, 59% married/partnered, 88.6% overweight/obese, 50% lived in moderate/severe food insecure households, 35.7% had increased depressive symptoms, and 80% had A1C above 7.0%. Mean duration of T2D since diagnosis was 11.5 years (±7.1). There were no between-group differences on baseline characteristics. There was 89% attendance at sessions and 6% attrition at 6 months. Group by time effects were seen in blood glucose monitoring (p&amp;lt;.01), diabetes self-efficacy (p&amp;lt;.04); with a trend for lower A1C in the intervention group at 6 months (-1.76% in treatment group vs. -.97 in control group, p=.08). Time effects for the intervention group included improved diet, exercise, blood glucose monitoring, diabetes self-efficacy, depressive symptoms and A1C at 6 months (p&amp;lt;.05). Adults with T2D in Mexico City positively responded to the Yo Puedo! group + mHealth program with improvements in self-management, depressive symptoms, self-efficacy, and A1C. Empowering patients with T2D self-management skills can improve key behaviors, mental health and blood glucose outcomes in vulnerable populations. A fully powered clinical trial is warranted. Disclosure R. Whittemore: None. M. Vilar-Compte: None. S. De La Cerda: None. R. Delvy: None. S. Jeon: None. S.I. Burrola-Méndez: None. A.A. Lozano-Marrufo: None. R. Perez-Escamilla: None. Funding National Institute of Nursing Research

668-P: A Coaching Intervention with Low Literacy Progress Report Improves Glycemic Control

Diabetes imposes a greater burden on minority and disadvantaged populations. Tailored interventions are needed to improve self-management outcomes among these populations. Purpose: To determine a) the effect of tailored coaching on patient knowledge, attitudes, and A1c and b) whether patient age, diabetes duration, or education level moderated intervention effect. Methods: A pre-post efficacy analysis of a randomized patient coaching intervention in an urban diabetes clinic was conducted. Eligibility included diagnosed diabetes, A1c ≥ 7.0%, on insulin or high dose oral agents, at least two clinic visits in the prior year and at least four coaching sessions at ∼6-month intervals. Participants received either standard diabetes handouts (N=192) or one-on-one, low literacy tailored coaching (N=161). Coaching included review of home and clinic blood sugars/A1c using a color coded graphical printed progress report, goal setting and formulation of questions for the provider. Outcomes included A1c/blood sugar target knowledge, measured A1c, Diabetes Empowerment Scale scores, and Patient Activation Measure scores. Results: Most participants were female (64%), black (96%), had household incomes &amp;lt; $15,000/year (83%), and had type 2 diabetes (96%). Mean age was 56.5 years and mean baseline A1c was 8.7%. Coaching increased knowledge of target A1c compared to control (OR 3.2, CI 1.6-6.2) but not knowledge of target blood sugar. Coaching improved measured A1c (-1.0% vs. -0.4% p &amp;lt; 0.05). The magnitude of improvement tended to be somewhat greater at higher educational levels (high school -0.97, p&amp;lt;.01; more than high school -1.19, p&amp;lt;.05). Coaching did not significantly increase diabetes self-efficacy or patient activation. Summary: Personalized, multi-component low literacy coaching significantly improves A1c and knowledge of A1c control targets. Repeated coaching sessions can enhance the effectiveness of medical management visits. Disclosure R. Wolf: None. C.S. Barnes: None. C. Wan: None. J. Caudle: None. D.C. Ziemer: None. Funding American Diabetes Association (7-05-CR-03 to C.S.B.)

A scoping review of peer-led interventions following spinal cord injury

Scoping review. The objective of this study is to report on the extent, range and nature of the research evaluating peer-led interventions following spinal cord injury, and to categorize and report information according to study design, peer role, intervention type and intended outcomes. Arksey and O'Malley's methodological framework for conducting scoping reviews was used. Original research studies of a peer-led intervention published between 2010 and present were included. CINAHL Plus, Ovid MEDLINE and PsycINFO were searched using key terms, in addition to citation checks. Data were extracted against a previously published consolidated typology. Significant heterogeneity in studies (n = 21) existed in aims and methods. Two studies reported on randomized controlled trials with relatively robust sample sizes and qualitative methodology was common. Peer role was frequently described as 'peer support', but there was variation in the description and duration of the interventions, complicating the categorization process. The majority of interventions were conducted one to one (n = 15). Studies most commonly aimed to address community integration (n = 15) and health self-management outcomes (n = 10). A small number of studies were eligible for review, although increasingly with rigorous designs. The nature of the peer mentor and mentee experiences were explored, and the interaction between the two, offering rich insights to the value of lived experience. Further work refining typology describing intervention type, peer roles and outcomes would facilitate replication of programmes and study designs, enabling statistical synthesis and potentially strengthening the credibility of peers as a viable resource in in-patient and community settings.

A nurse-led structured education program improves self-management skills and reduces hospital readmissions in patients with chronic heart failure: a randomized and controlled trial in China.

Patient self-management skills are an important part of heart failure (HF) management. However, there is a lack of knowledge about the effectiveness of nurse-led education on patient self-management and the associated clinical outcomes of rural Chinese patients with chronic heart failure (CHF). As such, this study was designed to evaluate the impact of a nurse-led education program on patient self-management and hospital readmissions in rural Chinese patients with CHF. Ninety-six patients in the eastern Chinese province of Shandong with CHF were randomly divided into intervention and control groups. A structured education program was delivered to the intervention group during hospitalization and after discharge. Control group patients were managed as per clinical guidelines without structured education. Medication adherence, dietary modifications, social support, and symptom control were assessed 12 months after the educational intervention. The mean score of medication adherence, dietary modifications, social support and symptom control in the intervention group was higher than in the control group at the end of the study (p<0.01). The readmission rates for HF in the intervention and control group were 10.4% and 27.1%, respectively (p=0.036). This study has demonstrated that a structured education program was associated with a significant improvement in medication adherence, dietary modifications, social support, and symptom control in rural CHF patients. Furthermore, this program was associated with a significant reduction in hospital readmission. This study indicates that implementation of a nurse-led education program improves self-management and clinical outcomes of rural CHF patients, who may not have regular access to cardiac management services as per metropolitan populations.

Creative Arts Diabetes Initiative: Group Art Therapy and Peer Support for Youth and Young Adults Transitioning From Pediatric to Adult Diabetes Care in Manitoba, Canada

Abstract Psychosocial dysfunction is common in young adults of First Nations heritage living with type 2 diabetes in Manitoba. Improved psychosocial functioning may lead to better glycemic control, self-management and health outcomes. We offered 12 weeks of facilitated art therapy within a group/peer-support environment aiming to improve psychosocial functioning. A mixed methods study (n=12) with validated pre and post measures in diabetes related emotional distress (Problem Areas in Diabetes Questionnaire), social support (MOS Social Support Survey), emotional wellbeing (Mental Health Continuum-Short Form); portfolio review and satisfaction evaluation was completed. Of those who completed the art therapy intervention, diabetes distress decreased in 57.14%. Two individuals experienced a secondary diagnosis leading to increased distress. Social support increased in 71.43% of participants. Emotional wellbeing determined by high or low levels of positive emotion/positive functioning scores were categorized. Initially, 25% scored flourishing, 41.67% moderate, and 33.33% languishing with 28.57% improving to moderate post-intervention. The number of sessions attended was important. Those attending 70% tended to have better results. Consistent attendance was an issue for ∼40%. Growth was evident in artwork and qualitative responses. The program was evaluated highly and 90% would recommend it to others. Art therapy can serve as a catalyst for improved psychosocial functioning in young adults living with type 2 diabetes suggesting the need for more holistically-orientated health delivery models.

The Level of Satisfaction of Diabetic Patients with Healthcare Personnel Attending Outpatient Health Clinics in Jamaica

The burden of diabetes mellitus is increasing in low-income and middle-income countries, and it is a major contributor to premature mortality. The care of patients with diabetes mellitus is multidisciplinary and involves a number of healthcare personnel. Effective communication between diabetic patients and healthcare personnel influence self-management and health outcomes.

Achieving self-management goals among low income older adults with functional limitations

Although self-management interventions can improve symptoms and disease among older adults, there is a dearth of literature on how self-management behaviors may improve factors related to the older adults’ physical function. To fill this gap in the literature, we describe the patient-directed self-management goals in nursing visits that relate to physical function as part of a multi-component program. We analyze the self-management goals and outcomes of 367 low- income older adults with functional limitations who participated in the CAPABLE program: a program to reduce the health effects of impaired physical function in low-income older adults. We focus on the following self-management goals that participants chose with the nurses: pain management, depressive symptoms, incontinence, fall prevention, and communication with healthcare providers. The majority of participants chose pain (50%) or fall prevention (51%) as goals and partially or fully met their goals. Improvements across these areas may lead to improved physical function.

A descriptive, cross-sectional study examining treatment burden in people living with HIV

Aim(1) describe the percentage of people living with HIV (PLWH) experiencing high levels of treatment burden who are at risk for self-management non-adherence, and (2) examine the relationship between known antecedent correlates (the number of chronic conditions, social capital, and age) of self-management and treatment burden while controlling for sample socio-demographics. BackgroundChronic condition self-management is key to maintaining optimal health in the aging population of PLWH. Despite the efforts of providers, patients, and caregivers, self-management non-adherence is still a factor contributing to poor chronic condition self-management and subsequent poor health outcomes. Recent research has identified treatment burden as a risk factor of poor chronic disease self-management adherence. MethodCross-sectional, secondary analysis of a sub-sample of 103 community dwelling, men and women diagnosed with HIV/AIDS derived from a larger parent study examining physical activity patterns in PLWH. ResultsParticipants reported an overall low level of treatment burden (M = 22.84; SD = 24.57), although 16% (n = 16) of the sample indicated experiencing high treatment burden. The number of chronic conditions (r = 0.25; p ≤ .01) and social capital (r = −0.19; p = .03) were significantly correlated with treatment burden. Multivariate analysis testing known antecedent correlates of treatment burden was statistically significant (p < .05), but only explained 8% of treatment burden's variance. ConclusionFindings have implications for nursing care of PLWH demonstrating a subset of PLWH experience high treatment burden related to chronic condition self-management. Findings also identify characteristics of PLWH who may be at high risk for treatment burden and subsequent self-management non-adherence.