Self-management Style Research Articles

Classifying self-management clusters of patients with mild cognitive impairment associated with diabetes: A cross-sectional study.

This study aims to propose a self-management clusters classification method to determine the self-management ability of elderly patients with mild cognitive impairment (MCI) associated with diabetes mellitus (DM). MCI associated with DM is a common chronic disease in old adults. Self-management affects the disease progression of patients to a large extent. However, the comorbidity and patients' self-management ability are heterogeneous. A cross-sectional study based on cluster analysis is designed in this paper. The study included 235 participants. The diabetes self-management scale is used to evaluate the self-management ability of patients. SPSS 21.0 was used to analyse the data, including descriptive statistics, agglomerative hierarchical clustering with Ward's method before k-means clustering, k-means clustering analysis, analysis of variance and chi-square test. Three clusters of self-management styles were classified as follows: Disease neglect type, life oriented type and medical dependence type. Among all participants, the percentages of the three clusters above are 9.78%, 32.77% and 57.45%, respectively. The difference between the six dimensions of each cluster is statistically significant. This study classified three groups of self-management styles, and each group has its own self-management characteristics. The characteristics of the three clusters may help to provide personalized self-management strategies and delay the disease progression of MCI associated with DM patients. Typological methods can be used to discover the characteristics of patient clusters and provide personalized care to improve the efficiency of patient self-management to delay the progress of the disease. In our study, we invited patients and members of the public to participate in the research survey and conducted data collection.

The connection of dysfunctional breathing with Self-Government styles in the Russian population during the COVID-19 pandemic

IntroductionDysfunctional breathing is experienced as “difficulty in inhaling” and is similar to the symptoms of COVID-19 (Gavriatopoulou et al., 2020), which justifies the relevance of studying this phenomenon in the conditions of the COVID-19 pandemic.ObjectivesTo identifiy a relationship between self-management styles and the severity of dysfunctional breathing in the uninfected COVID-19 population of Russia.MethodsThe author used the socio-demographic questionnaire, the Naimigen Questionnaire (Van Dixhoorn, Duivenvoordent, 1985) and J. Kuhl’s and A. Fuhrman’s Self-Government Test (Kool, Furman, 1998; Kul, Kvirin, Kool, 2020). The study was conducted online from April 27 to December 28, 2020. It was attended by 1,362 people from all regions of Russia (38.3 ±11.4y.o.).ResultsThe components are Self-regulation (r = -0.454, p = 0.000) and Self-Control (r =-0.197, p=0.000). There is also a component of Will Development (r=-0,297, p = 0,000) and Sensitivity to oneself (r=-0,480, p=0,000). It is important to note that dysfunctional breathing has a strong positive correlation with the component of life stress experiencing (=0.335, p=0.000). At the same time, the components of Self-regulation and Self-sensitivity have large correlation coefficients, which indicates their greater role.ConclusionsPeople with low self-regulation and self-control, as well as with less expressed will and sensitivity to themselves, are more likely to have dysfunctional breathing and a more pronounced experience of life stress in a pandemic. The described components can be used as “targets” for individualized psychotherapy of dysfunctional breathing in the conditions of the COVID-19 pandemic. The study was supported of the Russian Science Foundation, project No. 21-18-00624.DisclosureThe study was carried out with the support of the Russian Science Foundation, project No. 21-18-00624.

Understanding bariatric patients' experiences of self-management post-surgery: A qualitative study.

Although most bariatric patients achieve significant weight loss and improvements in both physical and mental health-related quality of life (HRQoL) in the short-term, there is wide variability in weight and long-term HRQoL outcomes. The role of bariatric patients' self-management style in explaining variability in long-term outcomes is unclear. This qualitative study examined bariatric patients' self-management experiences after bariatric surgery in relation to long-term outcomes. A qualitative study was conducted using semi-structured individual interviews with post-surgery patients (n=23) at a Canadian bariatric surgery program. A constant comparative approach was used to systematically analyse the data and identify overarching themes. Variation in patients' experiences and follow-up time were the two primary units of analysis. Patients were predominantly female (n=19; 82.6%) and had a mean age of 50 ± 8.49 years. The median time post-surgery was 2 years (range: 6months-7 years). Three distinct phases described the process of self-management post-bariatric surgery: (1) rediscovering self-esteem and confidence in one's ability to self-manage (1-month to 1.5-years post-surgery), (2) achieving weight maintenance and addressing emotion dysregulation (1.5-3-years post-surgery) and (3) embracing a flexible balanced lifestyle (beyond 3-years). Bariatric surgery patients experience distinct challenges relative to their post-surgery time course. Facilitating access to interprofessional bariatric care after surgery allowed patients to acquire the self-management knowledge and skills necessary to address challenges to following the bariatric guidelines in the long-term.

User Experiences With a Type 2 Diabetes Coaching App: Qualitative Study.

BackgroundDiabetes self-management apps have the potential to improve self-management in people with type 2 diabetes (T2D). Although efficacy trials provide evidence of health benefits, premature disengagement from apps is common. Therefore, it is important to understand the factors that influence engagement in real-world settings.ObjectiveThis study aims to explore users’ real-world experiences with the My Diabetes Coach (MDC) self-management app.MethodsWe conducted telephone-based interviews with participants who had accessed the MDC self-management app via their smartphone for up to 12 months. Interviews focused on user characteristics; the context within which the app was used; barriers and facilitators of app use; and the design, content, and delivery of support within the app.ResultsA total of 19 adults with T2D (8/19, 42% women; mean age 60, SD 14 years) were interviewed. Of the 19 interviewees, 8 (42%) had T2D for <5 years, 42% (n=8) had T2D for 5-10 years, and 16% (n=3) had T2D for >10 years. In total, 2 themes were constructed from interview data: (1) the moderating effect of diabetes self-management styles on needs, preferences, and expectations and (2) factors influencing users’ engagement with the app: one size does not fit all.ConclusionsUser characteristics, the context of use, and features of the app interact and influence engagement. Promoting engagement is vital if diabetes self-management apps are to become a useful complement to clinical care in supporting optimal self-management.Trial RegistrationAustralia New Zealand Clinical Trials Registry CTRN126140012296; URL https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366925&isReview=true

Keeping safe. Continuous glucose monitoring (CGM) in persons with Type 1 diabetes and impaired awareness of hypoglycaemia: a qualitative study.

To further our understanding of individual use and experience of continuous glucose monitoring (CGM) in adults with Type 1 diabetes and impaired awareness of hypoglycaemia, we conducted a qualitative study supplementary to a randomized controlled trial, using semi-structured interviews. Twenty-three participants of the IN CONTROL trial were interviewed within 4weeks after the last study visit. The interview centred around experiences of CGM, taking into account the person's expectations prior to the trial. The interview was semi-structured, using open-ended questions and, if needed, prompts were offered to elicit further responses. Using thematic analysis, the interview transcripts were coded independently by three members of the research team. The consolidated criteria for reporting qualitative research (COREQ) were followed. Overall, CGM was experienced as helpful in gaining more insight into glucose variability, and temporarily improved sense of control, reduced distress and made participants less dependent on others. However, some participants experienced confrontation with CGM output as intrusive, while some reported frustration due to failing technique and difficulty trusting the device. Participants reported active and passive self-management behaviours mirroring individual differences in attitudes and coping styles. In adults with Type 1 diabetes at risk of recurrent hypoglycaemia due to impaired awareness of hypoglycaemia, CGM use enhances a sense of control and safety for most, but not all. Future studies should further explore differential use of CGM in this population in the context of active and passive self-management styles.

Social Self-Management of Parkinson’s Disease

Abstract Date Presented 3/31/2017 This study investigated disease severity and social self-management styles of individuals with Parkinson’s disease. Three social self-management styles were associated with disease severity: participation in social life, exchange of support with others, and management of social resources. Primary Author and Speaker: Linda Tickle-Degnen Additional Authors and Speakers: Jenna Eldridge Contributing Authors: Michael Stevenson

유방암 생존자들의 자가관리에 대한 현상학적 연구: 비약물적 접근방법을 중심으로

본 연구는 현상학적 방법을 적용하여 유방암 생존자들의 비약물적 추후 관리 경험에 대한 본질적 구조와 의미에 대해 심도 있게 파악하는 것을 목적으로 한다. 이번 연구에서 총 참여자는 10명으로 S시 E병원 외래에 정기적으로 내원하는 유방암 생존자로 수술, 화학요법, 방사선요법을 완료한 자들이었다. 자료수집 기간은 2014년 8월부터 2015년 2월까지로 수집된 자료는 심층면담 후 Colaizzi의 방법 적용하여 분석하였다. 연구결과, 7개의 주제와 16개의 하위범주가 도출되었다. 7개의 주제는 '1. 증상을 완화하기 위해 용이한 방법을 적용함, 2. 변화된 신체 상태를 위해 움직이려 함, 3. 재발 방지를 위해 특정 식용 작물을 섭취함, 4. 건강을 유지하기 위한 식생활 양식이 있음, 5. 보완대체요법에 대해 항상 예의주시함, 6. 주치의 처방외 필요한 치료가 있음, 7. 자연친화적인 환경에서의 삶을 지향함' 이었다. 이번 연구는 유방암 생존자들이 치료 후에 일상생활에서 어떻게 추후관리를 하는지 심도있게 파악하는 데 도움을 줄 것이다. 나아가 본 결과는 향후 유방암 생존자들에게 실제 관리 양식에 근거한 실행 가능한 지침과 프로그램을 제공하는데 있어 기초자료로써 제공될 것이다. The purpose of this study was to understand the essential structure and meaning of self-management intervention for breast cancer survivors by using non-pharmacological approaches. The study participants were 10 breast cancer survivors who were completing cancer treatment that involved surgery, chemotherapy, and radiation therapy. Data collected between August 2014 and February 2015 at E Hospital in S city were analyzed by using Colaizzi's phenomenological method. Outcomes were classified into seven essential themes: 1) application of comfort measures to alleviate ongoing symptoms, 2) movement to change physical conditions, 3) special herbal intake to prevent recurrence, 4) a specially designed diet plan for health self-management, 5) constant awareness of complementary and alternative medicine, 6) unmet needs treated by one's own doctor's prescription, and 7) future life toward a nature-friendly environment. The study results contribute to a deeper understanding of self-management interventions in the daily lives of Korean breast cancer survivors. In addition, results provide an essential resource, based on actual self-management styles, that will help survivors to obtain guidance and participate in appropriate programs.

Complementary and Integrative Therapies for Persistent Pain Management in Older Adults: A Review

Management of persistent pain in older adults is challenging given the prevalence of multiple comorbid painful conditions, polypharmacy, age-related changes restricting pharmacological options, and socioeconomic factors. The influences of these factors along with current concern for the use of opioid analgesics highlight the importance of incorporating complementary and integrative medicine approaches. Evidence suggests efficacy and satisfaction with integrating complementary pain management strategies for older adults, especially yoga, massage, and natural products. Nurses and other providers, given their emphasis on holistic care, are in a unique position to lead the transformation of pain management to a patient-centered, self-management style that integrates complementary therapies. [Journal of Gerontological Nursing, 42(12), 40-48.].

A Qualitative Exploration of Motivation to Self-Manage and Styles of Self-Management amongst People Living with Type 2 Diabetes.

The study examined the motives that people living with type 2 diabetes (T2D) had for self-managing their condition and ways they used to assess the success of their self-management efforts. Using semistructured interviews (N = 25), focus groups (3 × N = 12 participants), and open-ended questionnaires (N = 6), people living with and self-managing T2D were recruited from a community-based T2D participation group. Most participants were older (aged 60+) and lived in a socioeconomically deprived area in the United Kingdom. Data were analysed thematically using framework analysis. Patients' motives for self-management included (i) concern about the anticipative effects of T2D; (ii) wishing to “stay well”; (iii) maintaining independence; (iv) reducing the need for healthcare professionals; and (v) improving quality of life. Six self-management styles were found and pertained to self-managing: (i) through routinisation; (ii) as a burden; (iii) as maintenance; (iv) through delegation; (v) through comanagement; and (vi) through autonomy. Motivators for self-management shaped the criteria people used to judge the success of their self-management practices and influenced their self-management style. The findings show that styles of T2D self-management are mediated and moderated by sociocontextual issues. Healthcare professionals should take these into account when supporting people living with T2D.

Механизмы создания психологически безопасной образовательной среды в образовательной организации общего образования

At the moment the question of how to create and maintain the psychological safety of the educational environment of the school is not sufficiently studied. Meanwhile, there has been proved its positive effect on the psychological health of students, their emotional and personal well-being, the formation of a meta-subjective and personal educational outcomes. This paper describes a study the purpose of which was to examine and verify empiricaly the features of management activities in the educational organization to create a psychologically safe learning environment. We studied personality traits of the Head of an educational organization by the procedure "Troubleshooting leadership abilities" (E. Zharikova, E. Krushelnytsky), techniques "Diagnosis of the level of burnout" (V.V. Boyko), methods of self-management style assessment (A.V. Agrashenkova, modified by E.P. Ilyin), and methods for rapid assessment of health, activity, mood (SAN). We proposed mechanisms to solve the problem of creating a comfortable and safe learning environment in the educational organization of general education.

Longer Term Effect of Randomized, Controlled Group Cognitive Behavioural Therapy for Internet Addiction in Adolescent Students in Shanghai

The aim of the present study was to evaluate the therapeutic effectiveness of group cognitive behavioural therapy (CBT) for Internet addiction in adolescents. A total of 56 patients, who met Beard's diagnostic criteria for Internet addiction, aged 12-17 years, were divided randomly into an active treatment group (n = 32) and a clinical control group (n = 24). Participants in the active treatment group were treated with an eight-session multimodal school-based group CBT while participants in the clinical control group received no intervention. Internet use, time management, emotional, cognitive and behavioural measures were assessed for both groups at baseline, immediately after the intervention and at 6 month follow up by investigators blind to the participants' group status. Internet use decreased in both groups while only the multimodal school-based group CBT evinced improved time management skills and better emotional, cognitive and behavioural symptoms. Multimodal school-based group CBT is effective for adolescents with Internet addiction, particularly in improving emotional state and regulation ability, behavioural and self-management style.

The Fifth Vital Sign—What Does It Mean?

Acute pain is reported as a presenting symptom in over 80% of physician visits. Chronic pain affects an estimated 76.2 million Americans--more than diabetes, heart disease, and cancer combined. It has been estimated to be undertreated in up to 80% of patients in some settings. Pain costs the American public more than $100 billion each year in health care, compensation, and litigation. That's why pain was officially declared "The Fifth Vital Sign." Henceforth the evaluation of pain became a requirement of proper patient care as important and basic as the assessment and management of temperature, blood pressure, respiratory rate, and heart rate. The numeric pain scale certainly has a place in care and in pain management; however, it is important to assess the patient's communication and self-management style and to recognize that patients, like pain, are on a continuum with varied styles of communication and adaptation. It is easy to get lost in the process, even when the process is initiated with the best of intentions. In the quest for individualized medicine, it might be best to keep pain assessment in the individualization arena.

Identification of Distinct Self-Management Styles of Adolescents With Type 1 Diabetes

Using a profile-based approach to the assessment of diabetes management, the purpose of this study was to identify and evaluate an empirically derived classification system of distinct self-management styles. Youth with type 1 diabetes (n = 156) aged 10-16 years and their parents were administered a modified version of the Diabetes Self-Management Profile (DSMP). Cluster analyses were performed independently on parent and youth report forms to categorize patients based on their patterns of scores in five diabetes self-management areas. Cluster analyses revealed three self-management styles that emerged from both youth and parent report: a "methodical style" (33%) with an emphasis on careful meal planning and correct insulin administration; an "adaptive style" (46%), characterized by high rates of blood glucose testing, exercise, and self-care adjustments; and an "inadequate style" (21%) with moderate rates of self-care adjustments and otherwise low DSMP scores. Convergence between parent and youth report classifications was moderate (Cohen's kappa = 0.47, P < 0.0001). A1C was 1.6% higher in the inadequate style group than in both other groups (P < 0.0001), and the classification significantly accounted for differences in A1C above what was explained by an overall DSMP score. The findings provide support for recognizing subgroups of patients with unique multidimensional patterns of self-care behaviors. The assessment of self-management styles may prove useful for customized treatments that are targeted directly to the patients' needs.

Self-management interventions for people with chronic conditions in primary care: Examples from arthritis, asthma and diabetes

The increasing prevalence of chronic conditions has implications for health care provision, particularly primary care which acts as the gatekeeper to other services and provides long-term support for patients with enduring needs. One means of coping with this increasing patient demand centres on enhancing the ability of patients to successfully self- manage the day-to-day realities of their condition in partnership with health care professionals. Hence, it is not surprising that the provision of self-management style programmes has seen a rapid growth in the past five years, primarily in relation to hospital-based programmes led by health professionals. There are exceptions such as the community-based self-management interventions that are organised and delivered by voluntary organisations using peer educators. The value of increasing self-management provision through primary care is discussed in relation to three conditions that form a large part of the primary care caseload: arthritis, asthma, and diabetes. The typical management tasks associated with each condition are considered in terms of differences and commonalities. The implications of such similarities and differences for implementation of self-management on a much wider scale in primary care are discussed.

How do patients' views about medication affect their self-management in asthma?

Successful management of asthma increasingly depends on decisions by patients about when and how to use inhalers and tablets prescribed for their asthma control. Patients with negative attitudes to asthma medication may not be willing to follow their management plan's advice to increase medication when their symptoms worsen. Patients do not always believe their doctors' reassurance about side effects. Although patient dislike of steroid medication is sometimes believed to be the main influence on reluctance to take medication, studies suggest that patients dislike taking any medication regularly. Evidence shows that patients are no more likely to use a combined inhaler regularly than separate steroid and relief inhalers. A proportion of patients with difficult to control asthma follow a chaotic self-management style. Attitudes among these patients may reflect personal styles, and be difficult to change. Among the majority of patients studies now show that patient self-management, and outcomes for patients can be improved by structured behavioural interventions. For most patients attitudes to medication will follow control of symptoms. The experience of successful control by medication, in the ways that patients think are important, are most likely to influence patients in positive attitudes to medication.