Use Of Self-management Strategies Research Articles

Patient perspectives on the unwanted effects of multidisciplinary pain management programmes: A qualitative study.

This study aimed to understand the impact of pain management programmes, focusing on the unwanted effects and their influence on patients' long-term use of self-management strategies. Qualitative study. Specialist musculoskeletal hospital in North London, England. Patients with chronic musculoskeletal pain that have completed a pain management programme. Multidisciplinary pain management programmes. Data were collected regarding patients' experiences and unwanted effects from the pain management programme using semi-structured interviews. Data were analysed using thematic analysis. Fourteen participant interviews were included in the analysis (median age 54 years, 12 females). Four themes were generated from the data: Benefits and burdens, Pain management programme and real life, Social support and Healthcare interventions. Unwanted effects included heightened anxiety related to negative interactions with peers, being in a new environment, worries about ability to cope with the programme, social anxiety from being in a group, the strain on families due to participants being away from home and a sense of abandonment at end of the programme. Burdens associated with implementing pain management strategies were identified, including the emotional burden of imposing their self-management on close family and competing demands with time and energy spent on self-management at the expense of work or home commitments. Pain management programmes have an important role in helping patients to learn how to self-manage chronic pain. Their unwanted effects and the treatment burdens associated with long-term self-management may be an important consideration in improving the longevity of their beneficial effects.

Outcomes and Characteristics of Interdisciplinary Self-Management Interventions for Older Adults Living with Chronic Pain: Insights from a Scoping Review

Introduction: Up to 50% of community-dwelling older adults report living with some chronic pain that interferes with their daily functioning and leads to disabilities. Hence, it is crucial to provide these individuals with strategies to effectively manage pain. An interdisciplinary approach is warranted considering the numerous factors contributing to pain among older adults. Although several studies have been conducted on various interdisciplinary pain self-management programs, little effort has been made to synthesize knowledge about such programs for older adults. Objective: The objective of this review was to synthesize the characteristics and effects of interdisciplinary chronic pain self-management interventions targeting community-dwelling older adults. Methods: A scoping review was conducted following the steps recommended by Arksey and O’Malley (2005) and Levac et al. (2010). Keyword searches were performed in MEDLINE, CINAHL, EMBASE, and the Cochrane Library. Results: Sixty-six articles were included. Most interventions were based on a cognitive-behavioral group approach and used a combination of modalities, including education and training on the use of self-management strategies. The professionals most frequently involved in group interventions were psychologists, physiotherapists, and occupational therapists. Several benefits of these programs have been reported concerning pain intensity, independence in daily functioning, mental health, and quality of life. Conclusions: Interdisciplinary chronic pain self-management programs appear promising in guiding clinical and rehabilitation interventions for older adults living with chronic pain.

Exploring the use of self-management strategies for antiretroviral therapy adherence among women with HIV in the Miami-Dade County Ryan White Program.

Women with HIV (WWH) face increased difficulties maintaining adherence to antiretroviral therapy (ART) due to a variety of demographic and psychosocial factors. To navigate the complexities of ART regimens, use of strategies to maintain adherence is recommended. Research in this area, however, has largely focused on adherence interventions, and few studies have examined self-reported preferences for adherence strategies. The purpose and objectives of this study were to explore the use of ART self-management strategies among a diverse sample of WWH, examine demographic and psychosocial differences in strategy use, and assess the association between strategies and ART adherence. The current study presents secondary data of 560 WWH enrolled in the Miami-Dade County Ryan White Program. Participants responded to questionnaire items assessing demographic and psychosocial characteristics, use of adherence strategies, and ART adherence during the past month. Principal component analysis identified four categories among the individual strategies and multivariable binomial logistic regression assessed adherence while controlling for individual-level factors. The majority of WWH reported optimal ART adherence, and nearly all used multiple individual strategies. The number of individual strategies used and preferences for strategy types were associated with various demographic and psychosocial characteristics. Adjusting for demographic and psychosocial characteristics, optimal ART adherence during the past month was associated with the use of four or more individual strategies. When conducting regular assessments of adherence, it may be beneficial to also assess use of adherence strategies and to discuss with WWH how using multiple strategies contributes to better adherence.

The impact of aggregate positive lifestyle behaviors on low back pain resilience and care seeking

BACKGROUND CONTEXTLow back pain (LBP) is a global issue, and the high associated costs are mainly attributed to a small proportion of people with LBP who seek care. Importantly, the impact of aggregate positive lifestyle behaviors on LBP resilience and care seeking is not known. PURPOSEThis study aimed to evaluate the relationship between positive lifestyle behaviors and LBP resilience. STUDY DESIGNThis study was a prospective longitudinal cohort study. PATIENT SAMPLEData was collected as part of the AUstralian Twin BACK Study (AUTBACK). Participants who reported a lifetime previous history of LBP at baseline were included in this analysis (n = 340). OUTCOME MEASURESThe outcomes of interest were the number of weeks without activity limiting LBP and total number of days of healthcare usage, health practitioner care, self-management care, and medication intake. METHODSA lifestyle behavior score was built using variables of body mass index (BMI), physical activity, smoking status, and sleep quality. Negative binomial regression analyses were used to assess the relationship between the positive lifestyle behavior score and the count outcomes of number of weeks without activity limiting LBP and number of days participants used care. RESULTSAfter adjusting for covariates, no association was found between participants’ positive lifestyle behavior score and their number of weeks without activity limiting LBP (IRR: 1.02, 95% CI 1.00–1.05). There was a statistically significant relationship between higher positive lifestyle behavior scores and fewer number of days of participants’ total healthcare usage (IRR:0.69, 95% CI 0.56–0.84), healthcare practitioner visits (IRR:0.62, 95% CI 0.45–0.84), use of self-management strategies (IRR:0.74, 95% CI 0.60–0.91), and use of pain medication (IRR:0.55, 95% CI 0.44–0.68). CONCLUSIONPeople who adopt optimal lifestyle behaviors, such as engaging in adequate physical activity, achieving optimal quality sleep, maintaining an ideal BMI, and not smoking, may not experience less time suffering from activity limiting LBP, but are less likely to use healthcare and pain medication for their LBP.

Self-management strategies and multicomponent training to mitigate the effects of the interruption of physical exercise programmes in the pandemic context on functionality, sedentary behaviour, physical capacity, mental health, body composition and quality of life in older adults: a blinded randomized controlled study protocol

BackgroundConsidering the confinement recommended by the World Health Organization due to the pandemic caused by COVID-19, many community physical exercise programmes for older adults have had their activities cancelled. In this context, proposing strategies to recover the possible adverse effects of the confinement period is pertinent. The use of self-management strategies associated with regular physical activity reduces sedentary behaviour and improves physical capacity in older adults. Thus, the purpose of this study was to describe a multicomponent training programme combined with a self-management strategy protocol to mitigate the effects of interruptions in physical exercise programmes on functionality, physical capacity, mental health, body composition and quality of life in older adults.MethodsThis will be a blinded, randomized and controlled clinical trial performed in São Carlos, SP, Brazil. Eighty older adults will be divided into two groups: multicomponent training (Multi) and multicomponent training + self-management strategies (Multi+SM). The intervention will be performed over 16 weeks on three alternate days of every week, with 50-min sessions. The assessment of physical capacity will be performed before the interruption of physical exercise programmes (T0: initial assessment, March 2020), preintervention (T1: immediately after the return of the exercise programme) and postintervention (T2). The assessments of physical activity level, quality of life, mental health, functionality and body composition will be performed at T1 and T2.DiscussionThe results from this MC+SM protocol will allow us to contribute clinical support to evaluate the variables analysed and to guide future public health policies with the aim of minimizing the possible deleterious effects arising from the physical exercise interruption periods caused by epidemics and pandemics.Trial registrationRBR-10zs97gk. Prospectively registered in Brazilian Registry of Clinical Trials (ReBEC) on 17 June 2021. Registry name: Use of self-management strategies combined with multicomponent training to mitigate the effects of social distancing due to COVID-19 on capacity, physical capacity, mental health and quality of life in older adults - A blind, randomized and controlled clinical trial.

User Engagement Within an Online Peer Support Community (Depression Connect) and Recovery-Related Changes in Empowerment: Longitudinal User Survey.

The chronic nature of depression and limited availability of evidence-based treatments emphasize the need for complementary recovery-oriented services, such as peer support interventions (PSIs). Peer support is associated with positive effects on clinical and personal recovery from mental illness, but little is known about the processes of engagement that foster change, and studies targeting individuals with depression specifically are limited. This study aimed to evaluate whether the level of user engagement, assessed on several dimensions, in an online peer support community for individuals with depression promotes empowerment and the use of self-management strategies and reduces symptom severity and disability. In a longitudinal survey conducted from June 2019 to September 2020, we analyzed the data of the users of Depression Connect (DC), an online peer support community hosted by the Dutch Patient Association for Depression and the Pro Persona Mental Health Care institute, on measures of empowerment, self-management, depression, and disability. Of the 301 respondents, 49 (16.3%) respondents completed the survey again after 3 months and 74 (24.6%) respondents, after 6 months. Analysis of 3 parameters (ie, total time spent on the platform, number of page views, and number of posts) derived from their data logs yielded 4 engagement profiles. Linear mixed models were fitted to determine whether the outcomes had significantly changed over time and differed for the various profiles. Baseline engagement with the online peer support community was "very low" (177/301, 58.8%) or "low" (87/301, 28.9%) for most of the participants, with few showing "medium" (30/301, 9.9%) or "high" engagement patterns (7/301, 2.3%), while user profiles did not differ in demographic and clinical characteristics. Empowerment, self-management, depressive symptoms, and disability improved over time, but none were associated with the intensity or nature of user engagement. With most DC members showing very low to low engagement and only a few being identified as high-engaged users, it is likely that this flexibility in use frequency is what provides value to online PSI users. In other more formal supportive environments for depression, a certain level of engagement is predetermined either by their organizational or by their societal context; at DC, users can adapt the intensity and nature of their engagement to their current needs on their personal road to recovery. This study added to the current knowledge base on user engagement for PSIs because previous studies targeting depression with an online format focused on active users, precluding passive and flexible engagement. Future studies should explore the content and quality of the interactions in online PSIs to identify optimal user engagement as a function of current, self-reported clinical parameters and reasons to engage in the PSI.

Changes in Perceived Impact of Stroke on Everyday Life over Five Years in a Rehabilitation Sample that Received an Activity of Daily Living Intervention: A Follow-Up Study.

ObjectiveTo compare changes in the perceived impact of stroke on everyday life over time in a rehabilitation sample that received a client-centred activities of daily living (CADL) intervention or usual ADL (UADL) intervention.DesignLongitudinal follow-up of a randomized controlled trial.MethodsA total of 145 persons with stroke were assigned into CADL or UADL. Groups were assessed using the Stroke Impact Scale (SIS) at 3 months, 12 months and 5 years post-intervention. Changes in SIS domain scores over time were compared within and between groups.ResultsChanges in the impact of stroke over time were not related to which intervention the groups received. There were no significant differences in the SIS domains or stroke recovery between groups at the 3-month, 12-month and 5-year follow-ups. Despite an increased impact of stroke over time in some domains in both groups, both groups perceived a decreased impact of stroke in the Participation domain at 12 months. Perceived participation was sustained at the same level at 12 months as at 5 years in both groups.ConclusionThese findings stress the importance of access to follow-up rehabilitation interventions 1-year post-stroke to enable participation in daily activities. Such follow-up and enablement would support the use of self-management strategies in the performance of persons’ valued activities, which might be difficult to perform, due to, for example, impact on hand function or mobility. The results of this study emphasize the importance of prioritizing participation in activities that are meaningful from a personal perspective.LAY ABSTRACTIn this study, perceived impact of stroke on everyday life over time was compared among 145 persons with stroke who received the client-centred or usual activities of daily living intervention. They were followed up at 3, 12 months and 5-years post-stroke. No differences were found in the impact of stroke over time between groups. Despite increased impact of stroke (indicating more problems) over time in some areas, the groups perceived decreased impact of stroke (less problems) in their participation at 12 months. Perceived participation was sustained at the same level at 12 months as at 5 years in both groups. Findings stress the importance of access to follow-up rehabilitation interventions one-year post-stroke to enable participation in daily activities, and to support the use of self-management strategies to facilitate participation in valued and meaningful activities that might be difficult due to person’s functional limitations.

Construing journeys to recovery from psychosis: Aqualitative analysis of first-person accounts.

To perform a qualitative analysis of the factors that were construed as salient in facilitating the process of recovery in the narratives of people with psychosis who had their first-person accounts (FPAs) published in an academic journal. Computerized textual analysis was undertaken of 156 FPAs written by persons who had experienced psychosis and published in the Schizophrenia Bulletin between 1979 and 2020. Constructs were extracted from the FPAs and coded in terms of Mental health treatment and therapy, Self-management and Multiple factors; recovery processes (Connectedness, Hope, Identity, Meaning and Empowerment), Struggles and Turning points. Psychosis impacted on individuals in profound and diverse ways. This was reflected in the different pathways to recovery included in the FPAs. Underlying the different pathways was the salience of re-engagement in the shared reality of others; development of a cohesive and positive self; empowerment through the use of self-management strategies, and making sense of experience through reconstruing what was meaningful. Personal constructs identified in the FPAs provided insight into both challenges faced and alternative avenues of movement that were perceived as available. Processes that support individuals re-engaging with the shared reality of others are central to recovery. Supportive relationships and fostering open dialogue were consistent themes across the different pathways that recovery journeys took. Establishing a meaningful lifestyle and recovering a positive sense of identity were a key challenge following psychosis onset. Appreciation of experiences contained in FPAs has the potential to enhance the effectiveness and humanity of mental health care.

Consultations with health care providers and use of self-management strategies for prevention and treatment of COVID-19 related symptoms. A population based cross-sectional study in Norway, Sweden and the Netherlands

ObjectivesThe present study was initiated to determine consultations with health care providers and use of self-management strategies for prevention or treatment of COVID-19 related symptoms in countries with a full lockdown (Norway), a partial lockdown (the Netherlands) and no lockdown (Sweden) during the first three months of the COVID-19 pandemic, and if such use correlates with worries of being infected by COVID-19 disease. DesignData were collected in collaboration with Ipsos A/S in April-June 2020. An adapted version of the International Questionnaire to measure use of Complementary and Alternative Medicine (I-CAM-Q) was used with the categories “for prevention of COVID-19” and “to treat COVID-19-related symptoms” added. Data were collected among a representative sample in Norway, Sweden and the Netherlands using data assisted telephone interviews (Norway, n=990 and Sweden, n=500), and an online survey (the Netherlands, n=1004). Total response rate was 30%. ResultsVery few consulted a health care provider with the intention to treat or prevent COVID-19 (1.2% and 1.0% respectively) with medical doctors mostly visited (1.0% and 0.9% respectively). Similarly, the use of self-management strategies to prevent or treat COVID-19 was low (3.4% and 0.2% respectively); most commonly used for prevention of COVID-19 were vitamins and minerals (2.8%). Consultations with health care providers and use of self-management strategies for prevention of COVID-19 were positively associated with worries of being infected with COVID-19. ConclusionsThe COVID-19 pandemic does not seem to have evoked a large-scale difference in behavior related to consultations with health care providers or the use of self-management strategies in any of the three countries.

Women Caring for Retired Men: A Continuation of Inequality in the Sport Marriage

Drawing from longitudinal qualitative research on the heteronormative sport marriage that primarily featured interviews with women married to male professional athletes, this article focuses on how women were affected by and managed their retired husbands’ physical and mental–emotional health issues. It explores the women’s continued use of self-management strategies they developed during their husband’s career as they offered increasingly challenging care work to their husbands and examines how long-held expectations about their caregiver role continued to contribute to post-career gender inequality in their marriages. It captures the women’s voices as they discovered that they were not sufficiently prepared for the emerging personal and relational complexities that emerged in retirement.

Postprostatectomy Incontinence and Self-management for Urinary Incontinence After Laparoscopic Radical Prostatectomy: A Cross-sectional Study.

The purpose of this study was to describe postprostatectomy incontinence (PPI) after laparoscopic radical prostatectomy (LRP), self-management strategies for managing incontinence, and factors influencing self-management. A descriptive, cross-sectional study. The sample comprising 37 males with prostate cancer who underwent LRP was recruited within first 2 years. The study setting was a tertiary care hospital in Beijing, China. An additional 78 individuals who responded to a mailed invitation sent from September 2015 to October 2016 participated in the study. Participants completed a questionnaire that queried demographic and pertinent clinical data. The questionnaire also included 2 validated instruments. The International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) was used to assess urinary incontinence (UI) following radical prostatectomy and its severity. The Strategy and Effectiveness of Symptom Self-Management questionnaire of Postprostatectomy Incontinence (SESSM-PPI) was used to evaluate self-management of UI, including strategies used and their perceived effectiveness. Data analysis was based on 115 respondents who completed all components of the questionnaire; 95 (82.6%) indicated having UI. Forty-one patients (43.2%) indicated mild UI, 47 (49.5%) indicated moderate UI, and 7 (7.4%) indicated severe UI. The mean score of the SESSM-PPI was 14.04 ± 7.92, indicating a low level of self-management.The top 5 strategies with moderate effectiveness were in the following order: "use pads or adult diapers"; "pelvic floor muscle training"; "avoid extracting heavy objects"; "avoid drinking"; and "eat more fruit to prevent constipation." The Spearman correlation analysis revealed a positive correlation between the frequency of use of self-management strategies and incontinence severity. Urinary incontinence is prevalent among males with prostate cancer managed by radical prostatectomy. Respondents tended to report mild to moderate UI severity. Self-management of UI among respondents is low.

Measuring Bladder Health: Development and Cognitive Evaluation of Items for a Novel Bladder Health Instrument.

We describe the item development and cognitive evaluation process used in creating the Prevention of Lower Urinary Tract Symptoms Bladder Health Instrument (PLUS-BHI). Questions assessing bladder health were developed using reviews of published items, expert opinion, and focus groups' transcript review. Candidate items were tested through cognitive interviews with community-dwelling women and an online panel survey. Items were assessed for comprehension, language, and response categories and modified iteratively to create the PLUS-BHI. Existing measures of bladder function (storage, emptying, sensation components) and bladder health impact required modification of time frame and response categories to capture a full range of bladder health. Of the women 167 (18-80 years old) completed individual interviews and 791 women (18-88 years) completed the online panel survey. The term "bladder health" was unfamiliar for most and was conceptualized primarily as absence of severe urinary symptoms, infection, or cancer. Coping mechanisms and self-management strategies were central to bladder health perceptions. The inclusion of prompts and response categories that captured infrequent symptoms increased endorsement of symptoms across bladder function components. Bladder health measurement is challenged by a lack of awareness of normal function, use of self-management strategies to mitigate impact on activities, and a common tendency to overlook infrequent lower urinary tract symptoms. The PLUS-BHI is designed to characterize the full spectrum of bladder health in women and will be validated for research use.

Pain and Its Management: Strategies and Outcomes in Older Adults With or at Risk for Knee Osteoarthritis

Knee osteoarthritis (KOA) is a leading cause of mobility disability that is characterized by chronic pain among older adults. Non-Hispanic Blacks (NHBs) suffer disproportionately from non-Hispanic Whites (NHWs), reporting higher pain intensity and disability. It is unclear how these differences in symptomatology translate into different patterns of utilization for self-management (SM) of pain, and if such patterns are associated with underlying biological pain mechanisms. This multisite observational study examined (1) use of self-management strategies among older NHB and NHW adults with/at risk for KOA and (2) associations among self-management strategies, clinical and experimental pain. After approval from institutional IRBs, NHB and NHW older adults (N= 202) with knee pain completed the McGill Pain Questionnaire-Short Form, questions on treatment strategies (e.g., massage, ice, heat, medications), and quantitative sensory testing. Covariates included study site and education. On average, participants reported using 2 ± 1.65 SM strategies, with 79% endorsing at least one SM strategy. Analysis of covariance revealed that clinical pain differed by race/ethnicity and use of SM and/or medical treatments (p’s < 0.01). SM use did not differ by race/ethnicity, p = 0.15, but did differ significantly by gender, p < 0.05. Multiple linear regression demonstrated significant positive associations between SM and heat pain sensitivity for both NHBs and NHWs, (p < 0.05). SM is an important component of OA management for NHBs and NHWs. Our study is one of the first to show that SM use is significantly associated with pain mechanisms. Improved understanding will facilitate better mechanism-targeted pain management.

The development and initial evaluation of the Diarrhoea Management Diary (DMD) in patients with metastatic breast cancer

PurposeChemotherapy-induced diarrhoea (CID) is a common, but often underreported problem in patients with breast cancer that has a profound effect on quality of life. It is best measured from a patient’s perspective, but tools are limited. The aim of this study was to develop and evaluate the Diarrhoea Management Diary (DMD), a self-report measure to assess CID, use of self-management strategies and treatment adherence.MethodsThe DMD was constructed using an iterative process of instrument development: concept elicitation (literature review), item generation and reduction (cognitive debriefing), and pilot testing in the target population. After translation into eight languages, the DMD was used in an international randomised trial for women receiving lapatinib and capecitabine for metastatic breast cancer with or without prophylactic octreotide. Patterns of missing data and sensitivity to change were examined.ResultsThe understandability and completeness of the 8-item DMD was confirmed in cognitive interviews and pilot testing. Practicability of the DMD was evaluated in 62 women with metastatic breast cancer (median age 57). Up to 68% reported CID at any given time-point, and 19% had diarrhoea at each time-point. Patients also described efficacy of different strategies for diarrhoea management. Missing data were associated with study discontinuation. DMD missing item response was 0.9%. Sensitivity to change was good at most assessment points.ConclusionsAlthough further psychometric testing is recommended, initial evaluation of the DMD showed good content validity and practicability in international research with cancer patients.

Effects of self-management education for persons with Parkinson's disease and their care partners: A qualitative observational study in clinical care.

Persons with Parkinson's disease and their care partners want support from health care to develop the skills to handle everyday life with the long-term condition. Earlier findings indicate that participants of the self-management program Swedish National Parkinson School experience several benefits of the program. The purpose of this qualitative observational study was to explore if participants had implemented the strategies of self-monitoring included in the program and use them to communicate health care status and needs in clinical encounters. Data were collected 3 to 15 months after participation in the program and analyzed using constant comparative analysis. Three categories were evident: "Self-observation in everyday life," "Self-care activities to promote health," and "Managing emotional impact of Parkinson's Disease." Categories were linked together in a core category that highlight the use of self-management strategies described by participants during clinical encounters. Results confirmed that persons with Parkinson's disease and care partners use the techniques of self-observation in their everyday lives. Observations of effects in clinical care can be a valuable approach to evaluate the outcomes educational interventions and their benefits for individuals and health care.

Chronic pain: good management of practical pain control strategies is associated with being older, more health activated and having better mental health.

INTRODUCTION Chronic pain affects a large proportion of the adult population and people in pain need to learn how to manage it in order to maintain quality of life. AIM This study aimed to examine how well people with long-term conditions make use of self-management strategies to control their pain, and to identify personal attributes associated with a higher degree of success. METHODS People with chronic pain who participated in the first phase of a longitudinal long-term conditions study in the MidCentral region made up the study sample (N=326, response rate 21%). They completed a questionnaire by mail or online, which included items on pain management, general health, patient activation, experiences with general practice and demographics. RESULTS Pain control strategies were managed fairly well overall. Taking pain medication and avoiding caffeine, alcohol, heavy meals and exercise before bed were managed best, whereas sleep, relaxation breathing and remaining socially active were managed least well. A multiple regression analysis found higher scores on patient activation, self-rated overall pain management at home, mental health and older age (≥75 years) to be associated with better management. DISCUSSION This study identified pain control strategies that are managed well, and less well, outside of a specific intervention. Results highlight topics for discussion in consultations and identify areas where general practice could provide better self-management support, such as sleep and exercise. Better overall pain control strategy management was most strongly associated with patient activation; that is, a combination of knowledge, skills and confidence to manage health and health care that is amenable to intervention. Improving the level of activation in people with long-term conditions may enhance their use of pain control strategies.

Reliability and validity of the Japanese version of the Mental Health Self-management Questionnaire among people with mental illness living in the community

BackgroundSelf-management is an important factor in maintaining and promoting mental health and recovery from mental health challenges. Thus, it is important to assess and support mental health self-management. In this study, we aimed to develop the Japanese version of the Mental Health Self-management Questionnaire (MHSQ-J), a scale to assess mental health self-management strategy, and clarify its psychometric properties among people with mental illness living in Japan.MethodsAn anonymous self-administered survey including MHSQ-J was conducted for psychiatric outpatient users (N = 295), and 104 of the participants completed MHSQ-J again about two weeks later. Internal consistency was assessed with Cronbach’s α, and test-retest reliability was confirmed by the intraclass correlation coefficient (ICC). Construct validity was assessed based on structural validity with confirmatory factor analysis (CFA) and exploratory factor analysis (EFA), and hypotheses testing. The Self-management Skill Scale, the University of Tokyo Health Sociology version of the Sense of Coherence Scale ver1.2, the Japanese version of Self-identified Stage of Recovery Part-B, the Japanese version of the Flourishing Scale, and the Japanese version of the WHO Disability Assessment Scale 2.0 were used for hypotheses testing.ResultsData from 243 respondents were analyzed. The result of CFA, the goodness-of-fit indices showed marginal fit (AGFI = .830, CFI = .852, RMSEA = .072). EFA identified three factors (Clinical, Empowerment, and Vitality), and the results suggested that the factor structure of the Japanese version of MHSQ was similar to the original 3-factor structure. Significant correlations were found with the hypotheses testing variables related to self-management and recovery, especially on the total score, the Empowerment subscale, and the Vitality subscale. Cronbach’s α (Clinical: .65, Empowerment: .81, Vitality: .75, Total: .83) and ICC (Clinical: .75, 95% confidence interval (CI) [.62, .84], Empowerment: .81, 95% CI [.70, .88], Vitality: .62, 95% CI [.44, .75], Total: .84, 95% CI [.75, .90]) indicated good reliability.ConclusionThe results show that MHSQ-J has acceptable reliability and validity to measure the use of self-management strategies for mental health among community living people with mental illness in Japan.

Prevalence and frequency of self-management strategies among female cancer survivors: the neglected roles of social relations and conscious living.

To assess prevalence and frequency of use of self-management strategies among female cancer survivors and to empirically identify categories of self-management. Female cancer survivors (N=673, mean age 51 years; >90% with breast cancer; M=5 years since diagnosis) completed an Internet survey indicating the frequency (never to very often) with which they had employed each strategy since diagnosis. The survey included commonly assessed self-management strategies, such as complementary and alternative medicine (CAM), religious practices, and exercise. Additionally we assessed the use of further strategies identified from recommendations of cancer survivors shared in Internet forums. A principal component analysis yielded five categories: More Conscious Living, Turning to Family/Friends, CAM, Religious/Spiritual Practices, and Exercise. Prevalence rates of commonly measured strategies like CAM, Religious Practices, and Exercise were similar to previous studies. Considering frequency of use, however, revealed that only few participants reported frequent use of these strategies (<10%). In contrast, about half of the women (>50%) reported Turning to Family/Friends and engaging in More Conscious Living strategies (very) often. Relying on prevalence assessments of commonly investigated behaviors such as CAM or exercise may overestimate their use among cancer survivors. Cancer survivors engage in a wide range of self-management strategies. Encouraging living more consciously and cultivating social relations might be of greater relevance compared with CAM use or exercise.

The use of self-management strategies for problem gambling: a scoping review

BackgroundProblem gambling (PG) is a serious public health concern that disproportionately affects people experiencing poverty, homelessness, and multimorbidity including mental health and substance use concerns. Little research has focused on self-help and self-management in gambling recovery, despite evidence that a substantial number of people do not seek formal treatment. This study explored the literature on PG self-management strategies. Self-management was defined as the capacity to manage symptoms, the intervention, health consequences and altered lifestyle that accompanies a chronic health concern.MethodsWe searched 10 databases to identity interdisciplinary articles from the social sciences, allied health professions, nursing and psychology, between 2000 and June 28, 2017. We reviewed records for eligibility and extracted data from relevant articles. Studies were included in the review if they examined PG self-management strategies used by adults (18+) in at least a subset of the sample, and in which PG was confirmed using a validated diagnostic or screening tool.ResultsWe conducted a scoping review of studies from 2000 to 2017, identifying 31 articles that met the criteria for full text review from a search strategy that yielded 2662 potential articles. The majority of studies examined self-exclusion (39%), followed by use of workbooks (35%), and money or time limiting strategies (17%). The remaining 8% focused on cognitive, behavioural and coping strategies, stress management, and mindfulness.ConclusionsGiven that a minority of people with gambling concerns seek treatment, that stigma is an enormous barrier to care, and that PG services are scarce and most do not address multimorbidity, it is important to examine the personal self-management of gambling as an alternative to formalized treatment.

Promoting the Use of Self-management Strategies for People With Persistent Musculoskeletal Disorders: The Role of Physical Therapists.

Persistent musculoskeletal pain is a worldwide health problem resulting in negative effects on individuals' wellbeing and substantial costs to society. Recently, there has been discussion about effective treatment approaches to persistent musculoskeletal disorders, including low back pain. In this Viewpoint, the authors argue that self-management strategies are essential to the management of persistent musculoskeletal disorders and outline the physical therapist's role in supporting effective self-management. J Orthop Sports Phys Ther 2019;49(4):212-215. doi:10.2519/jospt.2019.0605.