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1.
BMC Geriatr ; 24(1): 605, 2024 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-39009962

RESUMO

BACKGROUND: Urinary concerns increase with age impacting health and quality of life. The aims of this study were to describe: (1) urinary concerns as an age-related change (ARC); (2) the challenges of urinary concerns; (3) adaptation strategies used to manage urinary concerns; and (4) the value of engaging with aging (EWA) as a framework to promote self-management of urinary concerns. METHODS: Data was used from semi-structured interviews with 29 older adults (mean age 77 years). An iterative coding process was used. A codebook was developed based on a-priori themes derived from the EWA framework, our previous publication, and a line-by-line coding of one of the transcripts. As the analysis progressed, additional codes emerged, enriching the codebook. RESULTS: Six themes emerged: (1) the participants' experiences; (2) responses to urinary concerns, (3) adaptation and management strategies; (4) knowledge and understanding of urinary concerns; (5) available capacities and resources; and (6) the impact of the COVID-19 pandemic on urinary concerns. Participants tended to address their urinary concerns by adjusting routines, medication schedules, or diet patterns. They tried to secure restroom locations or use tools or reminders to resolve their urinary concerns. COVID-19 led to increased inconvenience for older adults to engage in outdoor activities due to the closure of public restrooms. CONCLUSIONS: Our in-depth qualitative analysis found that participants developed personalized adjustments to address their needs and abilities to their urinary concerns. These findings offer insights into the individual aging experience, which will further enhance our understanding and advancement of person-centered care.


Assuntos
COVID-19 , Envelhecimento Saudável , Pesquisa Qualitativa , Humanos , Idoso , Masculino , Feminino , Envelhecimento Saudável/psicologia , Envelhecimento Saudável/fisiologia , COVID-19/epidemiologia , COVID-19/psicologia , Idoso de 80 Anos ou mais , Qualidade de Vida/psicologia , Adaptação Psicológica/fisiologia , Autogestão/métodos , Autogestão/psicologia
2.
JMIR Hum Factors ; 11: e51086, 2024 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-39045815

RESUMO

Background: Artificial intelligence (AI) chatbots have the potential to assist individuals with chronic health conditions by providing tailored information, monitoring symptoms, and offering mental health support. Despite their potential benefits, research on public attitudes toward health care chatbots is still limited. To effectively support individuals with long-term health conditions like long COVID (or post-COVID-19 condition), it is crucial to understand their perspectives and preferences regarding the use of AI chatbots. Objective: This study has two main objectives: (1) provide insights into AI chatbot acceptance among people with chronic health conditions, particularly adults older than 55 years and (2) explore the perceptions of using AI chatbots for health self-management and long COVID support. Methods: A web-based survey study was conducted between January and March 2023, specifically targeting individuals with diabetes and other chronic conditions. This particular population was chosen due to their potential awareness and ability to self-manage their condition. The survey aimed to capture data at multiple intervals, taking into consideration the public launch of ChatGPT, which could have potentially impacted public opinions during the project timeline. The survey received 1310 clicks and garnered 900 responses, resulting in a total of 888 usable data points. Results: Although past experience with chatbots (P<.001, 95% CI .110-.302) and online information seeking (P<.001, 95% CI .039-.084) are strong indicators of respondents' future adoption of health chatbots, they are in general skeptical or unsure about the use of AI chatbots for health care purposes. Less than one-third of the respondents (n=203, 30.1%) indicated that they were likely to use a health chatbot in the next 12 months if available. Most were uncertain about a chatbot's capability to provide accurate medical advice. However, people seemed more receptive to using voice-based chatbots for mental well-being, health data collection, and analysis. Half of the respondents with long COVID showed interest in using emotionally intelligent chatbots. Conclusions: AI hesitancy is not uniform across all health domains and user groups. Despite persistent AI hesitancy, there are promising opportunities for chatbots to offer support for chronic conditions in areas of lifestyle enhancement and mental well-being, potentially through voice-based user interfaces.


Assuntos
Inteligência Artificial , COVID-19 , Humanos , COVID-19/psicologia , COVID-19/epidemiologia , Pessoa de Meia-Idade , Doença Crônica/terapia , Doença Crônica/psicologia , Masculino , Feminino , Inquéritos e Questionários , Idoso , Adulto , Autogestão/psicologia , Autogestão/métodos
3.
J Diabetes Res ; 2024: 2673742, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39035684

RESUMO

This review is aimed at unraveling the intricacies of diabetic self-management among geriatric people, drawing on current insights and understanding the complex paths geriatric people navigate. A wide search was conducted in health-oriented databases, including CINAHL, Embase, PsycINFO, MEDLINE, PubMed, Web of Science, and Cochrane Library, while gray literature was excluded. The search combined keywords and subject headings, focusing on the geriatric population, diabetes, self-management, and qualitative research. A three-tiered screening process was employed, with titles and then abstracts initially reviewed. Full-text analysis followed, with disagreements resolved among reviewers. In total, there were 248 participants included across these eight studies. Positive attitudes and perceptions were found to play a significant role in optimizing diabetes self-care outcomes. Support from family and friends was identified as crucial for self-care, while healthcare professionals often lacked adequate support and encouragement. Participants emphasized the importance of listening to their bodies and acknowledging hidden issues. These themes collectively highlight the multifaceted aspects of diabetes self-care and the impact of various factors on the self-management experiences of geriatric individuals with diabetes. The goal of this review is not to objectify self-management as a treatment strategy but to emphasize the importance of cultivating positive attitudes, respecting individual values, and addressing cultural and ethnic differences in healthcare practices to enhance self-management in this population. By embracing cultural diversity, understanding barriers, and respecting individual values, healthcare professionals and policymakers can improve the quality of life for the geriatric population living with diabetes.


Assuntos
Diabetes Mellitus Tipo 2 , Autogestão , Humanos , Diabetes Mellitus Tipo 2/terapia , Diabetes Mellitus Tipo 2/psicologia , Autogestão/psicologia , Estados Unidos , Idoso , Autocuidado , Conhecimentos, Atitudes e Prática em Saúde , Pesquisa Qualitativa , Apoio Social , Entrevistas como Assunto
4.
JMIR Mhealth Uhealth ; 12: e53652, 2024 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-39024567

RESUMO

BACKGROUND:  Cancer pain remains highly prevalent and persistent throughout survivorship, and it is crucial to investigate the potential of leveraging the advanced features of mobile health (mHealth) apps to empower individuals to self-manage their pain. OBJECTIVE:  This review aims to comprehensively understand the acceptability, users' experiences, and effectiveness of mHealth apps in supporting cancer pain self-management. METHODS:  We conducted an integrative review following Souza and Whittemore and Knafl's 6 review processes. Literature was searched in PubMed, Scopus, CINAHL Plus with Full Text, PsycINFO, and Embase, from 2013 to 2023. Keywords including "cancer patients," "pain," "self-management," "mHealth applications," and relevant synonyms were used in the search. The Johns Hopkins research evidence appraisal tool was used to evaluate the quality of eligible studies. A narrative synthesis was conducted to analyze the extracted data. RESULTS:  A total of 20 studies were included, with the overall quality rated as high (n=15) to good (n=5). Using mHealth apps to monitor and manage pain was acceptable for most patients with cancer. The internal consistency of the mHealth in measuring pain was 0.96. The reported daily assessment or engagement rate ranged from 61.9% to 76.8%. All mHealth apps were designed for multimodal interventions. Participants generally had positive experiences using pain apps, rating them as enjoyable and user-friendly. In addition, 6 studies reported significant improvements in health outcomes, including enhancement in pain remission (severity and intensity), medication adherence, and a reduced frequency of breakthrough pain. The most frequently highlighted roles of mHealth apps included pain monitoring, tracking, reminders, education facilitation, and support coordination. CONCLUSIONS:  mHealth apps are effective and acceptable in supporting pain self-management. They offer a promising multi-model approach for patients to monitor, track, and manage their pain. These findings provide evidence-based insights for leveraging mHealth apps to support cancer pain self-management. More high-quality studies are needed to examine the effectiveness of digital technology-based interventions for cancer pain self-management and to identify the facilitators and barriers to their implementation in real-world practice.


Assuntos
Dor do Câncer , Aplicativos Móveis , Autogestão , Telemedicina , Humanos , Dor do Câncer/terapia , Dor do Câncer/psicologia , Autogestão/métodos , Autogestão/psicologia , Telemedicina/normas , Aplicativos Móveis/normas , Aplicativos Móveis/estatística & dados numéricos , Aplicativos Móveis/tendências , Manejo da Dor/métodos , Manejo da Dor/normas , Neoplasias/complicações , Neoplasias/psicologia , Neoplasias/terapia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/psicologia
5.
Medicine (Baltimore) ; 103(29): e38836, 2024 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-39029078

RESUMO

Stroke is a potentially traumatic event that can lead to both positive changes associated with post-traumatic growth (PTG) and enduring mental distress. This study aimed to investigate the association between perceived stress and PTG among older postsurvivors, as well as to explore the potential mediating role of perceived social support and self-management in this relationship. A cross-sectional study was conducted to recruit 354 older poststroke survivors from 2 tertiary hospitals in Shenyang, China, between January 2022 and October 2023. Various multidimensional scales were utilized to measure perceived stress, perceived social support, self-management, and PTG. Structural equation modeling was employed by Amos 24.0 to analyze the mediating pathways. The average score of PTG was 50.54 ±â€…22.69 among older poststroke patients. Pearson analysis revealed significant associations between perceived stress, perceived social support, self-management, and PTG (all P < .01). The mediation model showed that perceived stress could both direct influence PTG (Effect = -0.196, 95% CI = [-0.259, -0.129]), and indirectly impact PTG through perceived social support (Effect = -0.096, 95% CI = [-0.157, -0.044]), through self-management (Effect = -0.033, 95% CI = [-0.064, -0.012]), and sequentially through perceived social support and self-management (Effect = -0.007, 95% CI = [-0.017, -0.002]), accounting for 58.9%, 28.8%, 9.9%, and 2.1% of the total effect, respectively. These findings confirmed the mediating roles of perceived social support and self-management between perceived stress and PTG among older poststroke survivors. This provides valuable insights into developing targeted social intervention programs to improve stroke management among older survivors.


Assuntos
Análise de Mediação , Autogestão , Apoio Social , Estresse Psicológico , Acidente Vascular Cerebral , Humanos , Masculino , Feminino , Idoso , Estudos Transversais , Autogestão/psicologia , Autogestão/métodos , Acidente Vascular Cerebral/psicologia , Estresse Psicológico/psicologia , Estresse Psicológico/etiologia , Pessoa de Meia-Idade , China/epidemiologia , Crescimento Psicológico Pós-Traumático , Idoso de 80 Anos ou mais
6.
BMC Neurol ; 24(1): 208, 2024 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-38890614

RESUMO

BACKGROUND: Parkinson's disease (PD) significantly impacts the health-related quality of life of affected individuals and their relatives. In order to support the affected individuals and their families in coping with PD, it is essential to offer comprehensive information about their experiences. A comprehensive understanding of their lived experiences with the disease, the healthcare system, applied self-management strategies and their needs is considered crucial for developing a PD support program. Therefore, we aimed to explore the lived experiences and support needs of individuals with PD and their relatives in Germany. METHODS: This non-interventional, qualitative study conducted an explorative status quo and needs assessment. It generated knowledge through semi-structured focus groups and interviews with individuals with PD at various disease stages and their relatives. The interviews were digitally recorded, transcribed verbatim, and analysed using content analysis. RESULTS: Fifty-two individuals with PD and 29 relatives participated in eight focus groups and 13 paired and 13 individual interviews. Four themes with corresponding subthemes emerged: (1) experiences, revealing individuals' experiences around their diagnosis and with disease-specific care provision; (2) management support offers, clarifying who provides support and the type of support offered; (3) self-management, including comprehensibility, meaningfulness and manageability; and (4) future needs, differentiating between deficits and needs. Most participants expressed a sense of abandonment when obtaining self-management strategies and mastering their lives with PD, often referred to as 'life 2.0'. They identified the lack of structured and adequate provision of information, system orientation and social awareness. CONCLUSIONS: In Germany, there is an urgent need for a comprehensive PD care program that addresses the needs of individuals with PD and their relatives from the start of their care trajectory. It could assist individuals in gaining a comprehensive understanding of the disease, obtaining self-management strategies, building a support network, and becoming experts in self-managing their disease. Moreover, it may positively influence their care trajectory and reduce burdens, such as overburdening, fear of progression, and health anxiety. TRIAL REGISTRATION: German Clinical Studies Register ( https://www.drks.de/DRKS00030090 , No. DRKS00030090, Date of registration: 15.12.2022).


Assuntos
Família , Doença de Parkinson , Pesquisa Qualitativa , Autogestão , Humanos , Masculino , Alemanha/epidemiologia , Doença de Parkinson/terapia , Doença de Parkinson/psicologia , Feminino , Autogestão/métodos , Autogestão/psicologia , Pessoa de Meia-Idade , Idoso , Família/psicologia , Grupos Focais/métodos , Adulto , Gerenciamento Clínico , Avaliação das Necessidades , Apoio Social , Idoso de 80 Anos ou mais , Qualidade de Vida/psicologia , Cuidadores/psicologia , Necessidades e Demandas de Serviços de Saúde
7.
BMJ Open ; 14(6): e081334, 2024 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-38904141

RESUMO

OBJECTIVES: Career self-management is believed to be a critical behaviour in the new career era. However, the underlying mechanisms that stimulate nurses' career self-management are unclear. The aim of this study was to examine the mediating effect of self-efficacy and the moderating effect of proactive personality on the relationship between perceived organisational support and career self-management among nurses. DESIGN: This was a cross-sectional survey. SETTING AND PARTICIPANTS: A total of 1866 nurses from 15 hospitals across 15 cities in China were recruited for this study. PRIMARY AND SECONDARY OUTCOME MEASURES: The Perceived Organizational Support Scale, General Self-efficacy Scale, Proactive Personality Scale and Individual Career Management Questionnaire were used. Data were analysed using moderated mediation regressions with Hayes' PROCESS macro in SPSS version 26.0. RESULTS: General self-efficacy mediated the relationship between perceived organisational support and career self-management. Proactive personality moderated the direct (B=0.043, p<0.001, 95% CI 0.026 to 0.060) and indirect relationship (B=0.098, p<0.001, 95% CI 0.074 to 0.123) between perceived organisational support and career self-management. Further, the positive effects of perceived organisational support on general self-efficacy and career self-management were stronger for nurses with a high level of proactive personality. The model explained 47.2% of the variance in career self-management. CONCLUSION: The findings highlight the crucial benefits of self-efficacy and important conditional effects of perceived organisational support on nurses' career self-management.


Assuntos
Personalidade , Autoeficácia , Humanos , Feminino , Estudos Transversais , Masculino , Adulto , China , Inquéritos e Questionários , Autogestão/psicologia , Análise de Mediação , Cultura Organizacional , Pessoa de Meia-Idade , Recursos Humanos de Enfermagem Hospitalar/psicologia , Satisfação no Emprego , Enfermeiras e Enfermeiros/psicologia , Atitude do Pessoal de Saúde , Apoio Social
8.
Nurs Res ; 73(4): 278-285, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38905621

RESUMO

BACKGROUND: Hypertension rates have increased worldwide, with the most significant increase in morbidity and mortality observed among African Americans. Resilience is a potential factor influencing how individuals manage health-related challenges or self-management tasks for hypertension. Research is scarce related to resilience and self-management frameworks in African Americans with hypertension. OBJECTIVES: We aimed to describe a conceptualized resilience framework and preliminary findings of the association among resilience precursors, stress response, hypertension self-management behaviors, and health outcomes in African Americans with hypertension. METHODS: This cross-sectional, descriptive-correlational study included African American adults with hypertension, aged 25 years and older, recruited from an academic university and surrounding urban communities in the Midwest. Participants completed standardized, validated questionnaires to examine the association among resilience precursors, stress response, hypertension self-management behaviors, health-related quality of life (HRQOL), and blood pressure at baseline. Descriptive statistics were used to describe the sample demographic characteristics, whereas Pearson's correlational and multiple regression analyses were conducted to determine the associations among the variables. RESULTS: African Americans with hypertension (N = 30) were included in this preliminary study, with a mean age of 59.17 years; 66.7% were female. The mean systolic blood pressure was 136 (SD = 16.8) mmHg; the mean diastolic blood pressure was 78.1 (SD = 13) mmHg. Pearson's correlation analysis revealed significant relationships between resilience precursors, stress response, hypertension self-management behaviors and capability, and health outcome components. Multiple regression analysis showed that poor perceived resilience significantly predicted depression. Low dispositional optimism and low perceived resilience were significant predictors of stress. Higher perceived resilience significantly predicted self-efficacy. Perceived stress was negatively and significantly associated with HRQOL. Finally, higher self-efficacy significantly predicted better HRQOL. DISCUSSION: This study underscores the significant association between resilience, stress, self-management behaviors, and health outcomes in African Americans with hypertension. Further research with larger sample sizes and longitudinal designs is warranted to confirm and expand upon these findings.


Assuntos
Negro ou Afro-Americano , Hipertensão , Resiliência Psicológica , Autogestão , Humanos , Feminino , Masculino , Negro ou Afro-Americano/psicologia , Negro ou Afro-Americano/estatística & dados numéricos , Hipertensão/etnologia , Hipertensão/terapia , Hipertensão/psicologia , Pessoa de Meia-Idade , Autogestão/psicologia , Autogestão/métodos , Estudos Transversais , Adulto , Idoso , Qualidade de Vida/psicologia , Inquéritos e Questionários
9.
Nurs Sci Q ; 37(3): 255-265, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38836477

RESUMO

The purpose of the study was to determine the effects of motivational interviewing as based on Pender's health promotion model (HPM) on diabetes self-management behavior among individuals with Type 2 diabetes. Apart from their routine care, the individuals in the intervention group were given a 30-45-minute motivational interview based on Pender's HPM once a week for three months. Statistically significant differences were determined between the groups in the total score of the scales and its sub-dimensions (p < .05). The intervention applied in the present study can be used as an effective and easy method through which to develop and maintain diabetes self-management behaviors.


Assuntos
Diabetes Mellitus Tipo 2 , Promoção da Saúde , Entrevista Motivacional , Humanos , Diabetes Mellitus Tipo 2/psicologia , Diabetes Mellitus Tipo 2/terapia , Promoção da Saúde/métodos , Entrevista Motivacional/métodos , Pessoa de Meia-Idade , Feminino , Masculino , Autogestão/métodos , Autogestão/psicologia , Autocuidado/métodos , Motivação , Comportamentos Relacionados com a Saúde , Adulto , Idoso
10.
Nurs Sci Q ; 37(3): 266-277, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38836490

RESUMO

This study aimed to determine how the nursing approach based on Meleis's transition theory affects the self-management and adjustment to the illness among newly diagnosed diabetic patients. The study was conducted as one-group and pretest-posttest quasi-experimental design. The data were collected using the Introductory Questionnaire, the Diabetes Self-Management Questionnaire (DSMQ), and the Psychosocial Adjustment to Illness Scale-Self Report (PAIS-SR). It was determined that there was a positive increase in the total score of the DSMQ after the intervention, and a positive decrease in the total score of the PAIS-SR, and the difference between the scores were statistically significant (p < .05).


Assuntos
Adaptação Psicológica , Teoria de Enfermagem , Autogestão , Humanos , Autogestão/psicologia , Autogestão/métodos , Masculino , Feminino , Inquéritos e Questionários , Pessoa de Meia-Idade , Diabetes Mellitus/psicologia , Diabetes Mellitus/enfermagem , Adulto , Autocuidado/métodos , Autocuidado/psicologia
11.
JMIR Mhealth Uhealth ; 12: e49024, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38717433

RESUMO

Background: Mobile health (mHealth) interventions have immense potential to support disease self-management for people with complex medical conditions following treatment regimens that involve taking medicine and other self-management activities. However, there is no consensus on what discrete behavior change techniques (BCTs) should be used in an effective adherence and self-management-promoting mHealth solution for any chronic illness. Reviewing the extant literature to identify effective, cross-cutting BCTs in mHealth interventions for adherence and self-management promotion could help accelerate the development, evaluation, and dissemination of behavior change interventions with potential generalizability across complex medical conditions. Objective: This study aimed to identify cross-cutting, mHealth-based BCTs to incorporate into effective mHealth adherence and self-management interventions for people with complex medical conditions, by systematically reviewing the literature across chronic medical conditions with similar adherence and self-management demands. Methods: A registered systematic review was conducted to identify published evaluations of mHealth adherence and self-management interventions for chronic medical conditions with complex adherence and self-management demands. The methodological characteristics and BCTs in each study were extracted using a standard data collection form. Results: A total of 122 studies were reviewed; the majority involved people with type 2 diabetes (28/122, 23%), asthma (27/122, 22%), and type 1 diabetes (19/122, 16%). mHealth interventions rated as having a positive outcome on adherence and self-management used more BCTs (mean 4.95, SD 2.56) than interventions with no impact on outcomes (mean 3.57, SD 1.95) or those that used >1 outcome measure or analytic approach (mean 3.90, SD 1.93; P=.02). The following BCTs were associated with positive outcomes: self-monitoring outcomes of behavior (39/59, 66%), feedback on outcomes of behavior (34/59, 58%), self-monitoring of behavior (34/59, 58%), feedback on behavior (29/59, 49%), credible source (24/59, 41%), and goal setting (behavior; 14/59, 24%). In adult-only samples, prompts and cues were associated with positive outcomes (34/45, 76%). In adolescent and young adult samples, information about health consequences (1/4, 25%), problem-solving (1/4, 25%), and material reward (behavior; 2/4, 50%) were associated with positive outcomes. In interventions explicitly targeting medicine taking, prompts and cues (25/33, 76%) and credible source (13/33, 39%) were associated with positive outcomes. In interventions focused on self-management and other adherence targets, instruction on how to perform the behavior (8/26, 31%), goal setting (behavior; 8/26, 31%), and action planning (5/26, 19%) were associated with positive outcomes. Conclusions: To support adherence and self-management in people with complex medical conditions, mHealth tools should purposefully incorporate effective and developmentally appropriate BCTs. A cross-cutting approach to BCT selection could accelerate the development of much-needed mHealth interventions for target populations, although mHealth intervention developers should continue to consider the unique needs of the target population when designing these tools.


Assuntos
Terapia Comportamental , Autogestão , Telemedicina , Cooperação e Adesão ao Tratamento , Humanos , Autogestão/métodos , Autogestão/psicologia , Autogestão/estatística & dados numéricos , Telemedicina/métodos , Telemedicina/estatística & dados numéricos , Telemedicina/normas , Cooperação e Adesão ao Tratamento/estatística & dados numéricos , Cooperação e Adesão ao Tratamento/psicologia , Terapia Comportamental/métodos , Terapia Comportamental/instrumentação , Terapia Comportamental/estatística & dados numéricos , Terapia Comportamental/normas , Doença Crônica/terapia , Doença Crônica/psicologia
12.
BMC Public Health ; 24(1): 1456, 2024 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-38822296

RESUMO

BACKGROUND: As a chronic metabolic disease, diabetes poses a serious threat to human health and has become a major public health problem in China and worldwide. In 2020, 30% of Chinese people (aged ≥ 60 years) reported having diabetes mellitus. Moreover, individuals with diabetes living in rural areas face a significantly higher mortality risk compared to those in urban areas. In this study, we explored the inner experience of self-management behaviors in elderly patients with type 2 diabetes in rural areas to inform targeted interventions. METHODS: A phenomenological research design was used to explore the inner experience of self-management in rural elderly diabetes. Ten elderly diabetic patients were sampled from December 2022 to March 2023 in rural areas of Yangcheng County, Jincheng City, ShanXi Province, China. The seven-step Colaizzi phenomenological was used to analyze the interview data and generate themes. RESULTS: Four themes emerged: "Insufficient self-management cognition", "Negative self-management attitude", "Slack self-management behavior", and "No time for self-management". CONCLUSION: The level of self-management among elderly patients with type 2 diabetes in rural areas is low. Healthcare professionals should develop targeted interventions aimed at enhancing their cognitive levels, modifying their coping styles, and improving their self-management abilities to improve their quality of life.


Assuntos
Diabetes Mellitus Tipo 2 , Pesquisa Qualitativa , População Rural , Autogestão , Humanos , Diabetes Mellitus Tipo 2/terapia , Diabetes Mellitus Tipo 2/psicologia , Idoso , Masculino , Feminino , Autogestão/psicologia , População Rural/estatística & dados numéricos , China/epidemiologia , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais
13.
Soc Sci Med ; 351: 116968, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38759387

RESUMO

OBJECTIVE: Familial Hypercholesterolemia (FH) is an inherited disorder leading to increased risk of premature atherosclerotic cardiovascular disease. This risk can be ameliorated through adherence to pharmacological treatment and salient lifestyle behaviors (e.g., physical activity participation, healthy eating). Identifying theory-based, modifiable determinants of these behaviors may inform behavioral interventions promoting participation in FH self-management behaviors. We aimed to identify the belief-based social cognition constructs uniquely associated with intentions to perform, and actual participation in, FH self-management behaviors in the extant research. METHOD: A systematic database search identified studies (k = 9, N = 1394) reporting relations between social cognition theory constructs and intention toward, or actual participation in, self-management behaviors in FH patients. As no studies examining prospectively-measured behaviors were identified, we tested relations among social cognition constructs, intentions, and past FH-self-management behavior using random effects multi-level meta-analysis and meta-analytic structural equation modelling. RESULTS: We found non-zero averaged correlations among the key social cognition constructs (attitudes, norms, risk perceptions, self-efficacy), intentions, and past behavior. A meta-analytic structural equation model indicated non-zero averaged direct effects of attitudes, norms, self-efficacy, and past behavior on FH self-management behavioral intentions. There were also non-zero averaged indirect effects of past behavior on intentions mediated by the social cognition constructs. CONCLUSION: Findings provide evidence to support the proposed model and highlight the importance of personal, normative, and capacity related beliefs and past experience as unique correlates of intentions to perform FH self-management behaviors. The model may signal potential constructs that could be targeted in behavioral interventions to promote participation in FH self-management behaviors.


Assuntos
Hiperlipoproteinemia Tipo II , Autogestão , Cognição Social , Humanos , Autogestão/psicologia , Autogestão/métodos , Hiperlipoproteinemia Tipo II/psicologia , Hiperlipoproteinemia Tipo II/terapia , Comportamentos Relacionados com a Saúde , Intenção , Autoeficácia
14.
Respir Care ; 69(6): 678-685, 2024 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-38806226

RESUMO

A self-management intervention is a personalized approach to individuals aiming to engage individuals in a behavior change to develop skills to live better with their condition. Self-management involves an iterative process between participants and providers in which goals are formulated and feedback is given. All respiratory societies advocate self-management as part of chronic care because it may improve quality of life and health-care utilization. Self-management is an integral part of pulmonary rehabilitation. Self-management interventions usually involve education and exercise prescription, and that is an asset of current programs; however, recent reports indicate that effective strategies for motivation and a behavior change focus are often missed. A recent systematic review on self-management urges the need for a specific aspect and characteristic of self-management interventions: iterative interactions between participants and health-care professionals competent in using behavior change practices to elicit participants' motivation, confidence, and competence to develop skills to better manage their disease. A recent review of self-care intervention in chronic disease states that the major deficits found in self-care interventions included a lack of attention and/or innovation to the psychological consequences of chronic illness, technology, and behavior change techniques to help patients manage symptoms. There is a need for exploration of mechanisms to explain the relationships between both anxiety and depression, and adherence to treatment in COPD. The latter is particularly appropriate for pulmonary rehabilitation, for which greater adherence is needed. This report aims to introduce basic aspects of behavior change and a proposed roadmap to introduce behavior change into pulmonary rehabilitation and chronic care programs.


Assuntos
Motivação , Doença Pulmonar Obstrutiva Crônica , Autogestão , Humanos , Terapia Comportamental/métodos , Doença Crônica/psicologia , Comportamentos Relacionados com a Saúde , Cooperação do Paciente/psicologia , Educação de Pacientes como Assunto , Doença Pulmonar Obstrutiva Crônica/psicologia , Doença Pulmonar Obstrutiva Crônica/terapia , Doença Pulmonar Obstrutiva Crônica/reabilitação , Qualidade de Vida , Autocuidado/psicologia , Autogestão/métodos , Autogestão/psicologia
15.
Sci Diabetes Self Manag Care ; 50(3): 235-249, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38726912

RESUMO

PURPOSE: The purpose of the 12-month randomized controlled trial was to evaluate the effectiveness of a Telephonic Self-Management Support (T-SMS) program among adults with type 2 diabetes (T2D). METHODS: Eight hundred twelve adults with T2D participated in NYC Care Calls (mean age = 59.2, SD = 10.8; female = 57%; mean A1C = 9.3, SD = 1.8; Latino = 86%) and were randomly assigned to T-SMS or enhanced usual care (EUC). A1C (primary outcome), blood pressure, and body mass index (secondary outcomes) were extracted from electronic medical records. Secondary patient-reported outcomes, including depressive symptoms, diabetes distress, medication adherence, and self-management activities, were assessed by telephone in English or Spanish. For T-SMS, the number of assigned phone calls was based on baseline A1C, depressive symptoms, and/or diabetes distress. Analyses were conducted under the intention-to-treat principle. RESULTS: A1C decreased over 12 months in both T-SMS (0.72% percentage points; 95% CI, 0.53-0.91) and EUC (0.66% percentage points; 95% CI, 0.46-0.85; Ps < .001). Diabetes distress and self-management also improved over time in both arms (Ps < .05). Compared to EUC, participants in the T-SMS arm did not differ in outcomes. CONCLUSIONS: The T-SMS and EUC groups were found not to have an appreciable outcome difference. It is unclear whether improvements in A1C across both conditions represent a secular trend or indicate that print-based educational intervention may have a positive impact on self-management and well-being.


Assuntos
Diabetes Mellitus Tipo 2 , Hemoglobinas Glicadas , Autogestão , Telefone , Humanos , Diabetes Mellitus Tipo 2/terapia , Diabetes Mellitus Tipo 2/psicologia , Feminino , Masculino , Pessoa de Meia-Idade , Autogestão/psicologia , Autogestão/métodos , Cidade de Nova Iorque , Estudos Prospectivos , Idoso , Hemoglobinas Glicadas/análise , Hemoglobinas Glicadas/metabolismo , Adesão à Medicação/psicologia , Depressão/terapia , Telemedicina , Resultado do Tratamento
16.
Tunis Med ; 102(4): 205-211, 2024 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-38746959

RESUMO

AIM: To assess the effect of diabetes self-management education (DSME) on health related quality of life (HRQoL) of Tunisian children/adolescents with type 1 diabetes mellitus and their parents. METHODS: This monocentral study used a randomized controlled trial design, during five-month intervention and five-month follow-up and including 110 patients (54 in the DSME intervention group and 56 in the Individual Education by Pediatrician (IEP) control group) and their parents. Pediatric Generic Core Quality-of-Life Inventory 4.0-Scale (PedsQL4.0) evaluated HRQoL. RESULTS: At baseline, both groups had similar clinical features and PedsQL4.0 scores (p>0.05). In DSME, clinical outcomes were significantly improved from baseline to follow-up (p<0.001), while in the IEP group, which received no intervention, these outcomes remained unchanged. During follow-up, DSME showed higher PedsQL4.0 scores in parents' proxy-report and children/adolescents self-report (p<0.001). According to parents' proxy-report, PedsQL4.0 scores were significantly higher during follow-up compared to baseline in DSME (p<0.001) while they remained the same in IEP (p>0.05). DSME had higher percentage of change in the PedsQL4.0 scores than IEP (p<0.01). The median change varied from -5.01% to 0% vs 5.41% to 36.36% in IEP and DSME, respectively. CONCLUSION: Encouraging healthcare professionals to incorporate these interventions could enhance the HRQoL of diabetic children and bolster their self-esteem.


Assuntos
Diabetes Mellitus Tipo 1 , Pais , Educação de Pacientes como Assunto , Qualidade de Vida , Autogestão , Humanos , Diabetes Mellitus Tipo 1/terapia , Diabetes Mellitus Tipo 1/psicologia , Tunísia , Criança , Masculino , Feminino , Pais/psicologia , Autogestão/educação , Autogestão/métodos , Autogestão/psicologia , Adolescente , Educação de Pacientes como Assunto/métodos , Seguimentos
17.
Sci Diabetes Self Manag Care ; 50(3): 211-221, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38812453

RESUMO

PURPOSE: The purpose of this qualitative descriptive study was to describe the experience of diabetes burnout in young adults with type 1 diabetes (T1DM). In addition, aims included participant perspectives of risk and protective factors associated with burnout and ways to balance everyday life with diabetes self-management (DSM). METHODS: Young adults with T1DM (N = 11) were recruited through social media platforms and modified snowball sampling and interviewed. Informational redundancy was achieved. Qualitative thematic coding and analysis were conducted within and across transcripts. RESULTS: Diabetes burnout was described as the willingness to put diabetes and DSM on the "back burner" and let things slide due to exhaustion, frustration, apathy, and the desire to be like everyone else for a while. Risk and protective factors were identified along with strategies to achieve balance of DSM in everyday life. CONCLUSIONS: This study identified a clear definition of diabetes burnout and acknowledges this concept as distinct and separate from other psychosocial conditions. Health care providers can utilize this information to identify individuals at risk for diabetes burnout and offer more effective support to lessen the overall burden associated with T1DM.


Assuntos
Esgotamento Psicológico , Diabetes Mellitus Tipo 1 , Pesquisa Qualitativa , Humanos , Diabetes Mellitus Tipo 1/psicologia , Diabetes Mellitus Tipo 1/epidemiologia , Masculino , Feminino , Adulto Jovem , Adulto , Esgotamento Psicológico/epidemiologia , Autogestão/psicologia , Fatores de Risco , Adolescente
18.
Arch Psychiatr Nurs ; 49: 73-82, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38734458

RESUMO

PURPOSE: Self-management and lifestyle interventions are a key factor in treatment outcomes for persons with bipolar disorder (BD). A virtual environment (VE), due to it's ability to provide flexibility of involvement in its platform, may be an alternative to face-to-face treatment to provide support for self-management. The purpose of this study is to explore how a VE, developed for chronic illness self-management, may be modified to promote self-management and lifestyle changes in those with BD. METHOD: This study used a qualitative description design with focus groups. Data were collected via minimally structured interviews and analyzed using thematic content analysis. A total of seven focus groups were conducted, and the sample consisted of 30 adults with BD. Age range was 21-77 years with 21 females, seven males, and two non-binary individuals. RESULTS: Five themes emerged from the findings: Self-management and lifestyle interventions with regards to (1) mental health; (2) holistic health; (3) role of peers; (4) involvement of the family; (5) technological aspects of the VE. CONCLUSIONS: Focus group participants suggested that the VE may be an efficacious way to enhance self-management and promote lifestyle interventions in those with BD. Research is needed to adapt such platforms to the need of the patients and examine its' effect on health outcomes.


Assuntos
Transtorno Bipolar , Grupos Focais , Estilo de Vida , Pesquisa Qualitativa , Autogestão , Humanos , Transtorno Bipolar/terapia , Transtorno Bipolar/psicologia , Feminino , Masculino , Autogestão/psicologia , Adulto , Pessoa de Meia-Idade , Idoso , Realidade Virtual
19.
BMJ Open Respir Res ; 11(1)2024 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-38749535

RESUMO

INTRODUCTION: Self-management, as the most common method of chronic obstructive pulmonary disease (COPD) management, is not an isolated behaviour, but a set of physical, social, cultural, psychological and existential factors affecting it. AIM: This study aimed to explore the facilitators and barriers to self-management in men with COPD in the unique social, cultural, political and economic context of Iran. METHODS: This paper reports part of the findings of a qualitative grounded theory study aimed at exploring the process of self-management in Iranian men with COPD, which was conducted in Iran from January 2019 to July 2023. Participants included men with COPD, their family members and pulmonologists. The selection of participants in this research began with the purposeful sampling method. Data was collected using semistructured interviews. Data collection continued until the data saturation was achieved. A total of 15 interviews were conducted with nine patients, three family members of patients and three pulmonologists. The data was analysed using the constant comparative analysis method. RESULTS: The findings of this study showed that knowledge, education, experience, family involvement and financial support are the factors that facilitate self-management. Factors related to deficits include lack of education, lack of treatment support, family cooperation deficit, financial problems, medication obtaining problems and factors related to disease impacts include specific nature of the disease, residual effect, comorbidity and factors related to negative patients characteristics include false beliefs, poor self-efficacy, feeling shame and non-adherence are barriers to self-management in men with COPD. CONCLUSION: Based on results of this study, healthcare providers and health planners can strengthen the factors that facilitate self-management and weaken or remove the barriers to self-management, so that these patients use self-management strategies with maximum capacity to control the disease.


Assuntos
Doença Pulmonar Obstrutiva Crônica , Pesquisa Qualitativa , Autogestão , Humanos , Doença Pulmonar Obstrutiva Crônica/terapia , Doença Pulmonar Obstrutiva Crônica/psicologia , Masculino , Irã (Geográfico) , Autogestão/psicologia , Autogestão/métodos , Pessoa de Meia-Idade , Idoso , Conhecimentos, Atitudes e Prática em Saúde , Adulto , Teoria Fundamentada
20.
BMC Prim Care ; 25(1): 180, 2024 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-38778253

RESUMO

BACKGROUND: There is a rising prevalence of type 2 diabetes among older people. This population also suffers from co-morbidity and a greater number of diabetes related complications, such as visual and cognitive impairment, which can potentially affect their ability to manage insulin regimens. Understanding the experiences of older people when they transition to insulin will help the development of healthcare interventions to enhance their diabetes outcomes, overall health and quality of life. AIMS: The aims of this exploratory study were to (1) understand the experiences of older people with type 2 diabetes in relation to insulin treatment initiation and management and (2) use this understanding to consider how the insulin management support provided to older people by healthcare providers could be more tailored to their needs. METHOD: A qualitative study using semi structured (remote) interviews with older people with diabetes (n = 10) and caregivers (n = 4) from the UK. Interviews were audio recorded and transcribed, and framework analysis was used to analyse the data. RESULTS: Three main themes, along with six subthemes, were generated from the study data. Participants generally felt at ease with insulin administration following training, yet some reported feelings of failure at transitioning to insulin use. Participants were also frustrated at what they perceived were insufficient resources for effective self-management, coupled with a lack of professional interest in optimising their health as older people. Some also expressed dissatisfaction regarding the brevity of their consultations, inconsistent information from different healthcare professionals and poor treatment coordination between primary and secondary care. CONCLUSION: Overall, the study emphasised that older people need better support, education and resources to help manage their insulin use. Healthcare professionals should be encouraged to adopt a more individualised approach to supporting older people that acknowledges their prior knowledge, physical and psychological capabilities and motivation for diabetes self-management. In addition, better communication between different services and greater access to specialist support is clearly needed for this older population. PRACTICE IMPLICATIONS: An integrated care pathway for insulin use in older people could be considered. This would include an assessment of the older person's needs and capacity on their initiation to insulin; targeted education and training in self-management; timely access to appropriate emotional and peer support resources; care plans developed collaboratively with patients; and individualised glucose targets that recognise the needs and preferences of the older person.


Assuntos
Diabetes Mellitus Tipo 2 , Hipoglicemiantes , Insulina , Pesquisa Qualitativa , Humanos , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/psicologia , Idoso , Masculino , Feminino , Insulina/uso terapêutico , Insulina/administração & dosagem , Hipoglicemiantes/uso terapêutico , Hipoglicemiantes/administração & dosagem , Idoso de 80 Anos ou mais , Autogestão/psicologia , Reino Unido , Pessoa de Meia-Idade , Cuidadores/psicologia , Entrevistas como Assunto , Qualidade de Vida/psicologia
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