Self-Management

14,000,000 Leading Edge Experts on the ideXlab platform

Scan Science and Technology

Contact Leading Edge Experts & Companies

Scan Science and Technology

Contact Leading Edge Experts & Companies

The Experts below are selected from a list of 13221666 Experts worldwide ranked by ideXlab platform

Davide Ausili - One of the best experts on this subject based on the ideXlab platform.

  • How do self-care maintenance, self-care monitoring, and self-care management affect glycated haemoglobin in adults with type 2 diabetes? A multicentre observational study
    Endocrine, 2020
    Co-Authors: Diletta Fabrizi, Paola Rebora, Michela Luciani, Stefania Di Mauro, Maria Grazia Valsecchi, Davide Ausili
    Abstract:

    Purpose To evaluate how self-care maintenance, self-care monitoring, and self-care management affect glycated haemoglobin in type 2 diabetes mellitus patients and to set cut-off points of the Self-Care of Diabetes Inventory scales using glycated haemoglobin as outcome of interest. Methods A secondary analysis of a previous multicentre observational cross-sectional study was conducted. Overall, 540 adults with type 2 diabetes mellitus confirmed diagnosis were involved. Socio-demographic and clinical data were collected. Self-care maintenance, self-care monitoring, and self-care management were measured by the Self-Care of Diabetes Inventory. Linear regression models were performed to assess the relationship between self-care maintenance, self-care monitoring, and self-care management and glycated haemoglobin. Receiver operating characteristics curves were carried out to identify the best cut-off score for each self-care scale considering glycated haemoglobin >7% as outcome of interest. Results Self-care monitoring and self-care management were associated to glycated haemoglobin in both patients without (self-care monitoring p  = 0.0008; self-care management p  = 0.0178) and with insulin therapy (self-care monitoring p  = 0.0007; self-care management p  = 0.0224). Self-care maintenance was associated to glycated haemoglobin in patients without insulin therapy ( p  = 0.0118). Cut-off scores providing the best performance were 70 points for self-care maintenance and self-care monitoring, and 60 points for self-care management. Conclusions Self-care maintenance, self-care monitoring, and self-care management differently affect glycated haemoglobin in patients with type 2 diabetes mellitus. Clinicians could implement tailored interventions to improve glycaemic control considering the lacking area of self-care.

Peter G. Gibson - One of the best experts on this subject based on the ideXlab platform.

  • Asthma Self-Management education.
    Chronic respiratory disease, 2006
    Co-Authors: Vanessa M. Mcdonald, Peter G. Gibson
    Abstract:

    Asthma Self-Management education is a fundamental component of asthma management guidelines. Self-Management education should include the provision of information, self-monitoring, regular medical review and the provision of a written asthma management plan. Implementing this form of management can be challenging, this paper reviews the evidence supporting Self-Management education, provides recommendations and tools for delivering asthma education and discusses the challenges and solutions to implementing these recommendations. We have discussed ways to improve communication, develop patient partnerships and tailor management to facilitate behavioural change, adherence and Self-Management. Health Professionals providing education and guiding Self-Management require training to acquire and maintain the skills necessary to deliver this form of education. Provision of this training is important and can be achieved through varied methods of achieving competence.

  • options for self management education for adults with asthma
    Cochrane Database of Systematic Reviews, 2002
    Co-Authors: Heather Powell, Peter G. Gibson
    Abstract:

    Background Asthma education and Self-Management are key recommendations of asthma management guidelines because they improve health outcomes. There are several different modalities for the delivery of asthma Self-Management education. Objectives We evaluated programmes that: (1) Optimised asthma control through inhaled corticosteroid use by regular medical review or optimised asthma control by individualised written action plans; (2) Used written Self-Management plans based on peak expiratory flow self-monitoring compared with symptom self-monitoring; (3) Compared different options for the delivery of optimal Self-Management programmes. Search methods We searched the Cochrane Airways Group trials register and reference lists of articles. Selection criteria Randomised trials of asthma Self-Management education interventions in adults over 16 years of age with asthma. Data collection and analysis Fifteen trials met the inclusion criteria. Trial quality was assessed and data were extracted independently by two reviewers. Study authors were contacted for confirmation. Main results Six studies compared optimal Self-Management allowing self-adjustment of medications according to an individualised written action plan to adjustment of medications by a doctor. These two styles of asthma management gave equivalent effects for hospitalisation, emergency room (ER) visits, unscheduled doctor visits and nocturnal asthma. Self-Management using a written action plan based on peak expiratory flow (PEF) was found to be equivalent to Self-Management using a symptoms based written action plan in the six studies which compared these interventions. Three studies compared Self-Management options. In one, that provided optimal therapy but tested the omission of regular review, the latter was associated with more health centre visits and sickness days. In another, comparing high and low intensity education, the latter was associated with more unscheduled doctor visits. In a third, no difference in health care utilisation or lung function was reported between verbal instruction and written action plans. Authors' conclusions Optimal Self-Management allowing for optimisation of asthma control by adjustment of medications may be conducted by either self-adjustment with the aid of a written action plan or by regular medical review. Individualised written action plans based on PEF are equivalent to action plans based on symptoms. Reducing the intensity of Self-Management education or level of clinical review may reduce its effectiveness.

Sara Morassaei - One of the best experts on this subject based on the ideXlab platform.

  • Multiple sclerosis Self-Management model: Personal and contextual requirements for successful Self-Management.
    Patient education and counseling, 2018
    Co-Authors: Setareh Ghahari, Susan J. Forwell, Melinda Suto, Sara Morassaei
    Abstract:

    Abstract Objective To explore Self-Management strategies used by people with multiple sclerosis (MS) with aim of developing a MS Self-Management model. Methods A grounded theory approach guided development of a MS Self-Management model. Eighteen individuals living with MS for three or more years and self-identifying as successfully managing their MS were interviewed twice using semi-structured face-to-face or telephone interviews six months apart. Demographic and disease characteristics were descriptively analyzed. Field notes and interview data were qualitatively analyzed to identify concepts and categories. Results The emerging model revealed six person-related categories describing Self-Management strategies: adjusting outlook, managing stress, managing symptoms, healthy lifestyle, effective communication, and setting priorities and planning. Three context-related categories that required successful navigation for Self-Management were also identified: physical environment, personal social network, and community services and resources. Conclusions The emerging Self-Management model that is grounded in the perspective of people with MS includes person and context-related strategies that can be used concurrently to guide Self-Management in the variety of challenges experienced by people with MS. Practical Implications A Self-Management model of MS is useful to service providers, health professionals, advocacy organizations and people with MS to draw upon an organized and comprehensive approach to Self-Management.

Sara Demain - One of the best experts on this subject based on the ideXlab platform.

  • self management and self management support outcomes a systematic review and mixed research synthesis of stakeholder views
    PLOS ONE, 2015
    Co-Authors: Emma Boger, Sue Latter, Jaimie Ellis, Claire Foster, Anne Kennedy, Fiona Jones, Vicky Fenerty, Ian Kellar, Sara Demain
    Abstract:

    INTRODUCTION: Self-Management has received growing attention as an effective approach for long-term condition management. Little is known about which outcomes of supported Self-Management are valued by patients, their families, health professionals and those who commission Self-Management services. This study systematically reviewed published empirical evidence in accordance with PRISMA guidelines to determine the outcomes of Self-Management valued by these key stakeholder groups, using three prominent exemplar conditions: colorectal cancer, diabetes and stroke. AIM: To systematically review the literature to identify which generic outcomes of Self-Management have been targeted and are considered important using three exemplar conditions (colorectal cancer, diabetes and stroke), which collectively have a range of features that are likely to be representative of generic Self-Management issues. METHODS: Systematic searching of nine electronic databases was conducted in addition to hand searches of review articles. Abstracts were identified against inclusion criteria and appraised independently by two reviewers, using a critical appraisal tool. Synthesis of findings was conducted using mixed research synthesis. RESULTS: Over 20,536 abstracts were screened. 41 studies which met the review criteria were fully retrieved and appraised. The majority of evidence related to diabetes. Few studies directly focussed on stakeholders' views concerning desired Self-Management outcomes; the majority of evidence was derived from studies focusing upon the experience of Self-Management. The views of health care commissioners were absent from the literature. We identified that Self-Management outcomes embrace a range of indicators, from knowledge, skills, and bio-psychosocial markers of health through to positive social networks. CONCLUSIONS: Patients', families', health professionals' and commissioners' views regarding which outcomes of Self-Management are important have not been clearly elicited. The extent to which bio-psychosocial indicators relate to successful Self-Management from the perspectives of all groups of stakeholders is unknown. Further investigation regarding which Self-Management outcomes are considered important by all stakeholders is necessary to guide the commissioning and design of future Self-Management services.

  • Stroke Self-Management: A focus group study to identify the factors influencing Self-Management following stroke
    International journal of nursing studies, 2014
    Co-Authors: Emma Boger, Sara Demain, Sue Latter
    Abstract:

    Abstract Background Self-Management refers to the strategies, decisions and activities individuals take to manage a long-term health condition. Self-Management has potential importance for reducing both the personal and health service impact of illness. Stroke represents a significant health and social burden, however there is a lack of clarity about the factors that support successful Self-Management following stroke. Objective This study sought to investigate the factors which facilitate or hinder stroke Self-Management from the patients' perspective. Design Nested qualitative exploratory phase within a mixed-methods paradigm. Data were analysed thematically using Analytic Induction to guide development of themes. Setting Participants had experienced a stroke and were recruited from rural and urban community stroke support groups based in the South of England. Method Five focus groups ( n =28) using a semi-structured interview guide were conducted. Interviews were digitally recorded and transcribed. Findings The term ‘Self-Management' was unfamiliar to participants. On further exploration, participants described how Self-Management activities were helped or hindered. Self-Management was viewed as an important, unavoidable feature of life after stroke. Three key themes identified from the data affect stroke Self-Management: Individual capacity; support for Self-Management and Self-Management environment. People following stroke reported feeling ill-prepared to self-manage. The Self-Management support needs of patients following stroke are currently often unmet. Conclusion Successful stroke Self-Management consists of features which may be modifiable at the individual level, in addition to the presence of external support and an environment which supports and facilitates people following stroke to self-manage. These findings extend current conceptualisations of stroke Self-Management.

Dana Gelb Safran - One of the best experts on this subject based on the ideXlab platform.

  • Statewide Evaluation of Measuring Physician Delivery of Self-Management Support in Chronic Disease Care
    Journal of General Internal Medicine, 2009
    Co-Authors: Thomas D. Sequist, Ted Glahn, William H. Rogers, Dana Gelb Safran
    Abstract:

    BACKGROUND Self-Management support is an important component of improving chronic care delivery. OBJECTIVE To validate a new measure of Self-Management support and to characterize performance, including comparisons across chronic conditions. DESIGN, SETTING, PARTICIPANTS We incorporated a new question module for Self-Management support within an existing annual statewide patient survey process in 2007. MEASUREMENTS The survey identified 80,597 patients with a chronic illness on whom the new measure could be evaluated and compared with patients’ experiences on four existing measures (quality of clinical interactions, coordination of care, organizational access, and office staff). We calculated Spearman correlation coefficients for Self-Management support scores for individual chronic conditions within each medical group. We fit multivariable logistic regression models to identify predictors of more favorable performance on Self-Management support. RESULTS Composite scores of patient care experiences, including quality of clinical interactions (89.2), coordination of care (77.6), organizational access (76.3), and office staff (85.8) were higher than for the Self-Management support composite score (69.9). Self-Management support scores were highest for patients with cancer (73.0) and lowest for patients with hypertension (67.5). The minimum sample size required for medical groups to provide a reliable estimate of Self-Management support was 199. There was no consistent correlation between Self-Management support scores for individual chronic conditions within medical groups. Increased involvement of additional members of the healthcare team was associated with higher Self-Management support scores across all chronic conditions. CONCLUSION Measurement of Self-Management support is feasible and can identify gaps in care not currently included in standard measures of patient care experiences.