Dissertations / Theses on the topic 'Disease management'
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Philips, L. G. "Disease management in chronic kidney disease /." abstract and full text PDF (free order & download UNR users only), 2005. http://0-wwwlib.umi.com.innopac.library.unr.edu/dissertations/fullcit/1430446.
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Thesis (M.B.A.)--University of Nevada, Reno, 2005."May, 2005." Includes bibliographical references (leaves 92-97). Online version available on the World Wide Web. Library also has microfilm. Ann Arbor, Mich. : ProQuest Information and Learning Company, [2005]. 1 microfilm reel ; 35 mm.
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Murphy, Sean Michael. "Disease management and latent choices." Online access for everyone, 2008. http://www.dissertations.wsu.edu/Dissertations/Summer2008/S_Murphy_062608.pdf.
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Leslie, Wilma S. "Weight management and chronic disease." Thesis, University of Glasgow, 2009. http://theses.gla.ac.uk/1300/.
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Abstract Background: Obesity, in addition to being a serious condition in its own right, is causally associated with many chronic non-communicable diseases, and its prevention, identification and treatment is a public health priority. Results: The main findings of the present thesis were that 1) many drugs, used in the management of chronic disease, have an adverse effect on body weight with weight change of +10kg observed as a real side effect of some. 2) Identification and management of obesity is not a formal part of current practice in many secondary care clinics. While acknowledging the adverse health effects of obesity within their specialist areas, clinicians felt under-skilled and insufficiently resourced to provide effective management. 3) Improvements in iron status in pre-menopausal women can be achieved during weight loss, using eating plans that either include or exclude red meat. The data while in-conclusive suggest that a diet including red meat may confer greater benefits on iron status. Discussion: Weight gain is an adverse effect of many drugs used to treat chronic diseases. This should be discussed with patients prior to treatment and advice provided on how to avoid or minimise weight gain. NHS secondary care consultants are concerned about obesity and its impact on their patient’s health. Most have no weight management strategy and would like one. This will require additional training and resources. Excluding red meat did not adversely affect iron status in pre-menopausal women. A larger study is required for definitive health promotion advice. Conclusion: Pharmacotherapy is a significant factor in the rising prevalence of obesity. Weight management is not an integral part of patient care in secondary care clinic settings. The exclusion of red meat during weight management does not compromise iron status in pre-menopausal women with low iron stores.
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Joshi, S., and David L. Wood. "Telementoring for Chronic Disease Management." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/5165.
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Biati, Raquel Marie. "Chronic Disease Self-Management Program." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2598.
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The World Health Organization noted that 2 global health problems have reached epidemic proportions: obesity and type 2 diabetes. These conditions affect nearly 170 million people worldwide. The clinical practice problem addressed by this project was the prevalence of adults ages 50 and older in an ambulatory care setting who suffer from obesity and diabetes and may benefit from a tailored weight management and nutrition education intervention. The purpose of this project was to design a program that would decrease body mass index and hemoglobin A1c in older patients through adaption of the Chronic Disease Self-Management Program. The evidence supporting this project was obtained through a systematic literature review. The self-efficacy theory guided the project, and the evidence-based practice model used to plan the translation of the evidence into practice was the plan-do-check/study-act cycle, a continuous process improvement model used in many health care settings. The product of the project was an education intervention implementation plan that will be agreed upon by the project team and tracked using a Gantt chart. The program's effectiveness will be evaluated by analyzing the themes of qualitative feedback from patients who complete the program and through comparisons using t test statistics of body mass index and A1c that will be collected at 12 weeks and 12 months after the program start. The social change expected of this program, when implemented, is an increase in patients' engagement in and self-management of their care and a more trusting relationship among patients and the health care team. The recommendations from this project also may be useful in addressing health disparities often experienced by patients suffering from obesity and diabetes.
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Kirsch, Florian [Verfasser]. "Economic aspects of disease management programs in chronic diseases / Florian Kirsch." München : Verlag Dr. Hut, 2018. http://d-nb.info/1164293648/34.
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Dubey, Anil Kumar 1967. "DMA : a diabetes disease management system." Thesis, Massachusetts Institute of Technology, 2003. http://hdl.handle.net/1721.1/28582.
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Thesis (S.M.)--Harvard-MIT Division of Health Sciences and Technology, 2003.Includes bibliographical references (p. 40-44).
There is a clear and present need to improve the quality of diabetes care. Information technology can be used as a means to that end. In this article, we discuss the design and implementation of a web-based diabetes application. We show the role of modeling clinical workflow in the design philosophy of our application, and summarize our application's features and usage. Next, we describe observations made during and after design and implementation, and how they relate to the informatics literature. Finally, we elaborate on the paradigm of feedback control systems, its parallels with the design philosophy of our application, and its use as an organizational framework for the roles of information technology in diabetes care.
by Anil Kumar Dubey.
S.M.
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Nelson, Merritt, Larry J. Stowell, and Tom Orum. "Analyses of Virus Disease Management Programs." College of Agriculture, University of Arizona (Tucson, AZ), 1990. http://hdl.handle.net/10150/214494.
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Barach, Ilana. "Disease Management and Psychosocial and Health Outcomes in Pediatric Sickle Cell Disease." University of Cincinnati / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1337716279.
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Davies, Helen Elizabeth. "Investigation and management of malignant pleural disease." Thesis, St George's, University of London, 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.546774.
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Amrine, David E. "Diagnosis and management of bovine respiratory disease." Diss., Kansas State University, 2013. http://hdl.handle.net/2097/16542.
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Doctor of PhilosophyDepartment of Diagnostic Medicine and Pathobiology
Brad J. White and Robert L. Larson
Bovine respiratory disease (BRD) is the most costly disease of cattle in US feedyards and diagnosis based on clinical signs of illness is challenging. Over the course of five independent studies we evaluated the precision of multiple observers assigning clinical illness scores (CIS) to calves with induced Mycoplasma bovis pneumonia. We also evaluated the accuracy of CIS in relation to lung lesions at necropsy. Agreement among observers over all five studies was slight ({kappa]= 0.16; 95% confidence interval, 0.10 to 0.24) and ranged from 0.10 to 0.21 for individual trials. The accuracy of CIS varied based on the pulmonary consolidation score chosen to represent a truly ill animal. Inflammation associated with BRD can lead to significant pulmonary damage and reduced lung function. Treatment for BRD frequently involves antimicrobial administration and occasionally non-steroidal anti-inflammatory drugs. We evaluated how calves experimentally challenged with Mannheimia haemolytica respond to treatment with flunixin meglumine, alone or in combination with the antimicrobial florfenicol. Individual calf response to bacterial pneumonia was highly variable in this study. None of the changes in serum biomarkers, CBC or chemistry parameters provided reliable indicators of the pulmonary inflammation associated with the mild severity of bronchopneumonia in our study. Metaphylaxis is frequently administered to manage the risk of BRD within cohorts of cattle. We evaluated the impact of metaphylactic antimicrobial administration 10 days prior to experimental Mannheimia haemolytica inoculation to mitigate pulmonary lesions. We found that calves receiving tildipirosin had less lung damage and fewer clinical signs of illness compared to calves treated with tulathromycin or saline. Finally, the ability to predict those animals that would not finish the production cycle normally would provide benefits in effectively managing cattle. We evaluated the ability of classification algorithms to accurately predict an individual calf’s outcome based on data available at first identification of and treatment for BRD. We found accuracy of classifiers was dependent on the data recorded by the feedyard and there are sub-groups of calves within feedyard populations where classifiers were highly accurate. These data suggest the importance of pairing the proper classifier with the data available.
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Raikes, Carmen. "Integrated disease management on winter sports turf." Thesis, Liverpool John Moores University, 1995. http://researchonline.ljmu.ac.uk/5522/.
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The aim of this study was to formulate an integrated disease management (IDM) strategy for winter sports turf. (Winter sports turf, or coarse turf, consists primarily of perennial rye grass, Lolium perenne, which is used for football, rugby and hockey pitches because of its wear tolerant characteristics). IDM involves the use of a number of control strategies to suppress disease economically and efficiently. Such strategies incorporate cultural, biological, genetic, legislative and chemical control. In order to formulate a successful disease management strategy, all the significant diseases affecting winter sports turf and the effects of different management strategies on these target pathogens needed to be identified and collated. This was achieved by a comprehensive questionnaire survey to professional football clubs (who require a high level of turf maintenance) and local authorities (moderate/low maintenance). The questionnaire sought information regarding disease, pest and weed incidence, control measures employed and general problems, e. g. drainage, wear and routine management practices. Red thread, Laetisariafiiciformis, and Fusarium patch, Microdochium nivale appeared to be the most ubiquitous diseases on winter sports turf. Some important management practices that suppress red thread can, however, encourage Fusarium patch, e. g. the application of nitrogenous fertiliser. A series of experiments and field trials have been initiated to identify a number of specific factors which manage to effectively suppress both diseases. A field trial involving the use of species mixtures, perennial rye grass and smooth stalked meadow grass (Poa pratensis), illustrated that genetic diversity can help to reduce both red thread and Fusarium patch compared to turf grown in monoculture. The amount Fusarium patch and red thread cover indicated that disease severity was significantly lower in dual species stands as compared to monoculture. A mixture comprising 50% perennial rye grass and 50% smooth stalked meadow grass appeared the most effective at suppressing disease incidence. Similarly, mixtures of three perennial rye grass cultivars appeared more successful at suppressing slight outbreaks of red thread as compared to bi-blends and monoculture. In addition, individual perennial rye grass cultivars also vary in tolerance to red thread. One hundred and ten cultivars, under three different nitrogen regimes were assessedto determine which were the most disease resistant. The cultivars, received artificial football type wear treatment throughout the winter, to determine if red thread incidence predisposes rye grass to be less wear tolerant. The results indicate that a number of cultivars tolerant to red thread throughout the summer were also more resistant to wear. These cultivars included Quickstart, DelDwarf and Brightstar. Wear tolerance was also increased under a moderate nitrogen level (150 kg/ha/yr). Finally, a field trial investigating the effect of nitrogen rate on red thread and Fusarium patch incidence on five different constructions for football pitches was set down. Both diseases appeared to be efficiently suppressed under a moderate/high nitrogen level (N=225 kg/ha/yr). The 'pipe/slit' construction type also appeared to contain both diseases effectively, whilst sustaining a healthy, vigorous sward throughout the Winter when subjected to artificial football-type wear treatment. In addition to the field studies, an investigation to isolate potential microbial antagonists for use as biocontrol agents against Fusarium patch was undertaken; Fusarium patch was identified as the most economically important disease on winter sports turf from the original survey. A number of known antagonists and indigenous fungi and bacteria isolated from the phylloplane and rhizosphere of Lolium perenne were screened in vitro on turfgrass extract agar against Fusarium patch. This in vitro assay identified which species effectively suppressed disease growth. These potential antagonists were further tested in vivo to determine efficacy under field conditions. Fungi from the genus Trichoderma and bacteria from the genera Bacillus and Pseudornonos appeared the most effective antagonists against Fusarium patch in the in vivo study. In all cases where an antagonist was present, Fusarium patch severity was significantly lower than the untreated control, e. g. the indigenous Bacillus sp. reduced disease severity by 76.1 %. The results obtained from the field trials are encouraging and suggest that the use of species/cultivar mixtures, disease tolerant cultivars and a balanced fertiliser regime on a freely-draining construction type can successfully be incorporated into an IDM plan. An IDM strategy will help to effectively suppress both red thread and Fusariurn patch on winter sports turf. Biological control of Fusariurn patch was successful on an experimental basis, although further research is required to identify an appropriate formulation and optimum application technique for successful commercial use. The use of IDM on winter sports turf will help reduce reliance on chemical control, may delay the onset of fungicide resistance and reduce non-target impacts of fungicides. IDM will also help limit the need for potentially hazardous chemicals in recreational areas open to the public.
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Dias, Daniel de Matos. "Platform for chronic respiratory disease patient management." Master's thesis, Universidade de Aveiro, 2013. http://hdl.handle.net/10773/11560.
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Mestrado em Engenharia de Computadores e TelemáticaAs doenças respiratórias são uma das razões mais frequentes para consultas médicas e uma das causas de morte mais frequentes a nível mundial, representando gastos de vários milhões de euros. A frequência e grau de severidade de ocorrência de tosse é um dos principais indicadores a analisar, por ser este o sintoma mais frequente em grande parte destas doenças respiratórias e por ser também um bom indicador da evolução do estado do paciente. Dada a importância deste sintoma, foi desenvolvido o Leicester Cough Monitor, uma aplicação que permite obter, de forma automática e não invasiva, dados quantitativos fiáveis relativos à frequência de ocorrência de tosse. Contudo, essa aplicação funciona apenas em modo local, tendo esta de estar instalada no computador onde se deseje realizar o estudo não havendo qualquer tipo de ligação e comunicação entre mais que um computador. Dado este facto, não é possível manter de forma eficiente um sincronismo de informação e de estudos realizados em mais que um computador ou em diferentes centros. O trabalho descrito nesta dissertação teve como objectivo fundamental desenvolver uma plataforma Web que, através da integração da ferramenta LCM já existente, permita a realização de estudos sobre a evolução dos sintomas de tosse de vários pacientes. Foi então desenvolvida uma plataforma que permite ter informação organizada, sincronizada e reunida num único ponto estando esta acessível de qualquer local com acesso à Internet. A disponibilização das várias funcionalidades da ferramenta LCM numa vertente Web foi o foco principal, sendo que novas funcionalidades foram criadas de modo a permitir de uma forma organizada e controlada a gestão de toda a informação com a implementação de um sistema de gestão de utilizadores.
Respiratory diseases are one of the most frequent reasons for medical appointments and one of the main causes of death worldwide, accounting costs of several millions of Euros. The frequency and severity of occurrence of cough is one of the most important indicators, being the most frequent symptom in many of these diseases and also a good indicator of the evolution of the patient’s disease state. Given the importance of this symptom, the Leicester Cough Monitor, an application that allows obtaining, in an automatic and noninvasively way, reliable quantitative data on the frequency of occurrence of cough, was developed. However, this application only works locally, requiring that it is installed on the computer where we want to perform the study with no other kind of connection and communication between more than one computer. Given this fact, it is not possible to efficiently maintain synchronism of information and studies on more than one computer or between different centers. The work described in this dissertation had as fundamental goal the development of a Web platform that, through the integration of the existing LCM tool, enables studies of the evolution of patients with various symptoms of cough. Thus, a platform was developed that allows having information organized, synchronized and collected at a single point being this accessible from any location with Internet access. The availability of the various functionalities of the LCM tool on a Web context was the main focus, and new features were created to allow an organized and controlled management of all information with the implementation of a user management system.
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Bintcliffe, Oliver James. "The management of non-malignant pleural disease." Thesis, University of Bristol, 2017. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.738259.
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Steuten, Lotte Maria Gertruda. "Evaluation of disease management programmes for chronically ill." Maastricht : Maastricht : UPM, Universitaire Pers Maastricht ; University Library, Maastricht University [Host], 2006. http://arno.unimaas.nl/show.cgi?fid=7668.
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Behrenbruch, Christian P. "Image fusion for the management of breast disease." Thesis, University of Oxford, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.403936.
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Schick, Jona Fabian [Verfasser]. "Effizienz von Disease Management Programmen / Jona Fabian Schick." Ulm : Universität Ulm, 2019. http://d-nb.info/1200470087/34.
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Dahab, Mohamed Hassan. "Crop constraints on the mechanization of disease management." Thesis, University of Newcastle Upon Tyne, 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.358895.
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Bhattacharyya, S. "Carcinoid heart disease : diagnosis, investigation, progression and management." Thesis, University College London (University of London), 2011. http://discovery.ucl.ac.uk/1331871/.
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INTRODUCTION: Carcinoid heart disease is acquired form of valvular heart disease occurring in patients with carcinoid syndrome. We sought to identify the prevalence, predictive biomarkers, advanced echocardiographic features, risk factors for development and outcomes of cardiac surgery for carcinoid heart disease. METHODS: A prospective, observational, cohort study of 252 patients with a history of carcinoid syndrome attending a neuroendocrine tumour clinic was undertaken. Patients underwent serial evaluation of symptoms (cardiac and neuroendocrine), functional status, biochemical markers, echocardiography, and tumour staging over a three year period. RESULTS: Carcinoid heart disease was initially identified in 20% of patients with carcinoid syndrome. The sensitivity and specificity of NT-proBNP, at a cut-off level of 260pg/ml, for detection of carcinoid heart disease was 0.92 and 0.91, respectively. Involvement of the tricuspid, pulmonary, mitral and aortic valves were found in 90%, 69%, 29% and 27% of patients respectively. Myocardial metastases were found in 3.8% of patients. 3D echocardiography provided more detailed anatomical assessment, particularly for tricuspid and pulmonary valves, than 2D techniques. Independent predictors of the development or progression of carcinoid heart disease were a 5-HIAA greater than 300 ųmol/24hr and greater than 3 episodes of flushing per day. Overall 30 day mortality of cardiac surgery was 18.2%. 2 year survival was 44.4 %. Long term causes of death were related to advanced metastatic carcinoid tumour. No patient required re-operation for bio-prosthetic degeneration. CONCLUSION: The prevalence of carcinoid heart disease is significantly less than reported in previous decades. The high negative predictive value of NT-proBNP may allow its use as a screening test for carcinoid heart disease. 3D echocardiography allows more detailed assessment of valvulopathy than 2D techniques. A 5-HIAA > 300 ųmol/24hr and >3 episodes of flushing per day are predictors of the development and/or progression of carcinoid heart disease. Cardiac valve surgery is high risk but provides symptomatic relief.
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Lewis, M. H. "Peripheral arterial disease from aetiology to surgical management." Thesis, University of South Wales, 2013. https://pure.southwales.ac.uk/en/studentthesis/peripheral-arterial-disease-from-aetiology-to-surgical-management(7defd31a-6995-4fc7-9302-2fced42b5982).html.
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The work presented includes over thirty peer reviewed published manuscripts based on studies undertaken during my surgical career. As Principal Investigator, I led the study conception/design/data acquisition/analysis/interpretation and was involved with writing the final drafts of all manuscripts prior to their formal submission to high impact factor peer-reviewed specialist journals. The thesis is divided into subsections reflecting my development and different interests within surgery. The subsections start with my learning basic research principles, moving onto clinical problem solving in general surgical dilemmas, followed by a collection of papers in my subspecialty of vascular surgery. The work culminates with a group of papers focused on aneurysmal disease, specifically, abdominal aortic aneurysms (AAA), the clinical impact of which has had a bearing on the introduction of a National AAA Screening Program in Wales in 2013. I conclude these sections with a collection of papers that reflect my long term commitment to surgical training both at regional level (as Secretary and Deputy Chairman to the Higher Surgical Training Committee and Chairman of the Basic Surgical Training Committee) and national level including my involvement with the Four Royal Colleges of Surgeons for the Intercollegiate Examinations in General Surgery. This examination is undertaken at completion of junior surgical training and used to confirm a doctor's competence for safe independent practice as a consultant. In conclusion, over forty years of academic research during my career as a vascular surgeon has provided unique insight into the pathophysiology, treatment and ultimately prevention of artherosclerotic disease. These findings have improved health policies in Wales and significantly reduced patient morbidity and mortality.
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Hillman, Laketa Monique. "Experiences of Chronic Disease Self-Management Program Leaders." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/3105.
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Chronic conditions are public health threats. The Chronic Disease Self-Management Program (CDSMP) is an evidence-based disease management program that addresses personal self-management of chronic conditions. The CDSMP involves peer trainers who instruct and assist with chronic disease preventive measures. Although disease management demonstrates promise to improving patient self-maintenance, previous researchers have not evaluated how the program affects program leaders. The purpose of this study was to discover how self-help leaders feel about the CDSM program. The overarching research question asked about perspectives that self-help leaders had toward the program. Through a narrative qualitative approach, the perceptions of peer leaders were examined to determine if the program was personally beneficial. Guided by the social cognitive theory, a purposeful convenience sample of 20 participants completed the study. The participants were practicing peer trainers in the CDSMP program. Data analysis included hand coding using open and axial coding and content analysis. Study findings included themes surrounding how the CDSMP program benefits health in general as well as the management of facilitators' own chronic diseases, health behaviors, and increased quality of life. The ability for chronic disease management leaders to experience positive effects of the program they administer may result in positive social change. This awareness can positively affect social change by enhancing an already established evidence-based community health program with stronger and better-equipped leaders.
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Murphy, Kerri. "Nursing Staff Education for Heart Failure Disease Management." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6252.
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Heart failure (HF) has a global significance for the older population and is the most common reason for hospitalization. Patients with HF can reduce their risk for hospital readmissions and adverse outcomes through self-management of their disease. Nurses are responsible for educating patients about HF self-management; however, nurses at the project site lacked sufficient understanding and confidence to perform adequate HF patient education, creating a gap in practice. This project was guided by Pender's health promotion model and adult learning theory with the goal to increase nurses' knowledge and confidence with the self-management principles of HF. The purpose of this project was to develop an educational program for nurses to increase their knowledge of HF disease management and patient self-management principles. The education program was supported by research literature and recommendations from the Agency for Healthcare Research and Quality, in addition to input from a planning team consisting of 3 nursing leaders from the project site. The planning team provided process evaluation regarding satisfaction with the planning process by completing an anonymous, 10-question, Likert-type survey. Seven project evaluations were completed and all respondents indicated that they agreed or strongly agreed in response to questions regarding the effectiveness of the project, it's planning, and the leader. At the completion of the project, the education program was delivered to the project site, with a plan for later implementation and learner evaluation using assessment tools of HF knowledge and confidence. This project has the potential to achieve positive social change in relation to nurses' commitment to improving patient outcomes through quality initiatives and dedication to the implementation of evidence-based practice, thus, promoting positive patient outcomes.
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Marcante, Andrea. "PD_manager: an mHealth platform for Parkinson's disease Management." Doctoral thesis, Università degli studi di Padova, 2018. http://hdl.handle.net/11577/3421871.
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Parkinson’s disease (PD) current clinical management is mostly based on patient’s subjective report about the effects of treatments and on medical examinations that unfortunately represent only a snapshot of a highly fluctuating clinical condition. This traditional approach requires time, it is biased by patient’s judgment and is often not completely reliable, especially in moderate advanced stages. The main purpose of the EU funded project PD_manager (Horizon 2020, Grant Agreement n° 643706) is to build and evaluate an innovative, mHealth, patient-centric system for PD remote monitoring. After a first phase of research and development, a set of wearable devices has been selected and tested on 20 patients. The raw data recorded have been used to feed algorithms necessary to recognize motor symptoms. In parallel, other applications have been developed to test also the main non-motor symptoms. On a second phase, a case- control randomized multicentric study has been designed and performed to assess the acceptability and utility of the PD_manager system at patients’ home, compared to the current gold standard for home monitoring, represented by symptoms diaries. 136 couples of patients and caregivers have been recruited, and at the end of the trial the system was found to be very well tolerated and easy to use, compared to diaries. The developed System is able to recognize motor and non-motor symptoms, helping healthcare professionals in taking decisions on therapeutic strategies. Moreover, PD_manager could represent a useful tool for patient's self-monitoring and self-care promotion.
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Downing, Beatrice Catherine. "Disruption and disease : how does population management affect disease risk in wild bird populations?" Thesis, University of Exeter, 2017. http://hdl.handle.net/10871/29259.
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Despite the ubiquity of wildlife management, from reintroductions and supplemental feeding to culling and habitat destruction, very little is known of the effects of management practices on species’ social dynamics. Species’ social structure has the potential to affect not only behaviour and evolution but also the transmission of information or disease. Understanding the effects of population management on social behaviour and organisation is a key step in understanding these species’ ecology. This thesis examines the differences between individuals’ roles in the social structure and what this means for the transmission of disease. It demonstrates how similarity in movement behaviour scales with increasing social circles, how seasonality in movement and seasonality in association rates covary as well as detailing post-cull behavioural changes. It finds that there is the potential for certain individuals (most likely non-breeding individuals) to transmit infection far and wide. It reveals the similarities in movement behaviour and body condition that birds share with their pair and social group. It emphasises the importance of autumn and winter movement in the transmission of infectious disease and it follows the short- and long-term changes in social structure and movement behaviour following a cull. Cull survivors were observed to retain a higher proportion of associations with their previous associates and moved less far in the year following the cull than in the year preceding it. This is the first application of social network analysis to quantify social structure before and after culling. The findings suggest that culling an infected population may facilitate rather than constrain the transmission of disease.
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Al-Khdour, Maher Rateb. "An integrated disease and medicines management programme for patients with chronic obstructive pulmonary disease (COPD)." Thesis, Queen's University Belfast, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.501233.
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Locke, Richard Robert. "Anatomy of the transmastoid endolymphatic sac decompression in the management of Ménière's disease." Connect to e-thesis, 2008. http://theses.gla.ac.uk/208/.
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Thesis (Ph.D.) - University of Glasgow, 2008.Ph.D. thesis submitted to the Division of Neuroscience and Biomedical Systems, Institute of Biomedical and Life Sciences, University of Glasgow, 2008. Includes bibliographical references. Print version also available.
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Dickerson, Josephine Ellen Claire. "Investigations into the optimal management of hypertension." Thesis, University of York, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.313948.
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Bonner, Allison P. "Walking as a symptom management technique for Alzheimer's disease." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape9/PQDD_0018/MQ46963.pdf.
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Bernardi, Enrico. "Diagnostic and therapeutic management of venous and arterial disease." [S.l. : Amsterdam : s.n.] ; Universiteit van Amsterdam [Host], 2003. http://dare.uva.nl/document/68083.
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Matthie, Nadine. "Sickle Cell Disease: The Role of Self-Care Management." Scholar Commons, 2013. http://scholarcommons.usf.edu/etd/4538.
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Abstract
Sickle cell disease is the most common genetic disorder in the United States. Approximately 90% of the hospitalizations in this patient population occur due to the most common complication, pain crises. Prevention of these crises is therefore essential and requires the patient to assume an active role in his or her disease management. Studies suggest that further research is needed to examine the self-care management process and to identify factors influencing self-care behaviors. The relationships among these factors must be clearly defined before interventions to improve self-care management can be determined. The aims of the study were threefold. The first aim was to evaluate the relationships among psychosocial variables (SCD self-efficacy and social support) and socio-demographic variables (age, gender, education, employment status, income, and living situation) in understanding individual differences in self-care management variables (perceived self-care ability and self-care actions). It was hypothesized that higher SCD self-efficacy, greater social support, being employed, living with family or friends, increased age, more years of education, higher income, and being male are each associated with having higher perceived self-care ability and more frequent self-care actions. The second aim was to evaluate the relationships among psychosocial variables (SCD self-efficacy and social support), socio-demographic variables (age, gender, education, employment status, income, and living situation), and self-care management variables (perceived self-care ability and self-care actions) in understanding hospital visits for crises. It was hypothesized that higher perceived self-care ability and more frequent self-care actions are associated with fewer hospital visits for crises. The third aim was to evaluate the mediational role of perceived self-care ability and self-care actions in the relationships among psychosocial variables (SCD self-efficacy and social support), socio-demographic variables (age, gender, education, employment status, income, and living situation), and the number of hospital visits for crises. It was hypothesized that SCD self-efficacy, social support, and the socio-demographic variables have both a direct and an indirect relationship with the number of hospital visits for crises. In 103 young Black adults (ages 18-30) with sickle cell disease (SCD), an exploratory , correlational study was conducted, via secondary analysis of data, to examine the relationships among SCD self-efficacy, social support, socio-demographic variables, self-care management (self-care ability and self-care actions), and the number of hospital visits for crises. Bivariate correlations and regression analyses were conducted to evaluate the relationships among the variables and to examine the mediational role of self-care management. Sickle cell disease self-efficacy, social support, years of education, and income were significantly related to perceived self-care ability and self-care actions. Social support accounted for the majority of the variance in each self-care management variable. The hypothesis that higher SCD self-efficacy and greater social support are associated with higher perceived self-care ability and more frequent self-care actions was supported. Education was also associated with higher perceived self-care ability and self-care actions as hypothesized. The overall model with SCD self-efficacy, social support, years of education, income, perceived self-care ability, and self-care actions was not significant in predicting the number of hospital visits for crises. There were no significant associations noted among age, annual household income, living situation, employment status, and the self-care management variables. The hypothesis that higher perceived self-care ability and more frequent self-care actions are associated with fewer hospital visits for crises was not supported. Further, there was no adequate evidence to support a direct relationship between SCD self-efficacy, social support, years of education, and the number of hospital visits for crises. The indirect relationship, through self-care management, among the variables was also non-significant. There was however a significant direct relationship noted between income and the number of hospital visits for crises. The outcomes of the study may be important for clinical care, patient education, and health outcomes in the SCD population. Findings may be used to conduct larger confirmatory studies and to develop interventions that may be used to supplement therapy in the clinical setting and to enhance patient self-care management at home. Additional studies are needed, however, to clarify what additional variables may affect the number of hospital visits for crises and to identify specific pain prevention and management strategies used by SCD patients.
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Chinnery, Patrick Francis. "The pathogenesis, investigation and management of mitochondrial DNA disease." Thesis, University of Newcastle Upon Tyne, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.324935.
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Maxwell, Sylvia Lorraine. "Perthes disease : conventional surgical treatment, arthrodiatasis and physiotherapy management." Thesis, University of Ulster, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.400850.
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Moore, John Oliver. "Technology-supported apprenticeship in the management of chronic disease." Thesis, Massachusetts Institute of Technology, 2013. http://hdl.handle.net/1721.1/91853.
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Thesis: Ph. D., Massachusetts Institute of Technology, School of Architecture and Planning, Program in Media Arts and Sciences, 2013.109
Cataloged from PDF version of thesis.
Includes bibliographical references (pages 83-91).
Chronic disease is the most important cause of morbidity and mortality worldwide, but the current standard of care is woefully ineffective. It is paternalistic, episodic, and perversely incentivized based on volume, resulting in poor outcomes at extraordinary cost. Technology-supported apprenticeship is a model of chronic disease management that embraces the contribution of the patient. It is collaborative, continuous, and designed to achieve value through improvement in the experience, clinical outcomes, and cost of care. In this model, patients are the novice apprentices of master clinicians. A software platform called CollaboRhythm provides applications on mobile phones and tablets as scaffolding for collaboration. Tracking tools document progress, visualizations highlight associations between actions and outcomes, and personalized decision support encourages self-efficacy. Powerful virtual visits and instant messaging allow master clinicians to provide adaptive coaching within the context of daily life rather than in the artificial environment of the office. Apprentice patients have the potential to become master coaches themselves; thus producing an exponentially scaling health ecosystem at minimal cost. Two randomized, controlled trials were conducted to evaluate if technology-supported apprenticeship could augment the "best of the best" in office-based care and scale it via virtual deployment. Apprentice patients for basal insulin titration at the Joslin Diabetes Center were more satisfied with their care than controls, achieved better outcomes (-3.1% vs. -2.5% HbA1C), and did so with minimal increase in cost ($206). Those for hypertension management at the Massachusetts General Hospital were also more satisfied with their care, achieved better outcomes (-26.3 vs. -15.9 mmHg SBP), and did so with negligible increase in cost ($14). Over a longer period of time, apprenticeship is projected to produce better outcomes at decreased cost. Technology-supported apprenticeship has extraordinary potential, but the paternalistic culture of medicine and its volume-based economic model present significant impediments. Future work needs to address longer durations of coaching, greater numbers of apprentices per coach, patients as coaches, other chronic diseases, and patients with comorbidities.
by John Oliver Moore.
Ph. D.
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Hill, C. "Diabetic kidney disease : a study of management and outcomes." Thesis, Queen's University Belfast, 2014. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.676518.
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Diabetes mellitus is the most common cause of end-stage renal disease requiring renal replacement therapy in the United Kingdom. However, many aspects of the prevalence, management and outcomes of diabetic patients with chronic kidney disease (CKD) remain unclear. This thesis consists of three studies using local (Northern Irish) data, national data (from the National Diabetes Audit) and international data (combined as part of a multi-centre collaborative meta-analysis). Its aims were to assess the survival of Northern Irish diabetic patients with CKD, examine the prevalence and associations of diabetes-related CKD in the UK National Diabetes Audit and to assess the association between glycosylated haemoglobin (HbA1c) and survival in diabetic haemodialysis patients.
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Rajendram, R. "The management & medical treatment of thyroid eye disease." Thesis, University College London (University of London), 2014. http://discovery.ucl.ac.uk/1458879/.
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Thyroid eye disease (TED) is a disfiguring autoimmune orbital inflammatory condition that may result in loss of vision and intractable diplopia. Optimal treatment is highly debated as current evidence is conflicting, and long-term outcomes of management within the UK is lacking as a result of small cohorts and variability in individual physician:s treatment plans. I performed a retrospective casenote review of 425 patients presenting to Moorfields Eye Hospital under one consultant between 1997 and 2002 inclusively. Approximately two-thirds of patients (69%) with initial and final exophthalmometer readings (n=257) had a reduction in proptosis of 2mm or more and 67% of the 206 with diplopia at presentation improved by their final visit. Smokers at presentation required strabismus surgery more often than non-smokers (hazard ratio 1.8; p = 0.02, 95% confidence interval 1.08 – 3.22). These results indicate that there is room for improvement in outcomes and that smoking cessation should be emphasised. Orbital radiotherapy is the most controversial of current therapies used worldwide. I performed a systematic review which suggested that radiotherapy is superior to sham radiotherapy (natural history) with a relative risk of 1.92. To provide further Level 1 evidence, I established a multicentre factorial-designed 3 year follow-up randomised controlled trial (RCT) addressing the use of steroids in combination with either radiotherapy, a steroid sparing agent (azathioprine) or both (www.cirted.org). A high screening failure rate early on led to review of entry criteria and appropriate modifications of the protocol increased the proportion of eligible patients progressing to randomisation. At the time of writing recruitment is complete with 512 patients assessed for eligibility, 298 screened, 167 recruited and given a 2 week steroid trial leading to 127 responding and being randomised. The high conversion from recruitment to randomisation (76%) suggested the clinical enrolment criteria were effective for detecting active disease. To identify a novel objective measure of disease activity a nested magnetic resonance imaging (MRI) study was performed to explore the use of diffusion-weighted imaging. This technique was found to be subject to significant artefact and difficult to interpret, and therefore not of benefit in clinical practice. Taken together, the studies in this thesis show that, despite treatment deemed best management, proptosis or diplopia persists in one third of patients and additional medical treatments in the active stage are required to improve outcomes; robust RCTs are needed to provide evidence. Such RCTs are complex and our trial provides a template on which other collaborative work could be based, and therefore encourage homogeneity of outcome measures to allow future meta-analyses.
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Dalwai, Ebrahim. "Systems delays in the management of malignant breast disease." Master's thesis, University of Cape Town, 2016. http://hdl.handle.net/11427/20298.
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Centralised multidisciplinary management of breast cancer occurs in KwaZulu-Natal, South Africa and requires a diagnostic and staging pathway at the referring hospital. Delays in this pathway are unknown. This study, conducted at a referring hospital, R K Khan (RKK), quantifies and analyses these delays. A retrospective folder review included all patients with breast cancer diagnosed at RKK from January 2008 to January 2009. Data extraction included demographic data, time to diagnosis and initial staging using a standardised datasheet. Specific care steps were identified, namely delays to initial imaging with mammography, pathology confirmation, staging workup and eventual referral to a centralised breast clinic.
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Cordery, R. J. "The early diagnosis and management of Creutzfeldt-Jakob disease." Thesis, University College London (University of London), 2004. http://discovery.ucl.ac.uk/1446588/.
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This thesis describes work undertaken to improve the early diagnosis of variant Creutzfeldt-Jakob disease (vCJD), using existing clinical and research tools. Twenty-one cases referred to the National Hospital for Neurology and Neurosurgery and St. Mary's Hospital, London with suspected vCJD completed participation in the study. Fifteen cases were confirmed with definite or probable vCJD and six were given alternative diagnoses. These six cases with alternative diagnoses formed a control group. Further controls were recruited from patients referred with sporadic and familial forms of prion disease. A neuropsychiatry questionnaire comprising a battery of standardised tests was formulated. Of those with definite or probable vCJD, 86% exhibited anxiety, 93% irritability, 64% agitation and 79% displayed evidence of severe depressive symptoms. Fifty seven percent experienced simple delusions, most commonly of theft and suspicion and 36% described misidentifications (mean 8 months from illness onset). Behavioural change was common to all cases, 79% with aggression, 71% emotional lability and 79% sleep problems. Comprehensive neuropsychology assessments from those with vCJD were compared with sporadic and familial cases. Moderate to severe intellectual decline is characteristic of vCJD and impairment affects all cognitive domains. Only a minority of the vCJD cases presented with perceptual impairment compared with 50% of sporadic and familial cases. The proportion of cases with nominal impairment in the familial disease group was significantly lower than in the variant and sporadic groups. Serial volumetric MR imaging was only possible in a subgroup of cases with familial CJD. The annual mean rate of whole brain atrophy was 2.05% compared to 0.25% in normal controls. Single voxel proton magnetic spectroscopy performed in three cases with vCJD showed a 2.5 fold (150%) increase in the mean myo-inositol concentration and 50% reduction in N-acetylaspartate in the pulvinar region. Similar changes were seen in the caudate nucleus where no signal change was detected on T2 weighted images. The key to early diagnosis still relies on a high index of suspicion for vCJD and early referral to the appropriate specialist services. First hand experience of the problems faced by patients prompted a second, parallel project to be undertaken. A survey was conducted of all UK consultant neurologists and old age psychiatrists to assess current practices in the diagnosis and management of young people with dementia. It was concluded that young people may be under investigated if managed solely by an old age psychiatrist and may not receive adequate follow up services if managed solely by a neurologist.
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Amagwu, Anthony C. "Management of Chronic kidney Disease by Advanced Practice Nurses." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/4832.
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Despite best available care, uncontrolled chronic kidney disease (CKD) - a complex disease that impacts millions in the United States, will eventually progress to end stage renal disease which is associated with high morbidity and mortality. New evidence suggests management of earlier stages of CKD is effective in delaying disease progression. This project evaluated the impact of a CKD class, led by a nephrology nurse practitioner, on preventing disease progression in advanced CKD patients with diabetes and hypertension. The purpose of the class was to validate the need for the advanced practice nurse (APN) in the care continuum of CKD. CKD education is a quality improvement project based on the chronic illness trajectory nursing model by Corbin and Strauss. Using a case-control method and a simple descriptive statistic to compare the mean values, retrospective data from 52 patients were analyzed. Twelve non-participating patients had a mean 7% increase in serum creatinine levels at the 1-year mark. Forty participating patients saw a mean decrease of 30% serum creatinine. With significant evidence suggesting that disease progression is delayed and renal function is improved in all study markers for patients who participated in a CKD education class led by a nephrology nurse practitioner and who received usual care - an argument can be made for updating the APN role in the continuum of care for those with CKD. The results may contribute to social change by providing improved access to quality care that addresses the socioeconomic devastation of end stage renal disease.
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Parsons, Meg. "Spaces of Disease: the creation and management of Aboriginal health and disease in Queensland 1900-1970." University of Sydney, 2009. http://hdl.handle.net/2123/5572.
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Doctor of Philosophy(PhD)Indigenous health is one of the most pressing issues confronting contemporary Australian society. In recent years government officials, medical practitioners, and media commentators have repeatedly drawn attention to the vast discrepancies in health outcomes between Indigenous and non-Indigenous Australians. However a comprehensive discussion of Aboriginal health is often hampered by a lack of historical analysis. Accordingly this thesis is a historical response to the current Aboriginal health crisis and examines the impact of colonisation on Aboriginal bodies in Queensland during the early to mid twentieth century. Drawing upon a wide range of archival sources, including government correspondence, medical records, personal diaries and letters, maps and photographs, I examine how the exclusion of Aboriginal people from white society contributed to the creation of racially segregated medical institutions. I examine four such government-run institutions, which catered for Aboriginal health and disease during the period 1900-1970. The four institutions I examine – Barambah Aboriginal Settlement, Peel Island Lazaret, Fantome Island lock hospital and Fantome Island leprosarium – constituted the essence of the Queensland Government’s Aboriginal health policies throughout this time period. The Queensland Government’s health policies and procedures signified more than a benevolent interest in Aboriginal health, and were linked with Aboriginal (racial) management strategies. Popular perceptions of Aborigines as immoral and diseased directly affected the nature and focus of government health services to Aboriginal people. In particular the Chief Protector of Aboriginals Office’s uneven allocation of resources to medical segregation facilities and disease controls, at the expense of other more pressing health issues, specifically nutrition, sanitation, and maternal and child health, materially contributed to Aboriginal ill health. This thesis explores the purpose and rationales, which informed the provision of health services to Aboriginal people. The Queensland Government officials responsible for Aboriginal health, unlike the medical authorities involved in the management of white health, did not labour under the task of ensuring the liberty of their subjects but rather were empowered to employ coercive technologies long since abandoned in the wider medical culture. This particularly evident in the Queensland Government’s unwillingness to relinquish or lessen its control over diseased Aboriginal bodies and the continuation of its Aboriginal-only medical isolation facilities in the second half of the twentieth century. At a time when medical professionals and government officials throughout Australia were almost universally renouncing institutional medical solutions in favour of more community-based approaches to ill health and diseases, the Queensland Government was pushing for the creation of new, and the continuation of existing, medical segregation facilities for Aboriginal patients. In Queensland the management of health involved inherently spatialised and racialised practices. However spaces of Aboriginal segregation did not arise out of an uncomplicated or consistent rationale of racial segregation. Rather the micro-histories of Fantome Island leprosarium, Peel Island Lazaret, Fantome Island lock hospital and Barambah Aboriginal Settlement demonstrate that competing logics of disease quarantine, reform, punishment and race management all influenced the ways in which the Government chose to categorise, situate and manage Aboriginal people (their bodies, health and diseases). Evidence that the enterprise of public health was, and still is, closely aligned with the governance of populations.
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Parsons, Meg. "Spaces of disease the creation and management of Aboriginal health and disease in Queensland 1900-1970 /." Connect to full text, 2008. http://hdl.handle.net/2123/5572.
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Thesis (Ph. D.)--University of Sydney, 2009.Degree awarded 2009; thesis submitted 2008. Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy to the Dept.of History, Faculty of Arts. Title from title screen (viewed 3 December, 2009). Includes graphs and tables. List of tables: leaf 9. List of illustrations: leaves 10-12. Includes bibliographical references. Also available in print form.
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Nyamekye, Isaac. "Photodynamic therapy in the management of angioplasty restenosis." Thesis, University of Bristol, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.294129.
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Shanmuganathan, Selvanaayagam. "Leadership role in health management of chronic disease management programs in 3 different health systems." Thesis, The University of Sydney, 2022. https://hdl.handle.net/2123/29847.
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Chronic disease is well recognized as a significant health challenge in developed and many emerging economies. Virtually all health care organizations within the system that deliver services, including those who plan, fund, and coordinate services, have a role in chronic disease prevention, management, and sustainability. Leadership, resources, incentives, and quality improvement across the healthcare system and within individual organisations are prerequisites to successful implementation and sustainability as part of the framework’s practice and system changes.
Mixed-method descriptive research was undertaken as part of the thesis. This study took place in three countries Malaysia, Nepal and Australia. Purposeful sampling was used in both the quantitative and qualitative research methods to identify and select participants for the studies. A semi-structured interview guide was used to conduct in-depth interviews among key informants in a leadership role across urban, rural and regional health districts in 3 countries, and a survey questionnaire was sent to key leaders in Malaysia.
Study findings highlighted key approaches to leadership and engagement in implementing NCDs programs at the district level. Leadership at the district level is constantly challenged by a lack of human, material, and technical resources in implementing chronic disease programs. This shortage impacts the decision-making and handling of social and professional workplace relationships by the leaders. Several issues emerged, including fostering collaborative leadership, setting a clear vision, engaging the community, and managing resources at the district level.
Effective and committed leadership is extremely important and should be emphasised for the implementation and sustainability of chronic disease programs. There is a demand for healthcare leadership development, which will certainly improve the health system's managerial, administrative and teamwork capacities at a micro-level in strengthening healthcare and improving health outcomes.
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Lukong, Paul Foka. "The integration of geospatial data into the surveillance and management of HIV/AIDS in Cameroon : thesis submitted for the degree of Doctor of Philosophy /." Title page, table of contents and abstract only, 2004. http://web4.library.adelaide.edu.au/theses/09PH/09phl9549.pdf.
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Steurer-Stey, Claudia. "Therapeutic considerations in the disease management of chronic respiratory illnesses /." Zürich, 2007. http://opac.nebis.ch/cgi-bin/showAbstract.pl?sys=000253352.
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Venter, Ignatius Johannes Erhardt. "The role of the community pharmacist in cardiovascular disease management." Thesis, Nelson Mandela Metropolitan University, 2007. http://hdl.handle.net/10948/652.
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Cardiovascular disease contributes to mortality and morbidity statistics worldwide and in South Africa. The current focus in health care revolves around activities aimed at preventing the development of cardiovascular disease, rather than the treatment of disease. The identification of risk factors that can predispose a patient to the development of cardiovascular disease is an essential component of any cardiovascular disease management programme. It is necessary that in the management of these risk factors, they are not considered to be isolated, but inter-related. Through the provision of point-of-care cardiovascular risk screening and monitoring services as well as disease-related counselling, the community pharmacist, as a readily accessible source of healthcare, can play an essential role in the cardiovascular disease management process. The aim of this study was to describe the nature of the services provided by community pharmacists with respect to cardiovascular risk and disease management in the Nelson Mandela Metropole. The research design was a non-experimental, descriptive study using a crosssectional survey method. Data was obtained through the utilisation of a questionnaire. The questionnaire consisted of three sections and was administered to community pharmacies in the Nelson Mandela Metropole, that provided cardiovascular point-of-care screening services. The community pharmacists correctly identified cardiovascular risk factors such as obesity (76.6 percent; 36, n=47) and smoking (27.7 percent; 13, n=47). Other cardiovascular risk factors such as abdominal obesity (4.2 percent; 2, n=47), gender (2.1 percent; 1, n=47) and family history (4.2 percent; 2, n=47) were largely ignored by the pharmacists. Point-of-care testing services were readily available in the pharmacies, with all of the pharmacies providing blood glucose and blood pressure measurements. Blood cholesterol measurements were only provided in 87.8 percent (36, n=41) of the pharmacies. The services were generally provided in a clinic facility, with 90.2 percent (37, n=41) of the pharmacies having a clinic facility available. Pharmacists were involved in the provision of point-of-care services, with 85.4 percent (35, n=41) of the pharmacies indicating that the pharmacists participated. Pharmacists readily provided counselling prior (70.7 percent; 29, n=41) to and after (80.5 percent; 33, n=41) the conduction of the screening services on areas such as lifestyle modification and treatment options. Only 15 percent (7, n=47) of the pharmacists indicated that they were aware of Cardiovascular Risk Calculator Tools and none of the pharmacists indicated that they had utilised such a tool. Pharmacists recommended frequent monitoring (60.5 percent; 26, n=43) and lifestyle modification (67.4 percent; 29, n=43) to patients, if the result of their screening service was within normal limits. However, the majority of the pharmacists indicated that they would refer patients, if the results obtained were out of the normal range. Conclusions based on the findings indicated that the pharmacists are readily providing cardiovascular risk screening services. The pharmacists were also able to identify the presence of any risk factors that can lead to the development of cardiovascular disease in the patients. However, active pharmaceutical involvement in further cardiovascular disease monitoring seemed to be lacking. Recommendations were made on areas such as reimbursement for pharmaceutical care services, increased utilisation of support staff and Continuing Professional Development events that could assist in improving the role of the community pharmacist in cardiovascular disease management.
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Mahon, David. "Modern management of gastro-oesophageal reflux disease : medicine or surgery?" Thesis, University of East Anglia, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.429584.
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Shum, Jessica. "The role of health literacy in chronic respiratory disease management." Thesis, University of British Columbia, 2017. http://hdl.handle.net/2429/63415.
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Background: Health literacy (HL) is defined as the ability to access, understand, evaluate, communicate, and use health information to make informed health decisions. Studies have reported a relationship between low HL and less health-related knowledge, poorer skills in taking medication, and treatment non-adherence. Despite this, measurement of HL (in particular to the abovementioned domains) is still in its infancy and the impact of HL on self-management (via a key informant lens) has yet to be studied.
Objectives: The main aim in this thesis was to incorporate both sides of the HL equation (patients and key informants) into investigating the role of HL in chronic respiratory disease management. This led to two objectives: 1) To identify HL tools used in asthma and/or chronic obstructive pulmonary disease (COPD) management and examine their characteristics; and 2) To assess key informants’ perspectives re barriers to asthma/COPD self-management and the solutions to address such challenges.
Methods: A systematic review was undertaken to review the literature on HL tools that assessed any of the five domains on asthma/COPD patients. Following this, a qualitative study was conducted with national and international key informants (e.g., health care professionals (HCPs), researchers, and policymakers) who were involved in the care of asthma/COPD patients to determine perceived patient barriers to competent self-management and the possible solutions to overcome these barriers.
Results: The review identified 65 tools with a majority assessing ‘understanding’ and a minority on ‘communication’. Only two tools assessed all five domains and less than half had been validated. Thematic analysis of the 45 interviews resulted in seven barriers surrounding the themes of time, information overload, and jargon and six solutions focusing on tailored education, better communication, and building relationships.
Conclusions: Self-management is a combined effort achieved only through the engagement of patients, HCPs, and the system. Both studies showed shortcomings in the ‘communication’ domain, possibly due to the complex phenomenon of communication requiring at least two individuals in the process. These findings suggest that HL researchers and health care programs should recommend new strategies for chronic respiratory disease management with a specific emphasis on the concept of ‘communication’.Medicine, Faculty of
Experimental Medicine, Division of
Medicine, Department of
Graduate
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Wildner, Daniel. "Die elektronische Patientenakte im Disease-Management-Programm Grundlagen & Perspektive." Saarbrücken VDM, Müller, 2006. http://deposit.d-nb.de/cgi-bin/dokserv?id=2845606&prov=M&dok_var=1&dok_ext=htm.
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Claesson, Maria. "Women's hearts : ischaemic heart disease and stress management in women." Doctoral thesis, Umeå : Department of Public Health and Clinical Medicine, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-725.
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Cheung, Ting-kin. "Gastro-oesophageal reflux disease in Chinese its management and impact /." Click to view the E-thesis via HKUTO, 2007. http://sunzi.lib.hku.hk/hkuto/record/B39707374.
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