Tesi: "Health self-Management"

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He, Zhuoran. "Mobile Health Application for Diabetes Self-Management". Thesis, North Dakota State University, 2020. https://hdl.handle.net/10365/31846.

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As mobile healthcare applications are becoming more and more popular, it brings patients a more convenient way to self-management and communicating remotely compare to the traditional healthcare system. This paper introduces a healthcare mobile application of diabetes self-management that designed, developed, and tested by professor Li’s research team. The application is going to be used by American Indian diabetes patients in Lower Sioux Tribe. The application enabled patients to self-monitor their nutrients intake and health information. The social chatting and education functionality allow users to communicate and get educated remotely. By combining the advantages of both mobile health application and self-management systems together, the application provides great benefits especially for chronic diseases like diabetes. It is thrilling to see more and more implementations of mobile health self-management applications and improve the treatment of chronic disease.

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Pan, Xi. "Type 2 Diabetes in China: Health Behaviors, Diabetes Self-Management, and Self-Rated Health". Miami University / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=miami1398002669.

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Cook, Susanne Welch. "Adolescent risk preference and asthma symptom self-management: Assessing symptom management scenarios". Diss., The University of Arizona, 2004. http://hdl.handle.net/10150/280507.

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Adolescent asthma symptom self-management choices frequently involve uncertain outcomes that include potential dangers such as trigger exposures or delays in treatments that can lead to increased morbidity or mortality. Nurses must understand factors that influence how adolescents make symptom decisions. The purpose of the investigation was to assess eight adolescent asthma symptom scenarios for use with the standard gamble technique (SGT) for making choices. The aims were to: (1) estimate the internal consistency and content validity of the scenarios; (2) estimate the relationship between measured risk preferences, age, and gender; and (3) describe adolescent responses to using the SGT. Thirty-six adolescents participated. Risk preferences or utilities elicited during face-to-face interviews with 31 adolescents were used to answer research questions. Data were analyzed using descriptive statistics, Cronbach's alpha, Kendall's tau correlations, and point biserial correlations. Content validity (CV) ratings from 36 adolescents were used to compute indexes and establish CV of the scenarios. Qualitative responses were analyzed using a modified case study strategy to further establish CV and assess using SGT with adolescents. The estimates of internal consistency reliability and relationships between utilities, age, and gender were limited by the non-normal distributions of utility and age data sets and small sample size. The standardized alpha was .70 for the eight-scenario composite. Eight significant inter-item correlations and seven significant item-total correlations were identified. One significant correlation between age and an individual scenario utility score was found. No significant relationships between age and mean utility scores or gender and the individual or mean utility scores were seen. The CV indexes support the relevancy of the content of the eight-scenario composite as evidenced by 94.5% of the adolescents rating the individual scenarios as CV for the domains and 92% for the risk areas. In addition, the adolescents rated 94% percent of the composites as CV. The qualitative responses support the quantitative data and describe the SGT as a method that adolescents can use. Future studies are needed with a larger sample to further examine the internal consistency of the scenarios and the relationships between age, gender, and utility scores measured with the SGT.

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Williams, Lesa Faye. "Diabetes Self-Management Education Program". ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/1235.

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Diabetes is a devastating disease in American. The disease can cause chronic health comorbidities, and untreated diabetes has negative consequences for individuals and on our nation's economy. Newly diagnosed diabetics often have a lack of knowledge about the disease process. The purpose of this project was to design and implement a diabetes educational program to enhance participants' knowledge about diabetes management and self-care using the Health Belief Model. Diabetes Self-Management Education (DSME) is critical in improving patient outcomes and the prevention of diabetes related complications. Participation in a standardized diabetic educational intervention will improve patient knowledge, as measured by a reliable and valid pretest and posttest questionnaire. The objective was to develop a DSME curriculum that will be recognized and approved by the American Diabetes Association. A one group pretest /posttest method was employed with ten participants. A sample of ten participants between the age of 22 years old through 65 years old included eight women and two men all identified as African American. Upon completion of the 5-week DSME program, participants were noted to have started participating in weekly exercise or increased the number of days of exercise from 2 days to 3 days per week. Participants also noted a decrease in their systolic and diastolic blood pressure reading. Participants noted on average a 2-3 pound weight loss. Significant improvements were shown on both the knowledge scale and confidence scale of the modified Diabetes Project Participation Questionnaire. Results from this project indicated that participants applied knowledge from the DSME program to improve their own health status.

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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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Schumacher, Constance Louise. "Understanding Self-Management Decision Making in Heart Failure". ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/4099.

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Heart failure patients are responsible for managing fluctuations in symptoms between exacerbations by employing treatment adherence, active monitoring, and management strategies based on expert guidelines. Despite education, delayed help seeking persists among those in the need of acute medical intervention, as evidenced by high hospital admission and readmission rates. The purpose of this qualitative grounded theory study was to explore the decision making processes undertaken by heart failure, community-dwelling individuals as they experience symptom changes. Eighteen face-to-face interviews were conducted with participants who had heart failure and received self-management education from a home care agency in Southern Ontario, Canada. Data were analyzed using iterative steps of open, axial, selective coding, and qualitative software text queries. Three process themes were identified: perceiving symptoms, normalizing symptoms, and adapting to symptoms, with an overarching theme of control and absence of consultative behaviors. The central concept revealed in this study was normalizing symptoms in heart failure which included actions taken by participants to mitigate symptom fluctuations. Daily fluctuations were assimilated into normal life resulting in desensitization of symptom recognition and a loss of functional capacity. These findings can be used to inform system changes needed to strengthen consultative patient-health professional relationships required for effective self-management problem-solving. This study leads to positive social change by explaining how self-management is practiced from the patient's perspective, which can inform practice recommendations and future research.

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Rahim-Williams, F. Bridgett. "African American Women With Type 2 Diabetes: Understanding Self-Management". [Tampa, Fla.] : University of South Florida, 2004. http://purl.fcla.edu/fcla/etd/SFE0000527.

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Rivera-Hernandez, Maricruz. "Self-Management, Social Support, Religiosity and Self-Rated Health Among Older Mexicans Diagnosed with Diabetes". Miami University / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=miami1366390281.

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9

Okafor, Eugene O. "Decreasing Acute Diabetes Complications Through Self-Management Education". ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5922.

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Diabetes mellitus is a chronic disease that affects millions of people in the United States. The purpose of this project was to develop a guideline to help clinical staff provide clear and concise diabetes self-management instructions to patients in a community setting. Orem's self-care deficit theory (SCD) and health belief model (HBM) provided a platform to assess how patients' self-care deficit contributes to illness and the effect of patients' perception of illness. SCD theory and the HBM provided the framework for the development of the guideline to decrease diabetes acute complications through self-management education. The practice-focused question was whether the diabetes treatment guideline would decrease diabetes complication, improve the quality of care received by the diabetic patients, and if the facility would adopt the developed guideline. AGREE II Tool was used to assess the quality of the guideline and the staffs' desire for the adoption of the guideline. Data were collected from questionnaires given to staff members at the practice site in 2 rounds. Six medical staff were asked to critique the initial guideline, and 5 medical professionals were asked to assess the final guideline. Most of the participants' scores indicated strong agreement that full consideration was met. The score in all 6 AGREE II domains was above 90%, and 100% of the participants recommended the guideline to be adopted in the facility. Data analysis indicated the diabetes practice guideline is valid, will enhance the treatment of diabetes, and the practice site employees were eager to adopt the treatment guideline. Findings may be used to increase population health and reduce acute complications from diabetes mellitus.

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Leksell, Janeth. "Diabetes-Related Blindness : Studies of Self-Management, Power, Empowerment and Health". Doctoral thesis, Uppsala University, Department of Medical Sciences, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-6262.

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Individuals with diabetes and blindness meet problems in daily life that are related to both conditions. The aim was to study diabetes self-management, burden of diabetes, power, sense of coherence (SOC) and health among individuals with diabetes-related blindness. The aim was further to determine psychometric properties of a diabetes empowerment scale (DES) and to use it in the evaluation of an empowerment programme. The participants were 39 blind diabetic and non-diabetic individuals and 21 diabetic individuals with threat of blindness. A convenience sample of 195 diabetic patients completed DES and 9 blind diabetic individuals participated in the empowerment programme. Two reference groups from the Swed-qual population studies were also included. Data were collected by questionnaires, interviews and by scrutinizing medical records. Quantitative data were analyzed with parametric and non-parametric methods and qualitative data with content analysis. Blind diabetic individuals expressed more problems with self-management than did those with threat of blindness. In some health domains, blind diabetic individuals perceived significantly poorer health than did non-diabetic blind individuals. There were though individual differences in how blind individuals perceived their health as well as how burdensome they experienced their self-management. Individuals with power and strong SOC felt less burden and perceived better health when compared to those with weak SOC or non-power. The diabetes empowerment scale showed acceptable validity and reliability and was used, along with qualitative interviews, to evaluate the effect of the empowerment programme. Evaluation of the programme showed that the participants had improved knowledge and awareness of self-management. The programme seems suitable for blind individuals and creates an inspiring learning climate enhancing empowerment. It is concluded that blind individuals have problems in their diabetes self-management and perceive poor health but the experience of power is a factor of importance for health and an empowerment education programme may enhance power.

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Leksell, Janeth. "Diabetes-related blindness : studies of self-management, power, empowerment and health /". Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-6262.

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12

Hulst, Samantha. "Diabetes Self-Management Education Service at a Rural Minnesota Health Clinic". Diss., North Dakota State University, 2019. https://hdl.handle.net/10365/29399.

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In 2015, there were an estimated 30.3 million Americans living with diabetes, and 95% of them were diagnosed with type 2 diabetes (T2D) (Centers for Disease Control and Prevention, 2017b). Patients living in rural America have an increased prevalence of diabetes, and their participation rates in preventative care practice are lower (Rutledge, Masalovich, Blacher, & Saunders, 2017). The increased prevalence of the T2D in rural communities does not positively correlate with the number of diabetes self-management education (DSME) services in these areas, which poses a gap in healthcare services (Rutledge et al., 2017). Diabetes self-management education can be defined as ?the process of facilitating the knowledge, skill, and ability necessary for diabetes care? (Powers et al., 2015, p. 71). Diabetes self-management education has shown to decrease participant?s A1c by as much as 0.9%, which has been associated with a 25% reduction in microvascular complications, a 10% decline in diabetes-related mortality, and a reduction in all-cause mortality by 6% (Chrvala, Sherr, & Lipman, 2016). The utilization of DSME services in rural health clinics has the potential to improve health outcomes by decreasing complications directly related to diabetes in those patients participating in the service. The practice improvement project established a pilot DSME group service, which was consistent with the Standards of Medical Care in Diabetes - 2019 (ADA, 2018d). The practice improvement project was structured using the Chronic Care Model and Model for Improvement to help provide a functional and sustainable DSME service. The overall goal of the practice improvement project is to have the organization continue the service after the conclusion of the practice improvement project. The practice improvement project yielded positive results. The organization?s surveys indicated strong support for the service and the ability of the DSME service to fill a gap in their current diabetic education. The DSME participant?s skills and confidence increased through completing the curriculum, positively correlated to improved glycemic control. The organization?s stakeholders also felt that the service would be marketable to the organization?s patient population and profitable by increasing quality numbers and providing the opportunity for reimbursement.

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13

Davis, Jo Ann. "The relationship between self-efficacy of diabetes management and health-promoting behaviors". Virtual Press, 1997. http://liblink.bsu.edu/uhtbin/catkey/1041919.

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Diabetes Mellitus is a chronic disorder that requires daily adherence to complex regimens for glucose control. The purpose of this study was to examine the relationship between the capability for self-management of diabetes and the practices of health-promoting behaviors. Instruments used were the Health Promotion Lifestyle Profile to measure health-promoting behaviors, the Insulin Management Diabetes Self-Efficacy Scale to measure self-efficacy in diabetes management, and a demographic questionnaire.Fifty participants from the outpatients of a midwestern veterans hospital responded to the questionnaires. Results showed a moderately positive significant correlation between self-efficacy in diabetes management and health-promoting behaviors (r=.52, p<001).The findings of this study point the importance of higher levels of self-efficacy and participation in health-promoting behaviors for more effective management of diabetes and improved health and well-being.
School of Nursing

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Horton, Jeryl Yvette. "Improving Self-Management in Patients With Chronic Conditions". ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2489.

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Care Coordination Home Telehealth (CCHT) maintains a positive impact on the delivery of patient care in the primary care clinic at the Department of Veterans Administration Medical Center (VAMC). This quality improvement initiative targets patients with chronic conditions such as diabetes, hypertension, heart failure, and chronic obstructive pulmonary disease. These patient are frequently seen in the emergency room, and are often admitted to the hospital, where they saturate the outpatient clinics' waiting room with multiple walk-ins. CCHT has, to some extent, reduced walk-ins, emergency room visits, and hospitalization while minimizing the strain on access to care at the VAMC. Sustaining self-management skills of veterans with chronic conditions at the VAMC continues to impose challenges. In this project, retrospective data from 95 randomly selected charts reviewed during a 2-year period were used to compare hospitalizations, emergency room visits, and primary care visits. The findings of the study indicate veterans enrolled in Home Telehealth show positive social change. The social change is evidenced by change in behavior patterns, such as maintaining a healthy diet, performing daily physical activity, and compliance with medication administration. Enrolled veterans had better outcomes regarding hospitalization, emergency room visits, and primary care visits. The data highlighted the need for incorporating disease-specific protocols guiding care coordinators at first point of contact with the veteran patient. Following these protocols may enhance communication style that matches the patient's stage of behavioral change with interventions.

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Merck, Stephanie F. "Pre-Diabetes, Self-Management and Technology| A Qualitative Case Study". Thesis, University of Phoenix, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10624381.

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Chronic disease is costly and requires a different approach to care than acute illness. Preventing chronic disease may improve health outcomes. This qualitative, explanatory case study explains the experiences of eight participants, from a suburban internal medicine practice in Fairfield County, CT, who used activity trackers/applications to adhere to diet and exercise. Daily email logs, information from the activity tracker/application and an exit interview provided detailed information about the participant used technology and what was most important to maintain lifestyle changes. The use of NVivo 11^® assisted with data analysis to identify common themes that emerged including accountability, awareness, challenges, and knowledge. Each participant’s information offered a unique perspective into how they viewed their responsibility to participate in their treatment plan. The use of technology assisted the participants to become actively involved in their disease management and development of new skills and strategies to support their lifestyle changes. Furthermore, the participant’s described difficulties adhering to the lifestyle changes within their daily lives. Since most of the management of any chronic condition occurs outside of a provider’s office, understanding the challenges and problems encountered by those with an early chronic disease, pre-diabetes, may assist providers to develop collaborative goals with their patients. Primary Care Providers, who understand the daily struggles of those Pre-diabetics, can offer realistic strategies for an individual to develop the necessary self-management skills to prevent diabetes.

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Austin, Erin. "Self-Management of Diabetes in Low-Income Appalachian Women". Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/honors/165.

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Diabetes mellitus is a major health concern and the number of Americans diagnosed with the disease is quickly increasing, affecting all aspects of an individual’s life and requiring significant self-involvement. Little is known about how low-income Appalachian women with Type 2 Diabetes Mellitus (T2DM) manage their diabetes from day-to-day. This population struggles to effectively manage the illness as they desire for many reasons. The purpose of this study is to better understand the experiences of Appalachian women in self-managing diabetes so that health care providers can better meet the social and cultural needs of this unique population. This study used a qualitative descriptive design. Data were collected by means of in-depth, semi structured interviews. The sample consisted of 5 low-income Appalachian women with T2DM who seek care at the Johnson City Community Health Center. The data analysis was completed by generating a set of themes from the narrative data. Three themes emerged from the interview data: Achieving Care with Limited Resources; Consistent and Involved Health Care Providers; and Family Support. Life situations unique to this population can influence the self-management of T2DM. Financial difficulties hinder the overall care that they need and desire, but through consistent and involved care givers and family support, successful self-management can occur in spite of significant barriers.

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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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So'Brien, van Putten Juliette M. "Diabetes self-management (DSM) education within managed care organizations in Ohio /". The Ohio State University, 1998. http://rave.ohiolink.edu/etdc/view?acc_num=osu1487949508369574.

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Jones, Leonie. "WISH (Well-being Intervention for Self-managing Health) : a feasibility work-based self-management intervention for employees with long-term health conditions". Thesis, University of the West of England, Bristol, 2017. http://eprints.uwe.ac.uk/31699/.

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Aim: The aim of this feasibility study is to design and evaluate the effectiveness of providing a self-management workplace intervention to employees with long-term health conditions, working in a Civil Service Department. Method: The WISH intervention (Well-being Intervention for Self-managing Health) was delivered in four-weekly sessions to two intervention groups, and compared to a waiting-list control group. 33 individuals took part in the study, with 21 participants (17 = female; 4 = male) taking part in the intervention, and 12 participants (11 = female; 1 = male) in the waiting-list control group. The Individual outcomes were competence, Self-efficacy, and well-being. The Organisational outcomes were: Absenteeism, Presenteeism, and Work-engagement. Measures included the Perceived Competency Scale (PCS); the Stanford Self-Efficacy for Managing Chronic Diseases (CDSE); the Stanford Presenteeism Scale (SPS-6); the Utrecht Work Engagement Scale (UWES); a modified version of the Gallup-Healthways Well-being Index; and a study-specific demographic questionnaire. Baseline data was taken at pre-intervention, followed by subsequent data being recorded at post-intervention, 3-months and 6-months. Results: The intervention demonstrated significant increase for Competence, Self-efficacy and Well-being over the 6-month period. A significant decrease in Absenteeism was also found over the 6-month period of the study. There were no differences found for primary health diagnosis, gender, or age. Conclusion: The feasibility study found the WISH workplace intervention, for employees with long-term health conditions, to be an effective programme for reducing organisational absenteeism in those with health concerns, but equally a beneficial and positive experience for the individual employees in empowering them to manage their health and well-being within the workplace setting.

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Xin, Chen. "Communicating Emotion Management: Improving Mental Health Self-care for Chinese Emerging Adults". University of Cincinnati / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1595499387373559.

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21

DeJesus, Yesenia. "Self-Efficacy and Self-Management Assessments on Hispanic Patients with Diabetes". ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2967.

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Hispanics are at increased risk for diabetes and are 40% more likely to die from the condition than are non-Hispanic Caucasians. The purpose of this project was to determine the effects of diabetes education conducted in Spanish by bilingual staff on the self-management and self-efficacy of a sample of 50 volunteer adult Hispanic clinic patients with diabetes. The education intervention incorporated the American Diabetes Association's Diabetes Self-Management Education program materials. Bandura's self-efficacy theory was selected as the theoretical support for the project that relied on self-management education of the patients to improve their self-efficacy to undertake the interventions necessary to manage their disease. The Diabetes Self-Management Questionnaire measured patient understanding and self-care management of diabetes before and after the education intervention, and the Diabetes Self-Efficacy Scale measured the self-efficacy of the patients before and after the intervention. Paired sample t tests were calculated to compare the pretest to posttest scores on the full questionnaire and subscales. The full scale and the glucose monitoring control and physical activity subscales showed statistically significant improvement pretest to posttest. An increase in the pretest to posttest Diabetes Self-Efficacy Scale scores was not significant. Results indicated that the diabetes education was an effective way to improve self-reported daily blood glucose monitoring and physical activity. The project may result in positive social change from the better self-management of some diabetes control skills among Hispanic adult patients when education is delivered in Spanish.

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Hipwell, Alison E. "Punjabi Sikh women's arthritis self management experiences". Thesis, Coventry University, 2010. http://curve.coventry.ac.uk/open/items/654f4c81-cbb9-545c-2f94-1f701f01cfab/1.

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Self-management interventions enhance the health self-management techniques and physical and psychological health outcomes among people with long-term health conditions (LTHCs). Few individuals from South Asian backgrounds attended the pilot phase of one such intervention: the Expert Patients Programme (EPP), a community-based self-management course. This raised concerns about exacerbating health inequalities. South Asian people have increased prevalence and severity of certain musculoskeletal conditions, yet little is known about their experiences of living with and self-managing these. This research aimed to rectify these omissions, by describing Punjabi Sikh women's experiences of living with and self-managing arthritis, and identifying barriers and facilitators to EPP. Three studies explored White and Punjabi Sikh EPP tutors‟ experiences of delivering EPP to South Asian attendees, and Punjabi Sikh women's experiences of living with and self-managing arthritis, both before and after they attended a Punjabi-language EPP. White and Punjabi Sikh tutors' sometimes dichotomous experiences of delivering EPP to South Asians, captured barriers to South Asian people's attendance, engagement and self-management. Facilitators identified included the need for sensitive tailoring of the Course, involving the Punjabi Sikh community. The Punjabi Sikh women's vibrant experiential accounts revealed the detrimental psychological and physical consequences that arthritis had upon their lives. Highly versatile in their proactive arthritis self-management prior to attending EPP, participants' refined techniques encompassed combinations of medication and Indian remedies, empowered by their religious and spiritual values. Following EPP attendance, the participants reported psychological and physical improvements in their arthritis. Thus, this Study established Punjabi Sikh 4 Abstract women's inherent acceptance of the concept of self-management, and, notwithstanding its current limitations, the likely appropriateness of EPP. Every Study represents a novel contribution to knowledge. Meaningful engagement with Punjabi Sikh community-members may produce a culturally-competent intervention that could better improve this group's physical and psychological outcomes, thus addressing one small area of health inequalities.

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Osman, Liesl M. "Patient self management and hospital admission in acute asthma". Thesis, University of Aberdeen, 1993. http://digitool.abdn.ac.uk/R?func=search-advanced-go&find_code1=WSN&request1=AAIU601997.

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This study describes self management behaviour and attitudes among asthmatics, in usual self care, in acute episodes and in behaviour in the month before admission. It relates these behaviours to morbidity, admission history (single admittees versus multiple admittees) and outpatient status (current, discharged or never outpatient). Two hundred and thirty four patients between 16 and 65 years old were interviewed for the study. One hundred and thirty were in hospital at interview, the remainder were not in hospital but had all had a hospital admission between January and December 1987. Details of admissions in the following twelve months were collected for the hospitalised interviewees. In both hospitalised and non hospitalised groups self management was related to being in current specialist care, rather than to admission history. Patients in current specialist care were more compliant and acted at earlier stages of deterioration. When care type was controlled for, patients with multiple admissions were more non compliant with regular medication, and non compliant patients had significantly more frequent episodes. Forty (30%) of the hospitalised group were readmitted within 12 months of interview. Readmission was not related to self management before the 1991 admission or asthma attitudes. It is argued that this is because patients are likely to be referred to specialist care after an admission (almost 50% of first admissions and almost 100% of second admissions) and that this referral will change both their medical management and their self management. Hence, pre admission behaviour and attitudes cannot predict post admission risk. The study concludes that patient behaviour is most strongly influenced by being in specialist care, and that differences in self management, particularly compliance with prophylaxis and early action in deterioration, affect the risk of severe episodes and hospital admission.

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Earle, Wendy. "Factors that influence heart failure self-management of community dwelling individuals". Thesis, University of Ottawa (Canada), 2005. http://hdl.handle.net/10393/27195.

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Heart failure (HF) affects 350,000 Canadians, and is the third most common primary diagnosis for a hospitalization in Canada. People with HF experience periods of stability interspersed with exacerbations requiring hospitalization. During the fiscal year 2000-01, 85,679 patients were admitted to hospitals in Canada accruing a cost of over $1 billion per year for inpatient hospital services alone. These statistics indicate that in addition to the considerable influence on the lives of many Canadians, the burden of the problem is significant on the current and future health care system. This thesis examines factors that influence HF self-management as well as the profile characteristics of community dwelling individuals. The results of a systematic review and findings of a study that combines a mixed method approach including a quantitative secondary analysis, and a set of qualitative telephone interviews are presented. The qualitative data focuses on one factor, perception of social support, and how it relates to HF self-management. Finally, an integration of the information is presented. (Abstract shortened by UMI.)

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Gibson-Scipio, Wanda. "The association of perceived emotional support self-regulation and asthma health related outcomes". Diss., Connect to online resource - MSU authorized users, 2006.

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Burks, Kathryn J. "Self-management of osteoarthritis : an intervention study /". free to MU campus, to others for purchase, 2001. http://wwwlib.umi.com/cr/mo/fullcit?p3012952.

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27

Shao, Jung-Hua. "Evaluation of health-related outcomes following a self-management program for older people with heart failure". Thesis, Queensland University of Technology, 2008. https://eprints.qut.edu.au/20702/1/Jung-Hua_Shao_Thesis.pdf.

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Background. Heart failure (HF) which is a chronic, disabling disorder is mainly found in older people and is one of the leading causes of hospitalisation and readmission around the world. Unfortunately, the mortality and morbidity rates for HF remain high. HF is a complex combination of symptoms which are related to an inadequate perfusion of the body tissues caused by fluid and sodium retention. Hence, enhancing HF patients’ self-efficacy to change their behaviours to perform fluid & sodium control is one of the most important issues for the management of HF. A self-management program has the potential to raise self-efficacy and self-care which is a method to improve health for those with chronic illness and to decrease patients’ health service utilisation and also to enhance these patients’ health status. Aim. The study aims to examine the effectiveness of a self-management program, based on self-efficacy theory, in older people with heart failure in Taiwan. Methods. An experimental design was used to examine the effectiveness of a self-management program on diet and fluid control among HF patients. A total of 93 subjects from two medical centres in Taiwan were randomly assigned to the intervention and control groups. In order to examine the effectiveness of self-management, data were collected at baseline, week 4, and week 12 using the following instruments: self-efficacy for salt and fluid control, HF self-management behaviour, HF related symptoms, and body weight. Moreover, health service utilisation and patient’s evaluation of care received were collected on all patients for the 12 weeks prior to commencing the study and for the 12 week study period. Demographic and disease information was also collected including age, gender, marital state, education, and New York Heart Association (NYHA) functional classification. A structured, individualized self-management training program created by the investigator was implemented for the intervention group through home visits and telephone follow-ups. This program emphasized self-monitoring of diet control and body weight for the self-management of heart failure. The purpose was to improve patients’ self-efficacy in their diet control behaviour. The “diet control” in this study focussed on sodium and fluid restriction. Outcome measures were analysed using the Statistical Package for the Social Sciences (SPSS) 15.0 version, and the level of significance (á) was set at 0.05 for statistical analysis. Results. There were differences for older Taiwanese HF patients’ self-efficacy for salt and fluid control, self-management behaviour, and HF related symptoms for participants who received a self-management intervention compared to those who did not. However, there were no significant differences between the two groups in weight and health serves utilization (p>.001). Conclusion. The self-management program had a positive impact on the improvement of self-efficacy for salt and fluid control, HF related self-management behaviours and symptoms in older Taiwanese with HF. This program may bridge the gap between theory and practice. Health care providers need to provide older people in Taiwan with HF the appropriate skills for self-managing their condition and thereby promoting their health status. These patients with HF and their caregivers have to receive individualized education that emphasizes self-efficacy in the self-management of their disease, thus improving their quality of life.

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Shao, Jung-Hua. "Evaluation of health-related outcomes following a self-management program for older people with heart failure". Queensland University of Technology, 2008. http://eprints.qut.edu.au/20702/.

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Abstract (sommario):

Background. Heart failure (HF) which is a chronic, disabling disorder is mainly found in older people and is one of the leading causes of hospitalisation and readmission around the world. Unfortunately, the mortality and morbidity rates for HF remain high. HF is a complex combination of symptoms which are related to an inadequate perfusion of the body tissues caused by fluid and sodium retention. Hence, enhancing HF patients’ self-efficacy to change their behaviours to perform fluid & sodium control is one of the most important issues for the management of HF. A self-management program has the potential to raise self-efficacy and self-care which is a method to improve health for those with chronic illness and to decrease patients’ health service utilisation and also to enhance these patients’ health status. Aim. The study aims to examine the effectiveness of a self-management program, based on self-efficacy theory, in older people with heart failure in Taiwan. Methods. An experimental design was used to examine the effectiveness of a self-management program on diet and fluid control among HF patients. A total of 93 subjects from two medical centres in Taiwan were randomly assigned to the intervention and control groups. In order to examine the effectiveness of self-management, data were collected at baseline, week 4, and week 12 using the following instruments: self-efficacy for salt and fluid control, HF self-management behaviour, HF related symptoms, and body weight. Moreover, health service utilisation and patient’s evaluation of care received were collected on all patients for the 12 weeks prior to commencing the study and for the 12 week study period. Demographic and disease information was also collected including age, gender, marital state, education, and New York Heart Association (NYHA) functional classification. A structured, individualized self-management training program created by the investigator was implemented for the intervention group through home visits and telephone follow-ups. This program emphasized self-monitoring of diet control and body weight for the self-management of heart failure. The purpose was to improve patients’ self-efficacy in their diet control behaviour. The “diet control” in this study focussed on sodium and fluid restriction. Outcome measures were analysed using the Statistical Package for the Social Sciences (SPSS) 15.0 version, and the level of significance (á) was set at 0.05 for statistical analysis. Results. There were differences for older Taiwanese HF patients’ self-efficacy for salt and fluid control, self-management behaviour, and HF related symptoms for participants who received a self-management intervention compared to those who did not. However, there were no significant differences between the two groups in weight and health serves utilization (p>.001). Conclusion. The self-management program had a positive impact on the improvement of self-efficacy for salt and fluid control, HF related self-management behaviours and symptoms in older Taiwanese with HF. This program may bridge the gap between theory and practice. Health care providers need to provide older people in Taiwan with HF the appropriate skills for self-managing their condition and thereby promoting their health status. These patients with HF and their caregivers have to receive individualized education that emphasizes self-efficacy in the self-management of their disease, thus improving their quality of life.

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Laster, Nastassia Lovie. "Self-Identified Barriers to Asthma Management among Urban Families". Digital Archive @ GSU, 2008. http://digitalarchive.gsu.edu/iph_theses/40.

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Asthma is one of the most common chronic diseases of childhood. Those particularly affected are young, poor, African American children. Moreover, rates of ED visits, hospitalizations, and mortality are substantially higher for black children (Akinbami, 2006). Despite the ample published research on asthma prevalence and asthma management interventions, there is little research available on barriers to asthma care among urban low-income families as perceived by children with asthma and their caregivers. This qualitative study analyzed focus group data from five focus groups conducted with 28 participants in metropolitan Atlanta. This study found caregiver and child health beliefs and perceptions concerning the usage of daily controller medications to be a significant barrier to asthma care. Barriers to environmental control consisted mostly of financial constraints making environmental remediations difficult. Psychological distress was prevalent among both children and caregivers demonstrating the burden endured from managing a chronic illness.

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Gunnarsson, Kristina. "Entrepreneurs and Small-Scale Enterprises : Self Reported Health, Work Conditions, Work Environment Management and Occupational Health Services". Doctoral thesis, Uppsala universitet, Arbets- och miljömedicin, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-126549.

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This thesis focused on factors contributing to improved work environment in small-scale enterprises and sustainable health for the entrepreneurs. In Study I, implementation of the provision of Systematic Work Environment Management (SWEM) with and without support was investigated. Two implementation methods were used, supervised and network method. The effect of the project reached the employees faster in the enterprises with the supervised method. In general, the work environment improved in all enterprises. However, extensive support to small-scale enterprises in terms of advice and networking aimed at fulfilling SWEM regulations had limited effect – especially considering the cost of applying these methods. Studies II, III, and IV focused on entrepreneurs’ health, work conditions, strategies for maintaining good health, and utilisation of Occupational Health Service (OHS). A closed cohort of entrepreneurs in ten different trades responded to two self-administered questionnaires on health and work conditions, with five years between the surveys: at baseline, 496 entrepreneurs responded, and 251 entrepreneurs responded at follow-up. Differences were tested by Chi2-test, and associations estimated with logistic regression analyses. Qualitative interviews on entrepreneurs’ strategies for maintaining good health were included. In Study II, the most frequently reported complaints, musculoskeletal pain and mental health problems, were associated with poor job satisfaction and poor physical work environment. In Study III, consistent self-reported good health, i.e. good health both at baseline and at follow up, was associated with self-valued good social life when adjusted for physical work conditions and job satisfaction. Entrepreneurs’ strategies for maintaining good health included good planning and control over work, flexibility at work, good social contact with family, friends and other entrepreneurs, and regular physical exercise. Study IV concerned entrepreneur’s utilisation of OHS. Entrepreneurs affiliated to OHS had either better or more adverse work conditions than non-affiliated entrepreneurs. Medical care and health check-ups were the services most utilised. Affiliation to OHS correlated with use of specific information sources and active work environment management. The entrepreneurs were not consistently affiliated to OHS over the five-year-period.

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Lin, Gwan-Ling. "THE TRANSITION FOR HEALTH CARE AMONG YOUNG ADULTS WITH CONGENITAL HEART DISEASE". Case Western Reserve University School of Graduate Studies / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=case1333378156.

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32

Radabaugh, Jessica Nan Clarke. "Cooking Matters® for Diabetes: Practical Application of Diabetes Self-Management Education". The Ohio State University, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=osu1586902384417885.

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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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Peng, Cong. "A Hybrid Cloud Approach for Sharing Health Information in Chronic Disease Self-Management". Thesis, Blekinge Tekniska Högskola, Institutionen för datalogi och datorsystemteknik, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:bth-3632.

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Context: Health information sharing improves the performance of patient self-management when dealing with challenging chronic disease care. Cloud computing has the potential to provide a more imaginative long-term solution compared with traditional systems. However, there is a need for identifying a suitable way to share patient health information via cloud. Objectives: This study aims to identify what health information is suitable and valuable to share from a type 2 diabetes patient when multiple stakeholders are involved for different purposes, and find out a promising and achievable cloud based solution which enables patients to share the health information what and where they want to share. Methods: To get a clear and deep understanding on the subject area, and identify available knowledge and information on relevant researches, a literature review was performed. And then, a prototype on the case of type 2 diabetes is implemented to prove the feasibility of the proposed solution after analyzing the knowledge acquired from literatures. Finally, professionals and patient were interviewed to evaluate and improve the proposed solution. Results: A hybrid cloud solution is identified as a suitable way to enable patient to share health information for promoting the treatment of chronic disease. Conclusions: Based on the research with type 2 diabetes, it was concluded that most records in daily life such as physiologic measurements, non-physiologic measurements and lifestyle are valuable for the treatment of chronic diseases. It was also concluded that hybrid cloud is suitable and achievable for sharing patient-recorded health information among trusted and semi-trusted stakeholders. Moreover, anonymous and patient opt-in consent model are suitable when sharing to semi-trusted stakeholders.

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Brinson, David Raymond. "The Self-Management of Type 2 Diabetes: changing exercise behaviours for better health". Thesis, University of Canterbury. Health Sciences, 2007. http://hdl.handle.net/10092/1409.

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New Zealand is currently in the midst of a diabetes epidemic and it has become clear that the increasing prevalence of obesity and a sedentary lifestyle are inextricably linked to this escalating health crisis. Extensive research has long made clear that people of all ages can enhance their health by incorporating moderate levels of physical activity as part of their normal daily routine and physical activity is now recognised as a major therapeutic modality for type 2 diabetes. Despite such evidence, most people in the western world do not engage in sufficient regular physical activity and there remains a paucity of evidence that elucidates effective methods of achieving the required behaviour change over time. This study set out to demonstrate meaningful correlations between the psychosocial constructs optimism, exercise self-efficacy, goal-directness, stage of change, anxiety and depression, the biochemical measures HbA1c and BMI and also the behavioural outcomes of general physical activity and physical exercise participation, all within a newly diagnosed type 2 diabetic population. Participants (n=30, newly diagnosed adults with type 2 diabetes; mean age 61.46 years; BMI 31.43 Kg/mÃ‚Â²[range 18.8-50.95 Kg/mÃ‚Â²]) were recruited from attendees of the Christchurch Diabetes Centre's education seminars. The recruitment strategy was designed to search out diabetic patients as near as practicable to the point in time when they first became cognisant of their disease state. A battery of instruments was assembled into a researcher-administered retrospective questionnaire and this was completed with all subjects at baseline and again at six month follow-up. Additional data comprised subject's demographics and selected bio-chemical measures (subject height, weight, and blood Haemoglobin A1c). Descriptive, correlational and qualitative statistics were evaluated. The level of physical activity reported was significantly less than is required to facilitate the biochemical and psychological changes that are generally considered necessary to support optimal health. On average, study participants did not perform their planned physical activity tasks as well as they might have, despite being relatively optimistic and goal-directed at baseline. Many participants clearly indicated an inadequate understanding of exercise modalities and the intensity, duration and frequency of physical activity required to support optimal health. Generally, participants tended to overestimate their physical activity levels. Exercise self-efficacy emerged as an especially important psychological construct, and one that appeared to be among those central to the participants' relationships with physical activity and exercise. The study group demonstrated a relatively high prevalence of low level anxiety and depression, and even at these sub-clinical levels, anxiety and depression were significantly inversely related to optimism, goal-directness, goal-attainment, exercise self-efficacy and stage of change. The study findings illuminate the wide contextual variability among patients who are suffering from the same chronic condition. Further, the implications of conducting detailed pre-assessments of patients' personal characteristics and their psychological profiles, in order to guide intervention tailoring, are also outlined and discussed. Areas for future research are highlighted. In conclusion, meso and macro-level policy implications are discussed, with reference to an array of the broader determinants of health.

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Anglese, Tucker. "Review of type 2 diabetes self-management programs in Hawai'i and mental health". Thesis, University of Hawai'i at Hilo, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=1596439.

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Background: Type 2 diabetes is a complex chronic condition. To achieve positive outcomes patients must have an understanding of diabetes and self-efficacy to carry out self-management. Studies have shown that diabetes self-management education interventions positively affect physical and mental health outcomes, thereby improving the patient?s diabetes self-management. Purpose: The purpose of this article was to determine if four diabetes self-management programs (DSMP) on the Island of Hawaii are providing competent care based on national standards of curriculum components, addressing mental health concerns affecting diabetes self-management, and providing culturally adapted care. Methods: This study was carried out in three stages: 1) selecting programs for analysis; 2) comparing evaluated programs based on American Association of Diabetes Educators Self-care behaviors through the review of program manuals and supplemental materials; and 3) interviewing program directors. Results: A review of community-based, self-management programs on Hawaii Island reveals that they provide competent care based on national Diabetes Self-Management Education standards. The reviewed programs appear to be successful and include culturally adapted education. However, assessments for mental health are not currently being used to assess a patient?s need for treatment of common mental health problems such as depression. Conclusion: The current evidence of a connection between diabetes and depression indicates that DSMPs should assess for depression and provide effective treatment, especially for ethnic groups that have a high prevalence of diabetes and diabetes-related hospitalizations. More research is needed to determine how programs could better address culture and mental health concerns related to diabetes self-management education.

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Ogungbayi, CarolineE Jokotola. "Strategies for Patient Engagement in a Self-Management Program for Adults with Diabetes". ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7174.

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Patients' lack of adherence to diabetes self-management education and support (DSMES) recommendations is a challenge for healthcare. One approach to addressing patient noncompliance with DSMES is through education of staff on current guidelines. In an outpatient facility in South Texas, staff training on current DSMES guidelines was recommended as one of the solutions to the problem of Type 2 diabetes mellitus (T2DM) complications observed among clinic patients. An educational module was created to increase staff knowledge on T2DM and to assist staff members in teaching patients to self-manage T2DM. The module was built on the self-management and health promotion models, as well as self-regulation, dual process, and social learning theories. The DSMES educational module created for clinic staff consisted of a lecture presentation on current diabetes information and management guidelines, and a pre and posttest survey based on 13 close-ended questions. The generated data were summarized and analyzed using McNemar's test for paired, binary data. Results revealed that the module was useful for clinic staff in updating their T2DM and DSMES knowledge. Improvement in staff expertise might lead to positive social changes related to improved patient self-care of diabetes and reduction in financial burden in the longer term.

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Fowora, Muinah Adenike. "Adherence to Self-Care Management of Sickle Cell Disease Among Caregivers". ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2257.

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The self-care management of sickle cell disease (SCD) improves mortality rate; however, compliance with SCD self-care management remains a problem. The purpose of this study was to examine the knowledge and factors that influence compliance with SCD self-care management recommendations among caregivers of children with SCD. The health belief model was used as the theoretical foundation of this study, theorizing that caregivers' perceived susceptibility, severity, and benefits of SCD self-care management will influence compliance. The study used a quantitative research design. A cross-sectional survey was administered to 100 caregivers of children with SCD attending sickle cell clinics in Lagos, Nigeria using convenience sampling. Information was obtained from participants using a structured interviewer-administered questionnaire, and data were analyzed using descriptive statistics, bivariate correlations, and binary logistic regression techniques. Findings confirmed a high adherence rate but low knowledge of SCD self-care management among the caregivers of children with SCD. There was no significant correlation between knowledge of SCD self-care management and adherence. However, the findings from the multivariate analysis identified knowledge as a predictor of adherence and religiosity and total number of barriers as barriers to adherence. Parental health beliefs did not influence adherence to SCD self-care management. These findings have social change implications by guiding the work of health educators, health care providers, and public health practitioners to incorporate group counseling on SCD self-care management at every sickle cell clinic.

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Zhang, Ling. "Health literacy of Chinese immigrants living in Australia: measurements, health consequences and opportunities for interventions". Thesis, The University of Sydney, 2019. https://hdl.handle.net/2123/21794.

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Background: Immigrants are some of the most vulnerable groups for health disparities, which are in part associated with socio-economic disadvantage among this population. However increasing evidence indicates that low health literacy present among this population may explain many of the health disparities observed. Low health literacy is independently associated with poor healthcare utilisation and health outcomes. Health literacy issues occurring in immigrants are increasingly important to address in the Australian context as one in every five Australians are born overseas. However, understanding of health literacy and related issues in China-born immigrants is lacking. This is an important deficit as China-born Australians currently constitute 2.6% of the total Australian population and are one of the most rapidly expanding groups. Aim: The overall aim of this thesis was to explore health literacy and related issues including disease self-management, healthcare utilisation, health, and health literacy measurement among Chinese immigrants. The potential role of digital solutions for supporting health literacy and self-management in this population was also examined. Methods: The methods utilised in this thesis include scoping review, systematic review, psychometric evaluation, and observational studies. The study participants were recruited from both clinical and community settings in New South Wales, Australia, who were Chinese speakers or Chinese immigrants. Results: The majority of Chinese immigrants included in the studies in this thesis reported inadequate health literacy across all domains and the most affected health literacy domains were those related to accessing health information and healthcare services and interacting with healthcare providers. A high prevalence of emergency department (ED) visits and poor perceived health was demonstrated in Chinese immigrants with 20% of the participants having presented to the ED in the past 12 months; 57% reported fair or poor health status. Inadequate health literacy was independently associated with higher prevalence of ED visits and poorer self-perceived health in these participants. Furthermore, the study participants who were older (≥ 65 years) or had migrated at an older age, had newly migrated, were female, and who lacked university level education or English proficiency were at the highest risk of having inadequate health literacy. Disease self-management in Chinese immigrants was found to be strongly influenced by Chinese core values and beliefs, in the review of the literature. Self-management issues such as having insufficient knowledge of disease and risk factors, and poor health-seeking behaviours, were common among people of Chinese ethnicity living in western countries, and the lower health literacy provides a potential explanation. While measuring health literacy of immigrants is important it is also challenging as health literacy is a broad and complex concept. In addition to the factors that predict health literacy across diverse populations, factors unique to immigrants include age at migration, time living in host country, and language proficiency should be considered when measuring immigrants’ health literacy, adding another layer of complexity to measurement. The systematic literature review of health literacy measurement tools for Chinese speakers shows that although there are a number of tools available to measure health literacy of Chinese speakers, the psychometric properties, measured health literacy components, and underpinning health literacy framework varied between these tools. Due to various adaptation processes and lack of standardisation of these processes, the validity and reliability of tools derived or translated from English language tools could be substantially impacted. Digital solutions such as mHealth, telehealth, and eHealth interventions may offer strong potential for delivering interventions to improve health literacy and self-management, given the wide adoption of digital devices observed in Chinese immigrants in our study. For instance, mobile technology such as smartphones were used by the majority of patients attending a cardiac rehabilitation program, including Mandarin-speaking patients. This technology offers a flexible method of delivering interventions that is not fixed in location or time compared to traditional cardiac rehabilitation. Usage patterns varied between different language speaking groups, indicating a need to involve the targeted consumer groups in the design and development of digital methods. Conclusions: Given the substantial limitations in health literacy experienced by Chinese immigrants, and the implications for their health service use, health and disease selfmanagement, Chinese immigrants urgently need support in accessing health information and services and communicating with healthcare providers. Digital solutions may provide an alternative in delivery care for this ‘hard to reach’ population. Consumer involvement in design, development, and evaluation of tailored interventions is likely to be essential for intervention effectiveness.

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Tolgyesi, Charlotte Sarah. "Psychosocial factors associated with self-management and well-being in childhood chronic illness". Thesis, University of Birmingham, 2011. http://etheses.bham.ac.uk//id/eprint/1406/.

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Volume I comprises a literature review and an empirical paper. The literature review explores the link between illness representations and self-management in children and young people with chronic illness. Fourteen published empirical studies were identified for the review. A risk of bias assessment was completed for each study. Consistencies and differences between papers were identified. Overall, treatment control beliefs were most consistently associated with self-management across a range of chronic health conditions. The empirical paper details a cross-sectional study investigating associations between illness representations, self-efficacy, self-management and psychological well-being in young people with Coeliac Disease. Forty young people and 34 parents recruited from hospital outpatient clinics completed questionnaires. Results indicated timeline-cyclical beliefs and treatment concerns were associated with self-management. Timeline-cyclical, identity, treatment control and coherence were correlated with well-being. In terms of self-efficacy, young people with high levels of self-efficacy were more likely to have better self-management and positive well-being. Finally, dissimilarity in timeline-cyclical beliefs between young people and their parents was related to higher parental stress. Four full length clinical practice reports and a summary of CPR 5 (oral presentation) are included in the Volume II. Firstly, a case of a 55 year old woman presenting with depression is presented. The case is formulated from both cognitive and psychodynamic perspectives. A service evaluation of an Assertive Outreach Service is then described. Both of these clinical practice reports were completed while on an adult mental health placement. The third clinical practice report is a single case experimental design, detailing the assessment and treatment of a 15 year old boy with a mild learning disability and anxiety. This is followed by a case study of the assessment, formulation and intervention of a 15 year old boy with anger and memory difficulties. Finally, a summary of an audit of a new clinical service delivering psychosocial interventions in dementia is provided.

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Fomengia, Yvonne Etenyi. "Staff Education on Chronic Obstructive Pulmonary Disease Self-Management Using Teach-Back". ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7000.

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Exacerbation of chronic obstructive pulmonary disease (COPD) is the leading cause of hospital admissions and an estimated 120,000 deaths among older adults in the United States. In the community health clinic that served as the project site, more than 80% of patients with a COPD diagnosis had frequent exacerbations, with a hospital readmission rate of 23.2%, which was higher than the national benchmark of 21%. The clinic did not have a COPD discharge education plan with a teach-back tool for staff to teach patients. The purpose of the project was to develop an evidence-based COPD educational packet for staff on self-management using the teach-back method and an evidence-based COPD educational plan for patient self-management. Guided by Orem's self-care theory and Rosswurm and Larrabee's model of evidence-based practice, the project focused on whether the literature supported the use of the teach-back method of teaching for COPD self-management. Participants reviewed the packet and evaluated the content using a Likert-type scale with 1 =strongly disagree to 5 = strongly agree. Ninety percent of the clinic's stakeholders and staff agreed/strongly agreed to all factors evaluated, and the educational packet was recommended for use on the unit. The teach-back method and educational packet for COPD might bring about positive social change by decreasing exacerbations, improving health-related quality of life, and improving stewardship of healthcare investments thus improving the human condition.

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Herron, Holly Lynn. "Paramedic Students' Perceived Self-Efficacy at Airway Management". Otterbein University / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=otbn1399291921.

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Riley, Anne W. "The processes of self management in coping with stress". Diss., Virginia Polytechnic Institute and State University, 1985. http://hdl.handle.net/10919/53896.

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This research investigates the question of how people undertake health behavior change. It attempts to define what people experience and do during the process of changing health related aspects of their lives. The question of how people make health relevant changes in, their habits and actions has become increasingly important as the responsibility for one's health has shifted from the medical care system to the individual...
Ph. D.

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44

Collins-Gilchrist, Christina. "The evaluation of a Self-Management Physiotherapy Programme for adults with cystic fibrosis". Thesis, University of Portsmouth, 2012. https://researchportal.port.ac.uk/portal/en/theses/the-evaluation-of-a-selfmanagement-physiotherapy-programme-for-adults-with-cystic-fibrosis(9be41e60-b70c-46af-8c4b-1df3b9954f0a).html.

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Introduction: Cystic Fibrosis (CF) is the most commonly inherited life limiting disease in the Caucasian population. It is the result of mutations affecting the gene which encodes for a chloride channel known as the cystic fibrosis transmembrane conductance regulator (CFTR) and is essential for the regulation of salt and water movements across cell membranes. Defects in this mechanism cause increased viscosity of secretions, chiefly in the lungs and the intestinal tract. This abnormality results in the early onset of progressive chest infections, intestinal mal-absorption and malnutrition. Physiotherapy is an essential part of the treatment and management of CF as it aims to minimise progressive lung damage by ensuring that the airways are as clear as possible and that a healthy lifestyle is maintained through exercise/activity. Adherence to physiotherapy is a well recognised problem. This study aims to investigate what these problems are from a patient’s perspective and to design a Self- Management Physiotherapy Programme (SMPP) to help improve the ability to adhere to physiotherapy treatment. Methodology: The study initially used an action research approach as it actively involves the participants in the research process so that the problems of adhering to physiotherapy could be understood from their perspective. The methodological tools selected were a semistructured interview and a survey in the form of a self-completed questionnaire that was issued before (Pre-Intervention Physiotherapy Questionnaire) the implementation of the SMPP and after (Post-Intervention Physiotherapy Questionnaire) to monitor any changes in adherence behaviours which may have occurred as a result of its use. The study group comprised the total full care patients (n = 61) in an Adult CF Specialist Centre of whom 55 were eligible to be in the study and of these 49 agreed to participate. The study involved two sets of semi-structured interviews, involving a total of eight purposively selected participants, representing a range of adherence behaviours, so that they could describe in their own words what problems they were having in adhering to physiotherapy and what having CF meant to them. The interviews were analysed and the findings informed the development of the questionnaires and the SMPP. The findings identified the significance of health beliefs and the perception of having CF on adherence behaviour. These factors were taken into account when developing the questionnaire and the design of the SMPP. Following the analysis of the semi-structured interviews it was decided that the involvement of the participants to the level that is required in action research was not necessary. The study process continued broadly following the action research cycle of plan, intervention, evaluation and reflection. The Pre-Intervention Physiotherapy Questionnaire was developed and after piloting it was issued to the study population (n = 49) of whom 43/49 (87.7%) completed it. The SMPP was implemented and reviewed at three months and finally at six months after its implementation. Each participant was empowered to work in partnership with the researcher/physiotherapist in order to encourage self-management and potentially improve adherence. Barriers to adherence were identified and addressed through patients education. The SMPP’s effectiveness in improving the ability to adhere to physiotherapy treatment was monitored using a Feedback Chart and the Post-Intervention Physiotherapy Questionnaire to capture their opinions. Results: The study was completed by 29/49 (59.1%) participants. The analysis of the questionnaires and the participant’s positive comments regarding the effectiveness of the SMPP indicated that there was a moderately increased trend in adherence following its the implementation. Although the results were not of statically significant they were of clinical importance. It appeared that health beliefs and the perceptions of having CF influences adherence behaviour. Education, empowerment and working in partnership with the researcher/physiotherapist to design their own individually tailored SMPP optimised the ability to adhere to physiotherapy treatment. Conclusion: The SMPP can be postulated as a new model of physiotherapy clinical practice that optimises the ability to adhere to physiotherapy treatment.

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Chafin, Ashley. "The Role of Impression Management in Differential Health Reporting". Cleveland State University / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=csu1421159770.

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Cornely, Helen Z. "Health changes in Hispanic older adults in a Spanish arthritis self management education program". FIU Digital Commons, 2003. http://digitalcommons.fiu.edu/etd/2640.

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Arthritis is the most common chronic condition affecting older people and is a major cause of limited activity. Arthritis education programs in English have demonstrated a positive impact on health but these programs have not reached the Hispanic communities where arthritis is the leading cause of disability. Minorities, such as Hispanics, have traditionally been reluctant to pursue self-help programs, and have been identified as an under-served population in terms of medical care. This study examined the effectiveness of one community health adult education program targeting Hispanic older adults with arthritis, the Spanish Arthritis Self Management Education Program (SASMEP), by evaluating changes in the participants’ general health, pain, disability, self-efficacy, health perceptions, frequency of physician visits, and exercise. A pre and post control group experimental design and analyses of covariance were used to determine the pre and post differences in health status and health behaviors for a group participating in the SASMEP and a group who did not using gender and age as covariates. A repeated measures design was also used, and repeated measures analyses of variance and post hoc tests were done on health status and health behavior data collected pre, post and one-year post education to determine long-term differences. Results indicated the participants’ health status significantly improved in general health, significantly decreased in pain, and significantly decreased in arthritic disability immediately following the education. Self-efficacy and health perceptions increased for both groups but not significantly. The participants’ health behaviors showed significantly fewer physician visits and significantly increased time spent performing stretching and strengthening exercise and time spent performing aerobic exercise. No group differences were found in the frequency of arthritis physician visits. The improvements seen immediately after the SASMEP participation were not reflected in the post one-year scores. No significant differences were found for the participants’ health status or health behaviors one year following the education. Health status and health behaviors did not return below baseline scores after one year suggesting the participants’ health, although not improved, did not deteriorate. Therefore, the SASMEP education provided short-term health benefits for older Hispanic adults with arthritis, but not long-term health benefits.

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Johnson, Kiana, e Peter Scal. "Let’s Get Motivated: Identifying what Facilitates Youth’s Motivation for Learning about Health Self-Management". Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etsu-works/7018.

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Crowder, Sharron Johnson. "Illness representations and self-management behaviors of African American adolescents with asthma". Thesis, Indiana University, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=3617300.

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African American adolescents have inadequate self-management behaviors, particularly during middle adolescence (14-16 years of age). Inaccurate beliefs, degree of asthma impairment (well controlled or not well controlled), and gender could influence asthma self-management (symptom management, medication management, and environmental control). The researcher used the illness representations concept from the common sense self-regulation model as the framework for this study.

The descriptive correlational study explored (1) differences in illness representations (cognitive and emotional) and self-management behaviors by gender, asthma impairment, and gender by asthma impairment of African American adolescents with asthma; and (2) relationships between illness representations and asthma self-management behaviors, gender, and asthma impairment in 133 African American adolescents with asthma. Data were collected using the Asthma Control Test, the Illness Perceptions Questionnaire-Revised, and the Asthma Self-Care Practice Instrument. Data were analyzed using ANOVA, MANOVA, Pearson correlations, and multiple regressions.

Findings indicated that females whose asthma was not well controlled had more beliefs about the chronicity of their asthma than those who were well controlled. However, there were no differences in such beliefs among males whose asthma was not well controlled from those who were well controlled. Well controlled adolescents differed from not well controlled adolescents for cognitive representations of cyclic timeline, treatment control, psychological attributes, and consequences as well as for emotional representations. There were no significant differences in the means of the self-management behaviors by gender, by asthma impairment, or by gender by asthma impairment. A significant bivariate relationship was found between representations of identity, consequences, treatment control, and symptom management. In the multiple regression model, representations of treatment control and consequences contributed to variances in symptom management; however, no other representations, gender, or asthma impairment variables were statistically significant. The representations, gender, and asthma impairment variables did not contribute to variances in medication management or environmental control. Limited studies have been conducted with African American adolescents with asthma; therefore, the findings will contribute information to the literature on their illness representations and self-management behaviors. The findings also contribute to the literature information based on adolescents' genders and levels of asthma impairment.

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Dinh, Thi Thuy Ha. "A Self-management program for people with heart failure in Hanoi, Vietnam : a cluster randomised controlled trial". Thesis, Queensland University of Technology, 2016. https://eprints.qut.edu.au/101527/1/Thi%20Thuy%20Ha_Dinh_Thesis.pdf.

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This project examined teaching of heart failure self-management to both nurses and patients in Vietnam. The main study was an evidence-based clinical trial, revealing that a short individual self-care education intervention improved patients’ knowledge and adherence to recommended self-care behaviours. The thesis also highlighted that people often struggle to understand health information. It demonstrated that the teach-back method should be a priority strategy in delivering health education to those with low health literacy.

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Toth, Lynn Nichols. "Nurses' Response to a Heart Failure Video to Teach Patients Self-Management". ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3418.

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Numerous scholars have examined multiprocessors and techniques to decrease the heart failure readmission rate and to improve heart failure patient self-management. This project examined a new teaching method to create the experts' awareness of possible solutions to improve heart failure education in a small community hospital. The purpose of this project was the assessment of a new iPad heart failure patient pre-discharge education program video HFPDEV). Pender's health care model (PHM) served as a framework for this project. Five local nursing educator experts (master prepared) were asked to view a new iPad HFPDEV. After reviewing the 15-minute iPad HFPDEV, the local experts were asked to evaluate the video by completing a Likert-type survey, which evaluated the content, process, design, time, and functionality of the iPad HFPDEV along with a section for comments and recommendations. Descriptive analysis was used to analyze the survey results. Four of the experts defined the content, process, design, and functionality of the iPad HFPDEV as 'excellent.' One defined the content, process, design, and functionality of the iPad HFPDEV as 'adequate.' All experts expressed recommendations to improve the IPad HFPDEV by doubling the iPad size with an enlargement of print for easy reading and erecting all teaching iPads on mobile stands. A future pilot project will evaluate the relationship of HF readmission rate to the iPad HFPDEV. Social change will occur when the organization provides HF patients with iPad HFPDEV that will increase HF self-management skills and decrease HF readmissions.

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