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Self-management Education (self-management + education)
Selected AbstractsImpact of Provider Self-Management Education, Patient Self-Efficacy, and Health Status on Patient Adherence in Heart Failure in a Veterans Administration PopulationCONGESTIVE HEART FAILURE, Issue 1 2008Usha Subramanian MD To address the need for more information on predictors of adherence to heart failure (HF) self-management regimens, this study analyzed surveys completed by 259 HF patients receiving care at 2 Veterans Affairs hospitals in 2003. Linear multivariable regression models were used to examine general health status, HF-specific health status (Kansas City Cardiomyopathy Questionnaire) self-management education, and self-efficacy as predictors of self-reported adherence to salt intake and exercise regimens. Self-management education was provided most often for salt restriction (87%) followed by exercise (78%). In multivariable regression analyses, education about salt restriction (P=.01), weight reduction (P=.0004), self-efficacy (P=.03), and health status (P=.003) were significantly associated with patient-reported adherence to salt restriction. In a similar model, self-efficacy (P=.006) and health status (P,.0001), but not exercise education, were significantly associated with patient-reported exercise adherence. Findings suggest that provider interventions may lead to improved adherence with HF self-management and thus improvements in patients' health. [source] Home-Based Asthma Self-Management Education for Inner City ChildrenPUBLIC HEALTH NURSING, Issue 3 2005Arlene M. Butz Abstract, Optimal home self-management in young children with asthma includes accurate symptom identification followed by timely and appropriate treatment. The objective of this study was to evaluate a home-based asthma educational intervention targeting symptom identification for parents of children with asthma. Two hundred twenty-one children with asthma were enrolled into an ongoing home-based clinical trial and randomized into either a standard asthma education (SAE) or a symptom/nebulizer education intervention (SNEI). Data included home visit records and parent's self-report on questionnaires. Symptom identification and self-management skills significantly improved from preintervention to postintervention for parents in both groups with the exception of checking medications for expiration dates and the frequency of cleaning nebulizer device and equipment. However, significantly more parents of children in the SNEI group reported treating cough symptoms as compared with the SAE group (p = 0.05). Of concern is that only 38% of all parents reported having an asthma action plan in the home. A targeted home-based asthma education intervention can be effective for improving symptom identification and appropriate use of medications in children with asthma. Home asthma educational programs should address accurate symptom identification and a demonstration of asthma medication delivery devices. [source] Impact of Provider Self-Management Education, Patient Self-Efficacy, and Health Status on Patient Adherence in Heart Failure in a Veterans Administration PopulationCONGESTIVE HEART FAILURE, Issue 1 2008Usha Subramanian MD To address the need for more information on predictors of adherence to heart failure (HF) self-management regimens, this study analyzed surveys completed by 259 HF patients receiving care at 2 Veterans Affairs hospitals in 2003. Linear multivariable regression models were used to examine general health status, HF-specific health status (Kansas City Cardiomyopathy Questionnaire) self-management education, and self-efficacy as predictors of self-reported adherence to salt intake and exercise regimens. Self-management education was provided most often for salt restriction (87%) followed by exercise (78%). In multivariable regression analyses, education about salt restriction (P=.01), weight reduction (P=.0004), self-efficacy (P=.03), and health status (P=.003) were significantly associated with patient-reported adherence to salt restriction. In a similar model, self-efficacy (P=.006) and health status (P,.0001), but not exercise education, were significantly associated with patient-reported exercise adherence. Findings suggest that provider interventions may lead to improved adherence with HF self-management and thus improvements in patients' health. [source] The global challenge of type 2 diabetes and the strategies for response in ethnic minority groupsDIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue 6 2010Flavio Lirussi Abstract Ethnic minorities living in high-income countries usually exhibit a greater risk of developing diabetes along with higher morbidity and mortality rates. We evaluated the effectiveness of interventions to improve glycaemic control in ethnic minority groups. Results of major controlled trials, systematic reviews and meta-analyses were included in the review. Only 1/47 studies addressing diet and exercise interventions reported details on the ethnicity of the studied population. Self-management education was successful if associated with increased self-efficacy; delivered over a longer period; of high intensity; culturally tailored; and when using community educators. Strategies adopted in community-gathering places, family-based, multifaceted, and those tackling the social context were likely to be more effective. A positive relationship was found between social support and self-management behaviour as well as quality of life, but there is little evidence about the impact of organizational changes within health-care services on diabetes control. More research is needed to strengthen the evidence on effective strategies for response to diabetes in ethnic minorities. Also, there is a need to take into account diabetes beliefs and communication difficulties, as well as potential protective factors. Globally, many health-care systems are inadequately equipped to improve diabetes prevention and disease outcomes in these communities. Copyright © 2010 John Wiley & Sons, Ltd. [source] Impact of Provider Self-Management Education, Patient Self-Efficacy, and Health Status on Patient Adherence in Heart Failure in a Veterans Administration PopulationCONGESTIVE HEART FAILURE, Issue 1 2008Usha Subramanian MD To address the need for more information on predictors of adherence to heart failure (HF) self-management regimens, this study analyzed surveys completed by 259 HF patients receiving care at 2 Veterans Affairs hospitals in 2003. Linear multivariable regression models were used to examine general health status, HF-specific health status (Kansas City Cardiomyopathy Questionnaire) self-management education, and self-efficacy as predictors of self-reported adherence to salt intake and exercise regimens. Self-management education was provided most often for salt restriction (87%) followed by exercise (78%). In multivariable regression analyses, education about salt restriction (P=.01), weight reduction (P=.0004), self-efficacy (P=.03), and health status (P=.003) were significantly associated with patient-reported adherence to salt restriction. In a similar model, self-efficacy (P=.006) and health status (P,.0001), but not exercise education, were significantly associated with patient-reported exercise adherence. Findings suggest that provider interventions may lead to improved adherence with HF self-management and thus improvements in patients' health. [source] How can structured self-management patient education improve outcomes in people with type 2 diabetes?DIABETES OBESITY & METABOLISM, Issue 1 2010J. Jarvis Type 2 diabetes (T2DM) is a long-term chronic condition that is complex to manage, with the majority of management being done by the person with diabetes outside of the clinical setting. Because of its complexities, effective self-management requires skills, confidence and the ability to make decisions and choices about treatments and lifestyle on a day-to-day basis. Equipping a person with these self-management skills is in itself challenging and it is now widely accepted that structured education is an integral part of the management of T2DM. This paper explores whether structured self-management education can improve outcomes in people with diabetes. The authors explore what self-management education is, why it is needed and then go on to examine the recent evidence from clinical trials from 2006 onwards. [source] Depressive symptoms in the first year from diagnosis of Type 2 diabetes: results from the DESMOND trialDIABETIC MEDICINE, Issue 8 2010T. C. Skinner Diabet. Med. 27, 965,967 (2010) Abstract Aims, To describe the course of depressive symptoms during the first year after diagnosis of Type 2 diabetes. Methods,Post hoc analysis of data from a randomized controlled trial of self-management education for 824 individuals newly diagnosed with Type 2 diabetes. Participants completed the Depression scale of the Hospital Anxiety and Depression Scale after diagnosis and at 4, 8 and 12 months follow-up. Participants also completed the Problem Areas in Diabetes scale at 8 and 12 months follow-up. We present descriptive statistics on prevalence and persistence of depressive symptoms. Logistic regression is used to predict possible depression cases, and multiple regression to predict depressive symptomatology. Results, The prevalence of depressive symptoms in individuals recently diagnosed with diabetes (18,22% over the year) was not significantly different from normative data for the general population (12%) in the UK. Over 20% of participants indicated some degrees of depressive symptoms over the first year of living with Type 2 diabetes; these were mostly transient episodes, with 5% (1% severe) reporting having depressive symptoms throughout the year. At 12 months post diagnosis, after controlling for baseline depressive symptoms, diabetes-specific emotional distress was predictive of depressive symptomatology. Conclusions, The increased prevalence of depressive symptoms in diabetes is not manifest until at least 1 year post diagnosis in this cohort. However, there are a significant number of people with persistent depressive symptoms in the early stages of diabetes, and diabetes-specific distress may be contributing to subsequent development of depressive symptoms in people with Type 2 diabetes. [source] Heart failure self-management education: a systematic review of the evidenceINTERNATIONAL JOURNAL OF EVIDENCE BASED HEALTHCARE, Issue 3 2009Suzanne Austin Boren PhD MHA Abstract Objective, The objective of this systematic review is to identify educational content and techniques that lead to successful patient self-management and improved outcomes in congestive heart failure education programs. Methods, MEDLINE, CINAHL and the Cochrane Central Register of Controlled Trials, as well as reference lists of included studies and relevant reviews, were searched. Eligible studies were randomised controlled trials evaluating congestive heart failure self-management education programs with outcome measures. Two of the investigators independently abstracted descriptive information, education content topics and outcomes data. Results, A total of 7413 patients participated in the 35 eligible congestive heart failure self-management education studies. The congestive heart failure self-management programs incorporated 20 education topics in four categories: (i) knowledge and self-management (diagnosis and prognosis, pathophysiology of how congestive heart failure affects the body, aims of treatment, management and symptoms, medication review and discussion of side-effects, knowing when to access/call the general practitioner, communication with the physician, follow up for assessment or reinforcement); (ii) social interaction and support (social interaction and support, stress, depression); (iii) fluids management (sodium restriction, fluid balance, daily measurement of weight, ankle circumference, self-monitoring and compliance relative to fluids); and (iv) diet and activity (dietary assessment and instructions, physical activity and exercise, alcohol intake, smoking cessation). A total of 113 unique outcomes in nine categories (satisfaction, learning, behaviour, medications, clinical status, social functioning, mortality, medical resource utilisation and cost) were measured in the studies. Sixty (53%) of the outcomes showed significant improvement in at least one study. Conclusion, Educational interventions should be based on scientifically sound research evidence. The education topic list developed in this review can be used by patients and clinicians to prioritise and personalise education. [source] The status and perspective of diabetes health education in China: Inspiration from AustraliaINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 2 2010Anne Wilson PhD MN BN FRCNA Wilson A, Gyi AA. International Journal of Nursing Practice 2010; 16: 92,98 The status and perspective of diabetes health education in China: Inspiration from Australia This paper discusses possible approaches to improving diabetes care and developing effective education models in China based on the experience of diabetes education in Australia. The prevalence of diabetes mellitus in China is increasing rapidly. China is currently second on the list of the top 10 countries with the highest diabetes burden. Enormous impact of diabetes on China health system is daunting and the urgent action is needed. Diabetes education is the keystone of diabetes care and structured self-management education is considered to be the key to successful outcomes. Although many diabetes education programmes have been initiated in China, barriers have been identified for implementation of the programmes. These include: lack of public awareness of diabetes; lack of standards of practice for diabetes educators; and lack of evaluation programmes to assess their performance. We suggest four possible approaches to addressing the current problems of diabetes education in China. [source] | ||||||||||