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Bushey E, Wu Y, Wright A, Pescatello L. The Influence of Physical Activity and Diet Mobile Apps on Cardiovascular Disease Risk Factors: Meta-Review. J Med Internet Res 2024; 26:e51321. [PMID: 39382958 PMCID: PMC11499721 DOI: 10.2196/51321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 03/04/2024] [Accepted: 08/23/2024] [Indexed: 10/10/2024] Open
Abstract
BACKGROUND The literature on whether physical activity (PA) and PA and diet (PA+Diet) mobile apps improve cardiovascular disease (CVD) risk factors is promising. OBJECTIVE The aim of this meta-review is to provide an evidence synthesis of systematic reviews and meta-analyses examining the influence of PA and PA+Diet apps on the major CVD risk factors. METHODS We systematically searched 5 databases until January 12, 2022. Included systematic reviews and meta-analyses (1) reported the CVD risk factor outcomes of BMI, waist circumference, body weight, blood pressure (BP), hemoglobin A1c (HbA1c), fasting blood glucose, blood lipids, or PA; (2) enrolled healthy participants ≥18 years who may or may not have the metabolic syndrome, diabetes mellitus, or preexisting CVD risk factors; (3) reviewed PA or PA+Diet app interventions integrating behavioral change techniques (BCT) to deliver their information; and (4) had a nonapp control. RESULTS In total, 17 reviews (9 systematic reviews and 8 meta-analyses) published between 2012 and 2021 qualified. Participants were middle-aged, mostly women ranging in number from 10 to 62,219. Interventions lasted from 1 to 24 months, with the most common behavioral strategies being personalized feedback (n=8), self-monitoring (n=7), and goal setting (n=5). Of the PA app systematic reviews (N=4), the following CVD risk factors improved: body weight and BMI (n=2, 50%), BP (n=1, 25%), HbA1c (n=1, 25%), and blood lipids (n=1, 25%) decreased, while PA (n=4, 100%) increased. Of the PA+Diet app systematic reviews (N=5), the following CVD risk factors improved: body weight and BMI (n=3, 60%), BP (n=1, 20%), and HbA1c (n=3, 60%) decreased, while PA (n=3, 60%) increased. Of the PA app meta-analyses (N=1), the following CVD risk factors improved: body weight decreased (-0.73 kg, 95% CI -1.45 to -0.01; P=.05) and PA increased by 25 minutes/week (95% CI 0.58-1.68; P<.001), while BMI (-0.09 kg/m2, 95% CI -0.29 to 0.10; P=.35) and waist circumference (-1.92 cm, 95% CI -3.94 to 0.09; P=.06) tended to decrease. Of the PA+Diet app meta-analyses (n=4), the following CVD risk factors improved: body weight (n=4, 100%; from -1.79 kg 95% CI -3.17 to -0.41; P=.01 to -2.80 kg 95% CI -4.54 to -1.06, P=.002), BMI (n=1, 25%; -0.64 kg/m2, 95% CI -1.09 to -0.18; P=.01), waist circumference (n=1, 25%; -2.46 cm, 95% CI -4.56 to -0.36; P=.02), systolic/diastolic BP (n=1, 25%; -4.22/-2.87 mm Hg, 95% CI -6.54 to -1.91/ -4.44 to -1.29; P<.01), and HbA1c (n=1, 25%; -0.43%, 95% CI -0.68 to -0.19; P<.001) decreased. CONCLUSIONS PA and PA+Diet apps appear to be most consistent in improving PA and anthropometric measures with favorable but less consistent effects on other CVD risk factors. Future studies are needed that directly compare and better quantify the effects of PA and PA+Diet apps on CVD risk factors. TRIAL REGISTRATION PROSPERO CRD42023392359; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=392359.
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Affiliation(s)
- Erica Bushey
- University of Connecticut, Storrs, CT, United States
| | - Yin Wu
- University of Connecticut, Storrs, CT, United States
- Hartford Hospital, Hartford, CT, United States
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Xu Q, Jiang H, Li Y, Qi X, Chen L. Construction and verification of rehabilitation nursing program for shoulder and neck discomfort after thyroid cancer surgery: A pilot randomized controlled trial. Medicine (Baltimore) 2024; 103:e39291. [PMID: 39151505 PMCID: PMC11332766 DOI: 10.1097/md.0000000000039291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 07/12/2024] [Accepted: 07/23/2024] [Indexed: 08/19/2024] Open
Abstract
BACKGROUND To develop a nursing program for the prevention and rehabilitation of shoulder and neck discomfort after thyroid cancer surgery based on the empowerment theory, and to evaluate the application effect of the program. METHODS The prevention and rehabilitation nursing program for shoulder and neck discomfort after thyroid cancer surgery was established by literature review and the Delphi method. Between July 2022 and January 2023, a total of 62 postoperative thyroid cancer patients were recruited and randomly allocated to either the intervention group (n = 31) or the control group (n = 31) in this randomized controlled trial. Comparisons of shoulder and neck function, self-efficacy, and quality of life between the 2 groups were performed using a 2-sample independent t test, Wilcoxon rank-sum test, and repeated-measures analysis of variance. RESULTS At the end of the study, the control group and intervention group were 30 cases each completed the study. After the intervention, the self-efficacy score of the intervention group was higher than the control group (P < .05), and the score of emotional function, cognitive function, and overall health dimension of the intervention group was higher than the control group (P < .05). The pain dimension score of the intervention group was lower than the control group (P < .05). There were significant differences in the group and time effects of the total shoulder joint scores between the 2 groups (P < .05). CONCLUSION This study demonstrated that the shoulder and neck rehabilitation nursing program can alleviate the symptoms of shoulder and neck discomfort and improve patients' self-efficacy and quality of life.
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Affiliation(s)
- Qiuqin Xu
- Xiamen Hospital, Beijing University of Chinese Medicine, Xiamen, China
- Xiamen TCM Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Xiamen, China
| | - Hongzhan Jiang
- School of Nursing, Beijing University of Chinese Medicine, Beijing, China
| | - Yuanchan Li
- Zunyi Hospital of Traditional Chinese Medicine, Zunyi, China
| | - Xiushan Qi
- Xiamen Hospital, Beijing University of Chinese Medicine, Xiamen, China
| | - Lijuan Chen
- Department of General Surgery, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
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Chattopadhyay A, Tak H, Anirudh J, Naick BH. Meta-analysis of Circulatory mitomiRs in stress Response: Unveiling the significance of miR-34a and miR-146a. Gene 2024; 912:148370. [PMID: 38490506 DOI: 10.1016/j.gene.2024.148370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 02/21/2024] [Accepted: 03/11/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND MicroRNAs (miRNAs) are short, noncoding RNAs with essential roles in cellular pathways and are often associated with various diseases and stress conditions. Recently, they have been discovered in mitochondria, termed "mitomiRs," with unique functions. Mitochondria, crucial organelles for energy production and stress responses, Dysregulated mitomiRs functions and expression has been evident in stress conditions such as cardiovascular and neurodegenerative. In this meta-analysis we have systematically identified miR-34a & miR-146a as possible potential biomarkers for affliction. METHODS A meta-analysis was conducted to assess the potential role of miR-34a and miR-146a, two specific mitomiRs, as biomarkers in stress-related conditions. The study followed PRISMA guidelines, involving comprehensive database searches in May and September 2023. Twelve studies meeting predefined inclusion criteria were selected, and data analysis included the evaluation of miR-34a and miR-146a expression levels in various stress conditions compared to control groups. We also performed Gene ontology (GO) and Pathway enrichment analysis to observe how mitomiRs affects our body. RESULTS The meta-analysis revealed a significant increase in overall mitomiRs (miR-34a and miR-146a) expression levels in experimental groups experiencing different stress conditions compared to control groups (Z = 3.54, p < 0.05 using RevMan software). miR-34a demonstrated more pronounced upregulation and exhibited potential as a specific biomarker in certain stress-related conditions (Z = 2.22, p < 0.05). However, miR-146a did not show a significant difference, requiring further investigation in various stress-related contexts. The Analysis indicated a high degree of heterogeneity among the studies. CONCLUSION This meta-analysis emphasises the importance of mitomiRs, especially miR-34a, as potential biomarkers in the intricate interplay between stress, mitochondrial function, and disease. The study opens new avenues for exploring miRNAs' diagnostic and therapeutic applications in stress-related diseases, highlighting their pivotal role at the crossroads of molecular biology, psychology, and medicine.
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Affiliation(s)
| | - Harshita Tak
- Department of Sports Biosciences, Central University of Rajasthan, India
| | - Jivanage Anirudh
- Department of Sports Biosciences, Central University of Rajasthan, India
| | - B Hemanth Naick
- Department of Sports Biosciences, Central University of Rajasthan, India.
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Virtič Potočnik T, Ružić Gorenjec N, Mihevc M, Zavrnik Č, Mori Lukančič M, Poplas Susič A, Klemenc-Ketiš Z. Person-Centred Diabetes Care: Examining Patient Empowerment and Diabetes-Specific Quality of Life in Slovenian Adults with Type 2 Diabetes. Healthcare (Basel) 2024; 12:899. [PMID: 38727456 PMCID: PMC11083539 DOI: 10.3390/healthcare12090899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 04/22/2024] [Accepted: 04/23/2024] [Indexed: 05/13/2024] Open
Abstract
Patient empowerment is crucial for promoting and strengthening health. We aimed to assess patient empowerment and diabetes-specific health-related quality of life (HRQoL) in adults with type 2 diabetes (T2D). A multi-centre, cross-sectional survey was conducted among adults with T2D in urban and rural primary care settings in Slovenia between April and September 2023. The survey utilised convenience sampling and included sociodemographic and clinical data, the Diabetes Empowerment Scale (DES), and the Audit of Diabetes-Dependent QoL (ADDQoL). The study included 289 people with T2D and a mean age of 67.2 years (SD 9.2). The mean overall DES score was 3.9/5 (SD 0.4). In a multivariable linear regression model, higher empowerment was significantly associated with residing in a rural region (p = 0.034), higher education (p = 0.028), and a lack of comorbid AH (p = 0.016). The median overall ADDQoL score was -1.2 (IQR [-2.5, -0.6]). The greatest negative influence of diabetes on HRQoL was observed in the domain 'Freedom to eat', followed by 'Freedom to drink', 'Leisure activities', and 'Holidays'. Despite high empowerment among adults with T2D, the condition still imposes a personal burden. Integrated primary care models should prioritise the importance of implementing targeted interventions to enhance diabetes empowerment, address comorbidities, and improve specific aspects of QoL among individuals with T2D.
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Affiliation(s)
- Tina Virtič Potočnik
- Primary Healthcare Research and Development Institute, Community Health Centre Ljubljana, Metelkova ulica 9, SI-1000 Ljubljana, Slovenia; (N.R.G.); (M.M.); (Č.Z.); (M.M.L.); (A.P.S.); (Z.K.-K.)
- Department of Family Medicine, Faculty of Medicine, University of Maribor, Taborska ulica 8, SI-2000 Maribor, Slovenia
- Community Health Centre Slovenj Gradec, Partizanska 16, SI-2380 Slovenj Gradec, Slovenia
| | - Nina Ružić Gorenjec
- Primary Healthcare Research and Development Institute, Community Health Centre Ljubljana, Metelkova ulica 9, SI-1000 Ljubljana, Slovenia; (N.R.G.); (M.M.); (Č.Z.); (M.M.L.); (A.P.S.); (Z.K.-K.)
- Institute for Biostatistics and Medical Informatics, Faculty of Medicine, University of Ljubljana, Vrazov trg 2, SI-1000 Ljubljana, Slovenia
| | - Matic Mihevc
- Primary Healthcare Research and Development Institute, Community Health Centre Ljubljana, Metelkova ulica 9, SI-1000 Ljubljana, Slovenia; (N.R.G.); (M.M.); (Č.Z.); (M.M.L.); (A.P.S.); (Z.K.-K.)
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Poljanski nasip 58, SI-1000 Ljubljana, Slovenia
| | - Črt Zavrnik
- Primary Healthcare Research and Development Institute, Community Health Centre Ljubljana, Metelkova ulica 9, SI-1000 Ljubljana, Slovenia; (N.R.G.); (M.M.); (Č.Z.); (M.M.L.); (A.P.S.); (Z.K.-K.)
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Poljanski nasip 58, SI-1000 Ljubljana, Slovenia
| | - Majda Mori Lukančič
- Primary Healthcare Research and Development Institute, Community Health Centre Ljubljana, Metelkova ulica 9, SI-1000 Ljubljana, Slovenia; (N.R.G.); (M.M.); (Č.Z.); (M.M.L.); (A.P.S.); (Z.K.-K.)
| | - Antonija Poplas Susič
- Primary Healthcare Research and Development Institute, Community Health Centre Ljubljana, Metelkova ulica 9, SI-1000 Ljubljana, Slovenia; (N.R.G.); (M.M.); (Č.Z.); (M.M.L.); (A.P.S.); (Z.K.-K.)
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Poljanski nasip 58, SI-1000 Ljubljana, Slovenia
| | - Zalika Klemenc-Ketiš
- Primary Healthcare Research and Development Institute, Community Health Centre Ljubljana, Metelkova ulica 9, SI-1000 Ljubljana, Slovenia; (N.R.G.); (M.M.); (Č.Z.); (M.M.L.); (A.P.S.); (Z.K.-K.)
- Department of Family Medicine, Faculty of Medicine, University of Maribor, Taborska ulica 8, SI-2000 Maribor, Slovenia
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Poljanski nasip 58, SI-1000 Ljubljana, Slovenia
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Timmermans L, Golder E, Decat P, Foulon V, Van Hecke A, Schoenmakers B. Characteristics of self-management support (SMS) interventions and their impact on Quality of Life (QoL) in adults with chronic diseases: An umbrella review of systematic reviews. Health Policy 2023; 135:104880. [PMID: 37536047 DOI: 10.1016/j.healthpol.2023.104880] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 07/06/2023] [Accepted: 07/20/2023] [Indexed: 08/05/2023]
Abstract
OBJECTIVE To provide an overview of types and characteristics of self-management support (SMS) interventions in adults with chronic disease and to assess the impact on the patient reported outcome Quality of Life (QoL). METHODS An umbrella review of systematic reviews was conducted. We searched PubMed, Embase, Web of Science, CINAHL and the Cochrane Library from January 2016 to November 2020 for reviews on SMS interventions for chronic diseases, assessing the impact on the patient reported outcome QoL. Quality assessment was based on the JBI Critical Appraisal Checklist for Systematic reviews and Research Syntheses tool. RESULTS 28 reviews were included. The extensive literature review revealed a variety of SMS interventions. The most frequently cited target group for the interventions were individuals with diabetes. Interventions primarily took place in the home setting. Interventional components that were often incorporated were education, eHealth and mHealth technologies, and coaching techniques. Telephone communication was regularly reported as a type of intervention follow-up. The impact on QoL was mixed and no firm conclusions can be drawn. However, our review revealed a beneficial effect of education. CONCLUSIONS AND PRACTICAL IMPLICATIONS Interventions including educational components seem promising for supporting self-management and showed a beneficial effect on QoL. More research is needed to explore where, by whom and how interventions are ideally delivered.
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Affiliation(s)
- Lotte Timmermans
- Academic Centre of General Practice, KU Leuven, Kapucijnenvoer 7 -Box 7001, Leuven 3000 Belgium.
| | - Elena Golder
- Health and Wellbeing, Plymouth Marjon University, Plymouth, UK
| | - Peter Decat
- General Practice and Primary Health Care, Ghent University, Ghent, Belgium
| | - Veerle Foulon
- Clinical Pharmacology and Pharmacotherapy, KU Leuven, Leuven, Belgium
| | - Ann Van Hecke
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; Staff Member of the Department Nursing Director, Ghent University Hospital, Ghent, Belgium
| | - Birgitte Schoenmakers
- Academic Centre of General Practice, KU Leuven, Kapucijnenvoer 7 -Box 7001, Leuven 3000 Belgium
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Stepanian N, Larsen MH, Mendelsohn JB, Mariussen KL, Heggdal K. Empowerment interventions designed for persons living with chronic disease - a systematic review and meta-analysis of the components and efficacy of format on patient-reported outcomes. BMC Health Serv Res 2023; 23:911. [PMID: 37626346 PMCID: PMC10463815 DOI: 10.1186/s12913-023-09895-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Empowerment approaches are essential for building the capacity of individuals with chronic disease to be in control of their health. Reviews of empowerment interventions have been focused on specific chronic diseases, thereby limiting the scope of findings. This study had three aims: 1) to describe the characteristics of empowerment interventions covering a broad range of chronic diseases, 2) to clarify consistency with the World Health Organization`s (WHO) definition of empowerment as a process composed of four fundamental components and 3) to summarize outcome measures and estimate the effects in group and individual intervention formats. METHODS Systematic literature review and meta-analysis. CINAHL, Medline, Embase, PsycINFO, Web of Science, COCHRANE and Central Register of Controlled Trials were searched using Chronic Disease, NCD, Empowerment, as MeSH terms. Eligible randomized and quasi randomized controlled trials were included. Review Manager 5.4 was used to conduct the meta-analysis. Risk of bias was assessed with the Cochrane risk-of-bias tool (ROB 2). RESULTS Thirty-nine articles representing 8,011 participants were included in the review. A majority (82%) of studies reported robust evidence for changes on study-defined outcome measures in favor of interventions. Intervention content was assessed against WHO's four fundamental components of empowerment, showing that all studies incorporated one component, but none targeted all components. Components reflecting knowledge acquisition, patient engagement with their health care providers and facilitating environment were scarcely reported. Meta-analyses found evidence for positive effects of group-format interventions measuring empowerment, HbA1c, and self-efficacy. Effects on empowerment were also found in some individual-format interventions. High levels of heterogeneity and variability among the conceptual frameworks were identified. CONCLUSION Empowerment interventions in group-format were most efficient, however, considerable conceptual inconsistencies were identified. Future studies should consolidate conceptual understandings by using WHO's empowerment framework to ensure that fundamental components of empowerment are explicitly included in intervention design. Furthermore, there is a need to clarify the role of empowerment through pathways that include patient activation, self- management, and clinical outcomes. This systematic review will inform the clinicians and researchers who aim to develop novel empowerment interventions to assist patients in the process of gaining control of their health. TRIAL REGISTRATION PROSPERO: International Prospective register of systematic reviews ID=CRD42020178286.
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Affiliation(s)
- Natalie Stepanian
- College of Health Professions, Pace University, One Pace Plaza, New York, NY, 10038, USA
| | | | - Joshua B Mendelsohn
- College of Health Professions, Pace University, One Pace Plaza, New York, NY, 10038, USA
| | - Kari L Mariussen
- Lovisenberg Diaconal University College, Lovisenberggaten 15, 0456, Oslo, Norway
| | - Kristin Heggdal
- Faculty of Health, VID Specialized University, Theodor Dahls Vei 10, 0370, Oslo, Norway.
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Bosma R, Bisson EJ, Cooper LK, Salomons TV, Galica J, Wilson R. Experience-based design: Empowering individuals while they wait for interprofessional chronic pain care. PATIENT EDUCATION AND COUNSELING 2023; 109:107623. [PMID: 36640452 DOI: 10.1016/j.pec.2023.107623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
OBJECTIVES Chronic pain is highly prevalent and a leading cause of disability. Long wait times for interprofessional care provide an opportunity to introduce web-based interventions that improve psychosocial function and patients' readiness and ability to manage their condition. Here we describe the process of partnering with people with lived experience (PWLE) to develop an online self-management program enhanced by motivational interviewing. We also report the multiphase usability testing of the program. METHODS PWLE were included in all aspects of this project from program inception to content creation, module development, usability testing, and knowledge dissemination. Phase 1 included the development of the interactive, web-based modules. This process involved weekly meetings and asynchronous content creation with a core team of interprofessional pain experts, researchers, and PWLE. Phase 2 included usability testing by our PWLE and clinical expert advisory. Phase 3 included survey-based usability testing with a sample of 10 PWLE. RESULTS We created a chronic pain & motivational empowerment program includes a series of eight interactive educational web-based modules. Topics included: setting expectations, chronic pain explained, biopsychosocial factors, empowered management, self-awareness & compassion & acceptance, values, goal setting, and communication. The program is accompanied by a reflection journal and can be enhanced by one-on-one coaching sessions using a motivational interviewing approach. Phase two usability testing resulted in numerous content changes and the addition of accessibility features. Phase 3 usability testing with PWLE found the program highly accessible and easy to use. CONCLUSIONS The engagement of our PWLE team member and advisors made the online program more relevant, sensitive and helpful to the needs of people with pain. PRACTICAL VALUE This PWLE-centric project sets the foundation for future work to examine the feasibility and effectiveness of the program for supporting individuals with chronic pain self-manage.
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Affiliation(s)
- Rachael Bosma
- Toronto Academic Pain Medicine Institute, Women's College Hospital, Toronto, Canada.
| | - Etienne J Bisson
- Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, Ontario, Canada
| | - Lynn K Cooper
- Person with Lived Experience, Canadian Injured Workers Alliance, Canada
| | - Tim V Salomons
- Department of Psychology, Queen's University, Kingston, Canada
| | - Jacqueline Galica
- School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, Canada
| | - Rosemary Wilson
- Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, Ontario, Canada; School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, Canada
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Eskolin SE, Inkeroinen S, Leino-Kilpi H, Virtanen H. Instruments for measuring empowering patient education competence of nurses: Systematic review. J Adv Nurs 2023. [PMID: 36808623 DOI: 10.1111/jan.15597] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 01/04/2023] [Accepted: 02/05/2023] [Indexed: 02/23/2023]
Abstract
AIM This review aimed to identify validated self-reported instruments used to measure nurses' competence or attribute(s) of competence in empowering patient education, to describe their development and main content and critically appraise and summarize the quality of the instruments. DESIGN Systematic review. DATA SOURCES Electronic databases of PubMed, CINAHL and ERIC were searched from January 2000 to May 2022. REVIEW METHODS Data was extracted following predetermined inclusion criteria. With the support of the research group, two researchers performed data selection and appraised the methodological quality using the COnsensus-based Standards for the selection of health status Measurement INstruments checklist (COSMIN). RESULTS A total of 19 studies reporting 11 instruments were included. The instruments measured varied attributes of competence and the contents were heterogenous reflecting the complex nature of both empowerment and competence as concepts. Overall, the reported psychometric properties of the instruments and methodological quality of the studies were at least adequate. However, there was variation in the testing of the instruments' psychometric properties and lack of evidence limited the evaluation of both the methodological quality of the studies and quality of instruments. CONCLUSION The psychometric properties of the existing instruments assessing nurses' competence in empowering patient education need to be tested further, and future instrument development should be built on a clearer definition of empowerment as well as on more rigorous testing and reporting. In addition, continued efforts to clarify and define both empowerment and competence on the conceptual level are needed. IMPACT Evidence on nurses' competence in empowering patient education and its valid and reliable assessment instruments is scarce. Existing instruments are heterogenous and are often missing proper testing of validity and reliability. These findings contribute to further research on developing and testing the instruments of competence in empowering patient education and strengthening nurses' empowering patient education competence in the clinical practice.
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Affiliation(s)
| | - Saija Inkeroinen
- Department of Nursing Sciences, University of Turku, Turku, Finland
| | - Helena Leino-Kilpi
- Department of Nursing Sciences, University of Turku, Turku, Finland.,Turku University Hospital, Turku, Finland
| | - Heli Virtanen
- Department of Nursing Sciences, University of Turku, Turku, Finland
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Han Y, Syed Ali SKB, Ji L. Feedback for Promoting Motor Skill Learning in Physical Education: A Trial Sequential Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15361. [PMID: 36430079 PMCID: PMC9690366 DOI: 10.3390/ijerph192215361] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/12/2022] [Accepted: 11/19/2022] [Indexed: 06/16/2023]
Abstract
Feedback can be used as an effective teaching method in physical education (PE) to promote students' learning of motor skills. However, there is no objective synthetic evidence to support the role of feedback in PE. Additionally, the effect of each feedback subtype on students' motor skill learning is still unclear. This study aimed to conduct a meta-analysis and trial sequential analysis (TSA) to evaluate the effects of feedback and feedback subtypes on students' motor skill learning. Nine databases were searched through September 2022 to identify appropriate literature. Meta-analysis was conducted using Review Manager 5.4 software and TSA was performed using TSA version 0.9.5.10 beta software. Fifteen studies were included. Feedback significantly improved students' motor skill learning in PE (SMD 0.47; 95% CI 0.01, 0.93; Z = 2.02; p = 0.04). The TSA confirmed the result of the meta-analysis. Sensitivity analyses showed that the subtypes of feedback, including visual feedback, visual combined verbal feedback, visual self-model, visual expert model, corrective feedback, and teacher-regulated feedback, significantly improved students' learning of motor skills. In contrast, verbal, evaluative, and informational feedback did not produce changes in motor skill learning. Both complex and simple motor skills were improved by feedback. The use of feedback in PE benefits motor skill learning, regardless of whether the motor skills are complex or simple.
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Affiliation(s)
- Yankun Han
- Faculty of Education, University of Malaya, Kuala Lumpur 50603, Malaysia
| | | | - Lifu Ji
- College of Physical Education, Jilin Normal University, Siping 136000, China
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Duarte-Díaz A, González-Pacheco H, Rivero-Santana A, Ramallo-Fariña Y, Perestelo-Pérez L, Peñate W, Carrion C, Serrano-Aguilar P. Factors associated with patient empowerment in Spanish adults with type 2 diabetes: A cross-sectional analysis. Health Expect 2022; 25:2762-2774. [PMID: 36047480 DOI: 10.1111/hex.13501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 03/14/2022] [Accepted: 04/02/2022] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE The aim of the present study is to identify factors associated with patient empowerment in people living with type 2 diabetes mellitus (T2DM) in the Canary Islands (Spain). METHODS Secondary cross-sectional analysis was carried out of data obtained in the INDICA study: A 24-month cluster randomized-controlled trial evaluating the effectiveness of educational interventions supported by new technology decision tools for T2DM patients. Sociodemographic variables, clinical data (years since diagnosis, glycated haemoglobin level, creatine, triglycerides, waist hip index, body mass index and number of comorbidities), diabetes knowledge (DIATEK), affective outcomes (Beck Depression Inventory-II, the State subscale of the State-Trait Anxiety Inventory and The Diabetes Distress Scale) and diabetes-related quality of life (The Audit of Diabetes-Dependent Quality of life) were assessed as potential correlates of patient empowerment, assessed using the Diabetes Empowerment Scale-Short Form. Multilevel mixed linear regression models on patient empowerment were developed. RESULTS The analysis included the baseline data of 2334 patients. Results showed that age (B = -0.14; p < .001), diabetes knowledge (B = 0.61; p < .001) and state-anxiety (B = -0.09; p < .001) are significantly associated with patient empowerment. Sex, education level, living alone, employment status, country of birth, time since diagnosis, number of comorbidities, glycated haemoglobin level, depression and distress were not independently associated with patient empowerment in the multivariate analyses. CONCLUSION Younger age, lower state-anxiety and greater diabetes-specific knowledge are important correlates of patient empowerment. In line with the results of the INDICA study, interventions based on patient-centred care might be effective in improving patient empowerment in adults with T2DM. Understanding the factors associated with empowerment may help clinicians and policymakers to identify high-risk groups, prioritize resources and target evidence-based interventions to better support people with T2DM to be actively involved in their own care. PATIENT OR PUBLIC CONTRIBUTION Patients with T2DM were actively involved in the design of the INDICA study. Two patient associations were included as part of the research team and actively participated in designing the interventions and selecting outcome measures.
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Affiliation(s)
- Andrea Duarte-Díaz
- Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain.,Department of Clinical Psychology, Psychobiology and Methodology, University of La Laguna (ULL), Tenerife, Spain
| | | | - Amado Rivero-Santana
- Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain.,Research Network on Health Services in Chronic Diseases (REDISSEC), Tenerife, Spain.,Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
| | - Yolanda Ramallo-Fariña
- Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain.,Research Network on Health Services in Chronic Diseases (REDISSEC), Tenerife, Spain.,Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
| | - Lilisbeth Perestelo-Pérez
- Research Network on Health Services in Chronic Diseases (REDISSEC), Tenerife, Spain.,Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain.,Evaluation Unit (SESCS), Canary Islands Health Service (SCS), Tenerife, Spain
| | - Wenceslao Peñate
- Department of Clinical Psychology, Psychobiology and Methodology, University of La Laguna (ULL), Tenerife, Spain
| | - Carme Carrion
- Evaluation Unit (SESCS), Canary Islands Health Service (SCS), Tenerife, Spain.,eHealth Lab Research Group, School of Health Sciences, Universitat Oberta de Catalunya (UOC), Barcelona, Spain
| | - Pedro Serrano-Aguilar
- Research Network on Health Services in Chronic Diseases (REDISSEC), Tenerife, Spain.,Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain.,Evaluation Unit (SESCS), Canary Islands Health Service (SCS), Tenerife, Spain
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11
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Greenwood DA, Litchman ML, Isaacs D, Blanchette JE, Dickinson JK, Hughes A, Colicchio VD, Ye J, Yehl K, Todd A, Peeples MM. A New Taxonomy for Technology-Enabled Diabetes Self-Management Interventions: Results of an Umbrella Review. J Diabetes Sci Technol 2022; 16:812-824. [PMID: 34378424 PMCID: PMC9264439 DOI: 10.1177/19322968211036430] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND A 2017 umbrella review defined the technology-enabled self-management (TES) feedback loop associated with a significant reduction in A1C. The purpose of this 2021 review was to develop a taxonomy of intervention attributes in technology-enabled interventions; review recent, high-quality systematic reviews and meta-analyses to determine if the TES framework was described and if elements contribute to improved diabetes outcomes; and to identify gaps in the literature. METHODS We identified key technology attributes needed to describe the active ingredients of TES interventions. We searched multiple databases for English language reviews published between April 2017 and April 2020, focused on PwD (population) receiving diabetes care and education (intervention) using technology-enabled self-management (comparator) in a randomized controlled trial, that impact glycemic, behavioral/psychosocial, and other diabetes self-management outcomes. AMSTAR-2 guidelines were used to assess 50 studies for methodological quality including risk of bias. RESULTS The TES Taxonomy was developed to standardize the description of technology-enabled interventions; and ensure research uses the taxonomy for replication and evaluation. Of the 26 included reviews, most evaluated smartphones, mobile applications, texting, internet, and telehealth. Twenty-one meta-analyses with the TES feedback loop significantly lowered A1C. CONCLUSIONS Technology-enabled diabetes self-management interventions continue to be associated with improved clinical outcomes. The ongoing rapid adoption and engagement of technology makes it important to focus on uniform measures for behavioral/psychosocial outcomes to highlight healthy coping. Using the TES Taxonomy as a standard approach to describe technology-enabled interventions will support understanding of the impact technology has on diabetes outcomes.
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Affiliation(s)
| | | | - Diana Isaacs
- Cleveland Clinic Diabetes Center,
Cleveland, OH, USA
| | | | | | | | | | - Jiancheng Ye
- Northwestern University Feinberg School
of Medicine, Chicago, IL, USA
| | - Kirsten Yehl
- Association of Diabetes Care &
Education Specialists, Chicago, IL, USA
| | - Andrew Todd
- University of Central Florida, College
of Nursing, University Tower, Orlando, FL, USA
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12
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Castro R, Ribeiro-Alves M, Oliveira C, Romero CP, Perazzo H, Simjanoski M, Kapciznki F, Balanzá-Martínez V, De Boni RB. What Are We Measuring When We Evaluate Digital Interventions for Improving Lifestyle? A Scoping Meta-Review. Front Public Health 2022; 9:735624. [PMID: 35047469 PMCID: PMC8761632 DOI: 10.3389/fpubh.2021.735624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 11/29/2021] [Indexed: 01/07/2023] Open
Abstract
Background: Lifestyle Medicine (LM) aims to address six main behavioral domains: diet/nutrition, substance use (SU), physical activity (PA), social relationships, stress management, and sleep. Digital Health Interventions (DHIs) have been used to improve these domains. However, there is no consensus on how to measure lifestyle and its intermediate outcomes aside from measuring each behavior separately. We aimed to describe (1) the most frequent lifestyle domains addressed by DHIs, (2) the most frequent outcomes used to measure lifestyle changes, and (3) the most frequent DHI delivery methods. Methods: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-ScR) Extension for Scoping Reviews. A literature search was conducted using MEDLINE, Cochrane Library, EMBASE, and Web of Science for publications since 2010. We included systematic reviews and meta-analyses of clinical trials using DHI to promote health, behavioral, or lifestyle change. Results: Overall, 954 records were identified, and 72 systematic reviews were included. Of those, 35 conducted meta-analyses, 58 addressed diet/nutrition, and 60 focused on PA. Only one systematic review evaluated all six lifestyle domains simultaneously; 1 systematic review evaluated five lifestyle domains; 5 systematic reviews evaluated 4 lifestyle domains; 14 systematic reviews evaluated 3 lifestyle domains; and the remaining 52 systematic reviews evaluated only one or two domains. The most frequently evaluated domains were diet/nutrition and PA. The most frequent DHI delivery methods were smartphone apps and websites. Discussion: The concept of lifestyle is still unclear and fragmented, making it hard to evaluate the complex interconnections of unhealthy behaviors, and their impact on health. Clarifying this concept, refining its operationalization, and defining the reporting guidelines should be considered as the current research priorities. DHIs have the potential to improve lifestyle at primary, secondary, and tertiary levels of prevention-but most of them are targeting clinical populations. Although important advances have been made to evaluate DHIs, some of their characteristics, such as the rate at which they become obsolete, will require innovative research designs to evaluate long-term outcomes in health.
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Affiliation(s)
- Rodolfo Castro
- Escola Nacional de Saúde Pública Sergio Arouca, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
- Instituto de Saúde Coletiva, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcelo Ribeiro-Alves
- Instituto Nacional de Infectologia Evandro Chagas, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | - Cátia Oliveira
- Centro de Desenvolvimento Tecnológico em Saúde, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | - Carmen Phang Romero
- Centro de Desenvolvimento Tecnológico em Saúde, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | - Hugo Perazzo
- Instituto Nacional de Infectologia Evandro Chagas, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | - Mario Simjanoski
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Flavio Kapciznki
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Vicent Balanzá-Martínez
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, CIBERSAM, Valencia, Spain
| | - Raquel B. De Boni
- Institute of Scientific and Technological Communication and Information in Health, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
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13
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Kim J, Shin N. Concept Analysis of the Empowerment of Patients With Coronary Artery Disease Using a Hybrid Model. ANS Adv Nurs Sci 2022; 45:E31-E46. [PMID: 34225284 DOI: 10.1097/ans.0000000000000368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
This study aimed to conceptualize the empowerment of patients with coronary artery disease (CAD) using a hybrid model. In the final phase, "perceived competence and knowledge on lifestyle management," "sense of control of one's own health care," "self-acceptance to change," and "motivation for voluntary behavior" were identified as intrapersonal aspects; "information search," "active communication between patients and health care professionals," and "supportive relationships" were identified as interactional aspects; "self-management in one's life" and "coping behavior with disease" were identified as behavioral aspects. A concept accurately reflecting CAD characteristics may facilitate the implementation of risk factor management.
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Affiliation(s)
- Jiyoung Kim
- Department of Nursing, Sangmyung University, Cheonan-si, Chungcheongnam-do, South Korea (Dr Kim); and Department of Nursing, CHA University, CHA Bundang Medical Center, Seongnamsi, Gyeonggido, South Korea (Dr Shin)
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14
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Ren Q, Shi S, Yan C, Liu Y, Han W, Lin M, He H, Shen Q. Self-Management Micro-Video Health Education Program for Hemodialysis Patients. Clin Nurs Res 2021; 31:1148-1157. [PMID: 34282644 DOI: 10.1177/10547738211033922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Self-management in hemodialysis patients is critical; however, is generally low. This study aimed to examine the effects of a theory-based micro-video health education program on the improvement of self-management, hemodialysis knowledge, and self-efficacy in hemodialysis patients. A pre-test post-test control group quasi-experimental design was used to recruit 80 hemodialysis patients in a dialysis center. The participants were assigned in a 1:1 ratio to receive routine care or a 3-month micro-video health education program. Between-group comparison showed that patients in the intervention group had significantly greater improvement in hemodialysis knowledge than those in the control group (p < .05). However, no significant group differences were observed in terms of self-management and self-efficacy. Within-group comparison showed that the overall self-management level of patients in both groups improved significantly, particularly in problem-solving skills and self-care dimensions. Therefore, micro-video health education can improve the self-management and hemodialysis knowledge in Chinese patients undergoing hemodialysis.Trial Registration: Registered at ClinicalTrials.gov with study number (ChiCTR1800018172; http://www.chictr.org.cn/index.aspx).
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Affiliation(s)
- Qingli Ren
- Xiamen University, Fujian, China.,Shanxi Medical University, Taiyuan, China
| | - Suhua Shi
- Xiamen University Affiliated Chenggong Hospital, Fujian, China
| | - Chen Yan
- Xiamen University, Fujian, China
| | - Yang Liu
- Xiamen University, Fujian, China
| | - Wei Han
- Zhongshan Hospital Xiamen University, Fujian, China
| | - Min Lin
- Xiamen University Affiliated Chenggong Hospital, Fujian, China
| | - Honggu He
- National University of Singapore, Singapore
| | - Qu Shen
- Xiamen University, Fujian, China
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15
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Mellergård E, Johnsson P, Eek F. Developing a web-based support using self-affirmation to motivate lifestyle changes in type 2 diabetes: A qualitative study assessing patient perspectives on self-management and views on a digital lifestyle intervention. Internet Interv 2021; 24:100384. [PMID: 33912400 PMCID: PMC8056219 DOI: 10.1016/j.invent.2021.100384] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 03/12/2021] [Accepted: 03/17/2021] [Indexed: 01/31/2023] Open
Abstract
AIMS The aim of the present study was to explore patients' experiences of diabetes self-management and views on a digital lifestyle intervention using self-affirmation to motivate lifestyle changes. METHODS Semi-structured interviews focusing on needs, attitudes, and barriers to diabetes self-management were conducted with 22 individuals with type 2 diabetes recruited from the All New Diabetics in Scania (ANDIS) cohort. The interviews were followed by three additional study visits, where participants gave feedback on computer-based assignments based on self-affirmation. Interviews and feedback were qualitatively analyzed using thematic analysis. RESULTS Participants described a range of barriers to diabetes self-management, and a varying sense of urgency and distress related to diabetes management. A need for accessible, reliable, and relevant information was reported, as well as a sense that required lifestyle changes was incompatible with current life situation. Further, the use of self-affirmation was described as relevant, motivating and engaging. CONCLUSIONS Barriers to diabetes self-management need to be addressed when supporting diabetes self-management, e.g. through carefully matching the support to the patient's readiness to change, supporting patient autonomy and focusing on long-term changes. Using self-affirmation may raise acceptability of a digital lifestyle intervention and help connect diabetes self-management with overall life context, by guiding the patient to focus on personal relevance.
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Affiliation(s)
- Emelia Mellergård
- Department of Health Sciences, Faculty of Medicine, Lund University, Margaretavägen 1B, 222 40 Lund, Sweden,Corresponding author at: Department of Health Sciences, Lund University, Box 157, 22100 Lund, Sweden.
| | - Per Johnsson
- Department of Psychology, Faculty of Social Sciences, Lund University, Allhelgona kyrkogata 16a, 223 62 Lund, Sweden
| | - Frida Eek
- Department of Health Sciences, Faculty of Medicine, Lund University, Margaretavägen 1B, 222 40 Lund, Sweden
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16
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Cuevas H, Carter S. Nurse-Talk Ratios as a Measure of Participation in a Cognitive Rehabilitation Intervention for People With Type 2 Diabetes. Res Theory Nurs Pract 2021; 35:67-81. [PMID: 33632923 DOI: 10.1891/rtnp-d-19-00130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Comprehensive cognitive rehabilitation teaches strategies to enhance strengths and has been used by nurses to target cognitive problems in chronic conditions. However, to date, no evaluations of web-based cognitive rehabilitation, based in empowerment theory, specifically for people with type 2 diabetes (T2DM), have been done. PURPOSE The purpose of this study was to analyze a cognitive rehabilitation intervention for people with T2DM, using qualitative content analysis and 10-second event coding to determine to what extent the classes reflected empowerment theory. METHODS Nineteen adults with T2DM and two nurses participated in an 8-week intervention that combined webinar classes with online home-based computer training. Classes were audio recorded and 10-second event coding was used to calculate nurse-talk ratios. Transcripts were examined using content analysis and compared with the talk ratios. RESULTS Talk ratios ranged from 40% to 74% for each class. Qualitative themes included (a) importance of goal setting; (b) pairing cognitive strategies with diabetes self-management; (c) experience and information sharing; and (d) validation by healthcare providers. Positive participant outcomes related to empowerment were associated with low nurse-talk ratios in some classes. However, high nurse-talk ratios were associated with factual content that participants also considered valuable. IMPLICATIONS FOR PRACTICE Talk ratios did not completely reflect the communication skills of the nurse. The 10-second method should be applied to other educational interventions in combination with qualitative analysis. Future interventions should include components of discourse evaluation and examinations of relationships to adherence and clinical outcomes.
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Affiliation(s)
- Heather Cuevas
- School of Nursing, The University of Texas at Austin, Austin, TX
| | - Sharon Carter
- School of Nursing, The University of Texas at Austin, Austin, TX
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17
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Lippke S, Dahmen A, Gao L, Guza E, Nigg CR. To What Extent is Internet Activity Predictive of Psychological Well-Being? Psychol Res Behav Manag 2021; 14:207-219. [PMID: 33642884 PMCID: PMC7903968 DOI: 10.2147/prbm.s274502] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 01/22/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Healthy internet activity (eg, making use of eHealth and online therapy) is positively associated with well-being. However, unhealthy internet activity (too much online time, problematic internet use/PIU, internet dependency/ID, etc.) is associated with reduced well-being, loneliness, and other related negative aspects. While most of the evidence is correlational, some research also shows that internet activity can be predictive for well-being. OBJECTIVE The aim of this article is to elaborate on the question as to what extent internet activity is predictive of psychological well-being by means of (a) a scoping review and (b) theoretical understanding which model the interrelation of internet activity and psychological well-being. METHODOLOGY We searched different electronic databases such as Web of Science by using the search terms "Internet" OR "App" OR "digital" OR "online" OR "mobile application" AND "Use" OR "Activity" OR "Behavior" OR "Engagement" AND "Well-being" OR "Loneliness" for (a, the scoping review) or CCAM for (b, the theoretical understanding). RESULTS The scoping review (a) summarizes recent findings: the extent to which internet activity is predictive for well-being depends on the internet activity itself: internet activity facilitating self-management is beneficial for well-being but too much internet activity, PIU and ID are detrimental to well-being. To understand (b) why, when and how internet activity is predictive for well-being, theoretical understanding and a model are required. While theories on either well-being or internet activity exist, not many theories take both aspects into account while also considering other behaviors. One such theory is the Compensatory Carry-Over Action Model (CCAM) which describes mechanisms on how internet use is related to other lifestyle behaviors and well-being, and that individuals are driven by the goal to adopt and maintain well-being - also called higher-level goals - in the CCAM. There are few studies testing the CCAM or selected aspects of it which include internet activity and well-being. Results demonstrate the potentials of such a multifactorial, sophisticated approach: it can help to improve health promotion in times of demographic change and in situations of lacking personnel resources in health care systems. CONCLUSION AND RECOMMENDATION Suggestions for future research are to employ theoretical approaches like the CCAM and testing intervention effects, as well as supporting individuals in different settings. The main aim should be to perform healthy internet activities to support well-being, and to prevent unhealthy internet activity. Behavior management and learning should accordingly aim at preventing problematic internet use and internet dependency.
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Affiliation(s)
- Sonia Lippke
- Department of Psychology & Methods/Focus Area Diversity, Jacobs University Bremen gGmbH, Bremen, 28759, Germany
| | - Alina Dahmen
- Dr. Becker Klinikgruppe, Cologne, 50968, Germany
| | - Lingling Gao
- Department of Psychology & Methods/Focus Area Diversity, Jacobs University Bremen gGmbH, Bremen, 28759, Germany
| | - Endi Guza
- Department of Psychology & Methods/Focus Area Diversity, Jacobs University Bremen gGmbH, Bremen, 28759, Germany
| | - Claudio R Nigg
- Institute of Sport Science, University of Bern, Bern, 3012, Switzerland
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18
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James S, McInnes S, Halcomb E, Desborough J. Lifestyle risk factor communication by nurses in general practice: Understanding the interactional elements. J Adv Nurs 2019; 76:234-242. [DOI: 10.1111/jan.14221] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 08/19/2019] [Accepted: 09/25/2019] [Indexed: 02/06/2023]
Affiliation(s)
- Sharon James
- School of Nursing University of Wollongong Bega NSW Australia
| | - Susan McInnes
- School of Nursing University of Wollongong Wollongong NSW Australia
| | | | - Jane Desborough
- Department of Health Services Research and Policy Research School of Population Health College of Medicine, Biology and the Environment Australian National University Canberra ACT Australia
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19
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Pereyra-Rodriguez JJ, Dominguez-Cruz JJ, Hernandez-Montoya C, Galan-Gutiérrez M, Carrasco PM, Luna SA, Navarro-Triviño FJ, Del Pozo J, Ruiz-Villaverde R. Development and validation of a questionnaire to measure empowerment in adult patients with atopic dermatitis. The DATEMP questionnaire. J Dtsch Dermatol Ges 2019; 17:923-931. [PMID: 31487109 DOI: 10.1111/ddg.13934] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 03/18/2019] [Indexed: 01/29/2023]
Abstract
BACKGROUND AND OBJECTIVES In recent years, the hypothesis that increasing the empowerment of patients can help to improve health outcomes and rationalize the use of health services has become relevant, especially for chronic diseases. Developing validated measurement tools is necessary to achieve this goal. In the field of dermatology, there are few studies related to empowerment of the patient. The aim of the present research is to develop and validate a self-administered questionnaire for adult patients diagnosed with atopic dermatitis (AD) in order to measure their level of empowerment. METHODS After a literature review and the establishment of consulting groups of patients and dermatologists, a large battery of 35 items was generated, based on the dimensions included in previous empowerment descriptions. A multidisciplinary group selected the 20 most suitable items to include in the questionnaire. A cross-sectional study was carried out with the items included in the questionnaire as well as demographic and clinical characteristics. To reduce the number of items and measure the construct validity, an exploratory factorial analysis (EFA) of the primary components and varimax rotation were used. Cronbach's α was used to measure the reliability of the individual scales and the global questionnaire. RESULTS 242 valid questionnaires were included. After completion of the EFA, the final Dermatitis Atópica EMPoderamiento (DATEMP) questionnaire was composed of 17 items that converged on four factors. The four scales had adequate reliability: "Knowledge" (Cronbach's alpha = 0.808), "Abilities" (Cronbach's alpha = 0.744), "Intention to change" (Cronbach's alpha = 0.798) and "Coping skills" (Cronbach's alpha = 0.772). The overall Cronbach's α of the questionnaire was 0.764. CONCLUSIONS The DATEMP questionnaire is the first specific empowerment measurement instrument developed for patients with AD that has demonstrated adequate levels of reliability and construct validity. It is a self-administered questionnaire that is simple and quick to answer.
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Affiliation(s)
| | | | | | | | | | | | | | - Jesús Del Pozo
- Complejo Hospitalario Universitario A Coruña, Coruña, Spain
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20
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Pereyra‐Rodriguez JJ, Dominguez‐Cruz JJ, Hernandez‐Montoya C, Galan‐Gutiérrez M, Martín Carrasco P, Alcántara Luna S, Navarro‐Triviño FJ, Pozo J, Ruiz‐Villaverde R. Entwicklung und Validierung eines Fragebogens zur Messung des Empowerments bei erwachsenen Patienten mit atopischer Dermatitis. Der DATEMP‐Fragebogen. J Dtsch Dermatol Ges 2019; 17:923-932. [DOI: 10.1111/ddg.13934_g] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 03/18/2019] [Indexed: 11/30/2022]
Affiliation(s)
| | | | | | | | | | | | | | - Jesús Pozo
- Complejo Hospitalario Universitario A Coruña Coruña Spanien
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21
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Bendig E, Bauereiß N, Daniel Ebert D, Snoek F, Andersson G, Baumeister H. Internet- Based Interventions in Chronic Somatic Disease. DEUTSCHES ARZTEBLATT INTERNATIONAL 2018; 115:659-665. [PMID: 30381130 PMCID: PMC6234467 DOI: 10.3238/arztebl.2018.0659] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 12/18/2017] [Accepted: 07/18/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Clinical guidelines recommend psychosocial care as an integral part of medical treatment, but access is often limited. Technology-based approaches provide an attractive opportunity to optimize health outcomes and quality of life in people with chronic somatic diseases e.g. by means of Internet- and mobile-based interventions (IMIs). The present article provides an overview on the basics of IMIs, applications and their evidence base for people living with chronic somatic diseases. METHODS We conducted a selective literature search in the PubMed and Cochrane databases. Reviews which included randomized controlled trials investigating psychological IMIs were discussed pertaining to their relevance for the population described. RESULTS IMIs lead to a change in unfavorable behavior connected to chronic somatic diseases. IMIs can foster protective factors like balanced physical activity or risk factors like smoking or alcohol consumption. However, studies reveal small effect sizes of d=0.25 for physical activity and an averaged effect size of d=0.20 for smoking and alcohol consumption. Additionally, IMIs can be used for the (co-)treatment of chronic somatic diseases, for instance to increase disease-specific selfefficacy in patients with diabetes (d=0.23). Studies included in meta-analyses are often highly heterogenous and are investigated in research contexts with limited health care services relevance. CONCLUSION IMIs are potentially effective when aiming at lifestyle changes and supporting medical treatment in people with chronic somatic diseases. However, results are still heterogenous and the evidence base is limited regarding specific settings, compounding the discussion of possible ways of implementing IMIs into our healthcare systems.
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Affiliation(s)
- Eileen Bendig
- Institute of Psychology and Education, Department of Clinical Psychology and Psychotherapy, University of Ulm, Ulm, Germany
| | - Natalie Bauereiß
- Institute of Psychology and Education, Department of Clinical Psychology and Psychotherapy, University of Ulm, Ulm, Germany
| | - David Daniel Ebert
- Department for Psychology, Clinical Psychology and Psychotherapy, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Frank Snoek
- Department of Medical Psychology, VU University Medical Center and Academic Medical Center, Amsterdam, Netherlands
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköpings University, Linköping and Department of Clinical Neuroscience, Karolinska Institut, Stockholm, Sweden
| | - Harald Baumeister
- Institute of Psychology and Education, Department of Clinical Psychology and Psychotherapy, University of Ulm, Ulm, Germany
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