scholarly journals Effectiveness of self-management on adherence to self-care and on health status among elderly people with hypertension

2021 ◽  
Vol 10 (s1) ◽  
Author(s):  
Silvia Elki Putri ◽  
Etty Rekawati ◽  
Dwi Nurviyandari Kusuma Wati

Background: Adherence to self-care is the goal of nursing care for elderly people with hypertension to give them optimal functional health status. The purpose of this paper is to determine the effectiveness of self-management on adherence to self-care and management of health status elderly people living with hypertension in Pekanbaru City. Design and methods: This study design was quasi-experimental with a pre-post test with a control group. The self-management intervention was provided through four home visits to elderly people living with hypertension with a caregiver. Samples were taken by the consecutive sampling technique, and a total number 134 elderly people were participants. The instruments used were the adherence to self-care questionnaire and the Short Form 12 Health Survey (SF12) for elderly people.Results: The results showed that most of the respondents with hypertension were 60-74 years of age (84.3%), were female (67.9%), of Minang ethnicity (48.5%), had completed primary school (44%), were unemployed (81.3) %), had a family history of hypertension (50%), were non-smokers (52.2%), and had never drunk alcohol (95.5%). The effects of self-management were positive on adherence to caring for themselves (p<0.001) and on health status (p<0.001). The most influencing factor on self-care compliance and health status after being controlled by confounding variables was self-management (p<0.001).Conclusions: This study recommends that nursing interventions on self-management for elderly people with hypertension in the community and should be integrated into the Community Health Nurses’ (Perkesmas) program in Indonesia. 


2020 ◽  
Author(s):  
Michael P. Dorsch ◽  
Karen B. Farris ◽  
Brigid E. Rowell ◽  
Scott L. Hummel ◽  
Todd M. Koelling

BACKGROUND Successful management of heart failure (HF) involves guideline based medical therapy as well as self-care behavior. As a result, the management of HF is moving toward a proactive real-time technological model of assisting patients with monitoring and self-management. OBJECTIVE Evaluate the effectiveness of a mobile application intervention that enhances self-monitoring on health-related quality of life, self-management, and reduces HF readmissions. METHODS A single-center randomized controlled trial was performed. Patients greater than 45 years of age and admitted for acute decompensated HF or recently discharged in the past 4 weeks were included. The intervention group used a mobile application (App). The intervention prompted daily self-monitoring and promoted self-management. The control group (No App) received usual care. The primary outcome was the change in Minnesota Living with Heart Failure Questionnaire (MLHFQ) from baseline to 6 and 12 weeks. Secondary outcomes were the Self-Care Heart Failure Index (SCHFI) questionnaire and recurrent HF admissions. RESULTS Eighty-three patients were enrolled and completed all baseline assessments. Baseline characteristics were similar between groups with the exception of HF etiology. The App group had a reduced MLHFQ at 6 weeks (37.5 ± 3.5 vs. 48.2 ± 3.7, P=0.039) but not at 12 weeks (44.2 ± 4 vs. 45.9 ± 4, P=0.778) compared to No App. There was no effect of the App on the SCHFI at 6 or 12 weeks. The time to first HF admission was not statistically different between the App versus No App groups (HR 0.89, 95% CI 0.39-2.02, P=0.781) over 12 weeks. CONCLUSIONS The mobile application intervention improved MLHFQ at 6 weeks, but did not sustain its effects at 12 weeks. No effect was seen on HF self-care. Further research is needed to enhance engagement in the application for a longer period of time and to determine if the application can reduce HF admissions in a larger study. CLINICALTRIAL NCT03149510



2021 ◽  
Vol 104 (2) ◽  
pp. 003685042110261
Author(s):  
Al Sawad Ayat Ali ◽  
Soo Kun Lim ◽  
Li Yoong Tang ◽  
Aneesa Abdul Rashid ◽  
Boon-How Chew

The complexity of chronic kidney disease (CKD) and its treatments have made self-management behaviors inevitably challenging. However, supplementing education with self-management skills may improve numerous health outcomes in people with nondialysis CKD. This study protocol describes a randomized controlled trial (RCT) aimed to evaluate the effects of a nurse-led self-management support program as an intervention for kidney disease knowledge and CKD self-management behaviors among people with pre-dialysis CKD. In Phase 1, people with CKD stage 3–4 and their family members are involved in co-designing, development and pilot testing of a theory-based self-management intervention. In Phase 2, we perform a cross-cultural adaptation of the Kidney Disease Knowledge Survey, CKD Self-Management and Self-efficacy for Managing Chronic Disease questionnaires. In Phase 3, a parallel RCT will be conducted to evaluate the intervention where 154 participants with CKD stage 3–4 will be randomly assigned to either the intervention ( n = 77) or control group ( n = 77). The intervention group will receive 6-week self-management program from a nurse-coach in addition to standard usual care, while the control group will receive only standard usual care. Outcome measures include kidney disease knowledge, CKD self-management behavior, self-efficacy, quality of life, blood pressure control and adherence to CKD diet as indicated by 24-h urine urea nitrogen, 24-h urine sodium and net endogenous acid production. Data will be collected at baseline and 12-week post-baseline. The between- and within-group intervention effects will be estimated using the Generalized Estimating Equations. The self-management intervention offers strategies to delay CKD progression and to encourage motivation to better self-manage at home. This study integrates self-management education and psychosocial support with culturally relevant scenarios, and evaluates important self-reported and objective outcomes. Clinical Trials Registration: www.ClinicalTrials.gov , identifier: NCT03974646.



2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
C Yang ◽  
Z Hui ◽  
S Zhu ◽  
X Wang ◽  
G Tang ◽  
...  

Abstract Introduction Medication self-management support has been recognised as an essential element in primary health care to promote medication adherence and health outcomes for older people with chronic conditions. A patient-centred intervention empowering patients and supporting medication self-management activities could benefit older people. This pilot study tested a newly developed medication self-management intervention for improving medication adherence among older people with multimorbidity. Method This was a two-arm randomised controlled trial. Older people with multimorbidity were recruited from a community healthcare centre in Changsha, China. Participants were randomly allocated to either a control group receiving usual care (n = 14), or to an intervention group receiving three face-to-face medication self-management sessions and two follow-up phone calls over six weeks, targeting behavioural determinants of adherence from the Information-Motivation-Behavioural skills model (n = 14). Feasibility was assessed through recruitment and retention rates, outcome measures collection, and intervention implementation. Follow-up data were measured at six weeks after baseline using patient-reported outcomes including medication adherence, medication self-management capabilities, treatment experiences, and quality of life. Preliminary effectiveness of the intervention was explored using generalised estimating equations. Results Of the 72 approached participants, 28 (38.89%) were eligible for study participation. In the intervention group, 13 participants (92.86%) completed follow-up and 10 (71.42%) completed all intervention sessions. Ten participants (71.42%) in the control group completed follow-up. The intervention was found to be acceptable by participants and the intervention nurse. Comparing with the control group, participants in the intervention group showed significant improvements in medication adherence (β = 0.26, 95%CI 0.12, 0.40, P &lt; 0.001), medication knowledge (β = 4.43, 95%CI 1.11, 7.75, P = 0.009), and perceived necessity of medications (β = −2.84, 95%CI -5.67, −0.01, P = 0.049) at follow-up. Conclusions The nurse-led medication self-management intervention is feasible and acceptable among older people with multimorbidity. Preliminary results showed that the intervention may improve patients’ medication knowledge and beliefs and thus lead to improved adherence.



2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Saowaluck Sukpattanasrikul ◽  
Supreeda Monkong ◽  
Sirirat Leelacharas ◽  
Orapitchaya Krairit ◽  
Chukiat Viwatwongkasem

PurposeThis study aims to examine the effects of a self-management program (SMP) on self-care behavior, blood pressure and quality of life among older adults with uncontrolled hypertension.Design/methodology/approachA quasi-experimental design with repeated measures was conducted in two primary care units in Krabi, Thailand. One hundred and fifty-six older adults with uncontrolled hypertension were selected based on the inclusion criteria and divided into experimental and control groups with 78 participants in each. The experimental group received the SMP, including the intervention related to the self-management process (from the 1st to 4th weeks) and a follow-up phase (from the 5th to 16th weeks). The control group received standard care. The outcomes were measured over time, including self-care behavior (baseline, 4th and 16th weeks), blood pressure (baseline, 4th, 8th, 12th and 16th weeks) and quality of life (baseline and 16th week).FindingsThe generalized estimating equations showed that the SMP, compared with the control group, statistically significantly improved self-care behavior (p < 0.001), decreased blood pressure (p < 0.001) and improved quality of life (p < 0.001) at the 16th week.Originality/valueThe SMP improved the self-care behavior, decreased blood pressure and improved the quality of life among older adults with uncontrolled hypertension. Registered nurses could administer this program for long-term benefits and help reduce the burden on primary care services.



2021 ◽  
Vol 104 (2) ◽  
pp. 264-270

Background: Asthma is a disease that causes a lot of suffering. It becomes a hurdle in everyday life. Asthma self-care program through mobile Line application (SALA) might be a good choice to help resolving this problem. Objective: To evaluate effectiveness of SALA program among asthma patients. Materials and Methods: The present study was a randomized controlled trial. The study sample consisted of 62 participants aged between 20 to 60 years with mild to moderate asthma. The study sample were randomly assigned to intervention plus usual care (intervention group, n=31) or usual care (control group, n=31) by computer generated. SALA program was sent to participants once a week for two months through their mobile phone, drug reminder appointment date for four months. The study period was six months. Clinical record form and Questionnaire were adapted to collect the demographic data and lung function via spirometer as FEV₁, FVC, FEV₁/FVC, PEFR, ACS, knowledge, attitude, and self-management. Mini Asthma Quality of Life (QOL) questionnaire was used to collect the data. Intention to treat (ITT), Repeated ANOVA, and General Linear model were statistical technique used to analyze the data. Results: Data from 60 asthma patients were available for analyses. The baseline characteristics of both groups were not significantly different. There were statistically significant mean differences in between the groups at three and six months. The mean difference in the following variables were FEV₁ 13.83 (5.01 to 22.65) FVC, 13.36 (2.62 to 24.09) FEV₁/FVC, 11.65 (4.8 to 18.49), PEFR 9.85 (0.03 to 19.67), ACS 2.45 (0.62 to 4.27), knowledge 2.64 (0.81 to 4.46), and self-management 4.26 (2.00 to 6.52). Conclusion: SALA improved knowledge, self-management, asthma status, and lung function among asthma patients. Keywords: Asthma, Self-care program, Mobile line application



2018 ◽  
Vol 8 (1) ◽  
pp. 35
Author(s):  
Muhamad Jauhar ◽  
Astuti Yuni Nursasi ◽  
Wiwin Wiarsih

Background: Patients with pulmonary TB experience physical, psychological, social, and spiritual changes, affecting their physical health status. Self-management counseling is an intervention which enhances the physical health status of patients with pulmonary TB.Purpose: This study aimed to identify the effects of self-management counseling on physical health status in patients with pulmonary TB.Methods: This study used a pre and post-test quasi-experimental design with a control group and took place in a hospital in Bogor. The total respondents were 60 patients who were assigned into two groups and recruited using purposive sampling. The counseling was given for four sessions in two weeks for about 60-90 minutes each session. The data were collected using the functional assessment of chronic illness therapy-tuberculosis (FACIT-TB) and analyzed using paired t-test and independent t-test.Results: The result showed that the physical health status in the intervention group increased significantly (MD=8.0, p=0.000) compared to the control group. However, there was no influence of self-management counseling on the improvement of physical health status (MD=3.24, p=0.314).Conclusion: Self-management counseling did not significantly increase the physical health status of pulmonary TB patients. More rigorous studies are needed to investigate the effect of self-management counseling delivered at early treatment on the improvement of physical health status. It is expected that patients can manage their TB symptoms and able to improve their physical health status.



2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Fan Zheng ◽  
Suixin Liu ◽  
Yuan Liu ◽  
Lihua Deng

Objective. This study is aimed at assessing the effectiveness of a simple outpatient diabetes self-management education programme. Methods. In the study, 60 patients with type 2 diabetes mellitus were randomly allocated into the control group (n=30) and intervention group (n=30). Regular and 2-session health education programmes were provided. The summary of diabetes self-care activity measure, problem areas in the diabetes scale, fasting blood glucose, postprandial 2 h blood glucose, and HbA1c were measured before and after the intervention to assess the effects of this 2-session diabetes education programme. Results. The total mean score of the summary of diabetes self-care activities measure was 17.60±6.63 points. The problem areas in the diabetes scale revealed that the total mean score was 29.82±15.22 points; 27% of the patients had diabetes-related distress, while 9% suffered from severe emotional distress. Compared with the control group, scores of the summary of diabetes self-care activities measure and problem areas in the diabetes scale, fasting blood glucose, postprandial 2 h blood glucose, and HbA1c were significantly improved in the intervention group after the intervention (P<0.01). Conclusion. This study showed that the 2-session diabetes education programme could effectively improve the level of self-reported self-management, psychological distress, and glycemic control in patients with type 2 diabetes mellitus.



Author(s):  
Massy Mutumba ◽  
Henry Mugerwa ◽  
Victor Musiime ◽  
Anudeeta Gautam ◽  
Hellen Nakyambadde ◽  
...  

The heightened vulnerability of adolescents to poor HIV care outcomes underscores the need for interventions that create and promote HIV self-management behavioral skills. Adolescents living with HIV (ALHIV) experience a complex array of physical, emotional, and social challenges that constrain their self-care, but the majority of existing psychosocial programs focus primarily on medication adherence. Understanding adolescents’ self-care needs, challenges, and preferences is necessary for developing effective culturally relevant interventions. The involvement of caregivers and stakeholders is also critical to realizing positive self-care outcomes. This article presents the findings from focus group discussions with ALHIV, caregivers, and healthcare providers on self-care. The data were collected as part of formative research in the development of a self-management intervention for Ugandan ALHIV. Participants’ discussions on self-care strategies and intervention approaches provide valuable insights to guide the development of interventions to promote positive HIV care outcomes among Ugandan ALHIV.



2012 ◽  
Vol 19 (4) ◽  
pp. E9-E16 ◽  
Author(s):  
Heng-Hsin Tung ◽  
Chun-Yu Lin ◽  
Kuei-Ying Chen ◽  
Chien-Jung Chang ◽  
Yu-Ping Lin ◽  
...  


1992 ◽  
Vol 32 (4) ◽  
pp. 438-443 ◽  
Author(s):  
N. M. Clark ◽  
N. K. Janz ◽  
M. H. Becker ◽  
M. A. Schork ◽  
J. Wheeler ◽  
...  


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