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Ong QEO, Ong JW, Ang MQ, Vehviläinen-Julkunen K, He HG. Systematic review and meta-analysis of psychoeducation on the psychological and social impact among first-time mothers. PATIENT EDUCATION AND COUNSELING 2023; 111:107678. [PMID: 36871401 DOI: 10.1016/j.pec.2023.107678] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 01/16/2023] [Accepted: 02/18/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE This systematic review aimed to synthesise evidence of the effectiveness of psychoeducation in improving self-efficacy and social support and reducing depression and anxiety in first-time mothers. METHODS A comprehensive search was conducted on nine databases, grey literature, and trial registries for randomised controlled trials published from the databases' inception to 27 December 2021. Two independent reviewers screened studies, extracted data, and appraised the risk of bias. RevMan 5.4 was used for the meta-analyses of all outcomes. Sensitivity and subgroup analyses were conducted. Overall evidence quality was appraised using GRADE approach. RESULTS Twelve studies involving 2083 first-time mothers were included. The meta-analyses favoured psychoeducation as compared to control groups. At immediate post-intervention, statistically significant increments were seen in self-efficacy and social support, while a significant reduction in depression was observed but not in anxiety. At three months postpartum, a statistically significant decrease in depression was observed, but the effects on self-efficacy and social support were insignificant. CONCLUSION Psychoeducation improved first-time mothers' self-efficacy, social support, and depression. However, the evidence was very uncertain. PRACTICE IMPLICATIONS Psychoeducation might be incorporated into patient education of first-time mothers. More studies with familial and digital-based psychoeducation interventions, especially in non-Asian countries, are needed.
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Affiliation(s)
- Qian-Er Oriana Ong
- National University of Singapore, Yong Loo Lin School of Medicine, Alice Lee Center for Nursing Studies, Singapore, Singapore; KK Women's and Children's Hospital, Division of Nursing, Singapore, Singapore
| | - Jing Wen Ong
- National University of Singapore, Yong Loo Lin School of Medicine, Alice Lee Center for Nursing Studies, Singapore, Singapore; KK Women's and Children's Hospital, Division of Nursing, Singapore, Singapore
| | - Mei Qi Ang
- KK Women's and Children's Hospital, Division of Nursing, Singapore, Singapore
| | - Katri Vehviläinen-Julkunen
- University of Eastern Finland, Department of Nursing Science, Kuopio, Finland; Kuopio University Hospital, Department of Nursing, Kuopio, Finland
| | - Hong-Gu He
- National University of Singapore, Yong Loo Lin School of Medicine, Alice Lee Center for Nursing Studies, Singapore, Singapore; National University Health System, Singapore, Singapore.
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Ouyang WW, Chen HF, Xu XY, Zhang XL, Fu LZ, Tang F, Wen ZH, Marrone G, Liu LC, Lin JX, Liu XS, Wu YF. Self-management program for patients with chronic kidney disease (SMP-CKD) in Southern China: protocol for an ambispective cohort study. BMC Nephrol 2022; 23:93. [PMID: 35247988 PMCID: PMC8897851 DOI: 10.1186/s12882-022-02700-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 02/12/2022] [Indexed: 11/16/2022] Open
Abstract
Background Chronic kidney disease (CKD) is a major global health problem. Short-term self-management has been considered to effect some renal and psychological endpoints. However, there are currently very few studies about self-management for CKD that a) have been scientifically designed by a theory-based framework and b) that evaluate the long-term effects and working mechanism. This study presents the rationale and design of a theory-based cohort study to explore how this self-management intervention works and its effectiveness on the Chinese CKD population. Methods In this ambispective intervention cohort study,1,200 patients with CKD stages 1–5 will be recruited from July 2015 to July 2024 in 3 branches of Guangdong Provincial Hospital of Chinese Medicine (GPHCM) in Guangdong province, China. The patients in the self-management cohort will choose to receive an intervention that consists of education, nutrition/diet modification, lifestyle change recommendation, medication review, and psychology support based on Social Cognition Theory (SCT). The patients in the control cohort will do regular follow-ups based on the clinic rules. All the patients will be followed up for 5 years, or until the occurrence of a primary outcome. Detailed clinical, laboratory markers, nutritional status, psychological exposures and outcome questionaries will be collected semiannually in CKD stage 1–2 and trimonthly in stage 3–5 patients. The primary outcome is the occurrence of composite clinical endpoints (doubling of serum creatinine level, ESKD, loss of renal function (≥ 40% decline in GFR from baseline), death, major cardiovascular or cerebrovascular events). The main secondary outcomes include the absolute change and slope of eGFR, absolute changes of urinary protein creatinine ratio, 24-h urine proteinuria, intact parathyroid hormone level, and self-management adherence rate and quality of life from baseline to end of the study. The effectiveness of self-management will be analyzed and the association between longitudinal trajectories of self-management and renal outcomes will be evaluated. Discussion This study aims to provide further evidence for the effectiveness of theory-based self-management in CKD patients and to improve the lives of patients with CKD by slowing progression, improving psychological well-being and overall quality of life. Trial registration Chinese Clinical Trial Register (ChiCTR1900024633). 19 July, 2019. http://www.chictr.org.cn/showproj.aspx?proj=38378
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Hussein WF, Bennett PN, Sun SJ, Reiterman M, Watson E, Farwell IM, Schiller B. Patient Activation Among Prevalent Hemodialysis Patients: An Observational Cross-Sectional Study. J Patient Exp 2022; 9:23743735221112220. [PMID: 35924026 PMCID: PMC9340399 DOI: 10.1177/23743735221112220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Patient activation is the product of knowledge, skills, and confidence that
enables a person to manage their own healthcare. It is associated with healthy
behaviors and improved patient outcomes. We surveyed prevalent hemodialysis (HD)
patients at 10 centers using the Patient Activation Measure 13-item instrument
(PAM-13). Activation was reported as scores (0-100) and corresponding levels
(1-4). Of 1149 eligible patients, surveys were completed by 925 patients (92%
response rate). Mean age was 62 ± 14 years, 40% were female, median vintage was
41 (IQR 19-77) months, and 66% had diabetes. Mean PAM score was 56 ± 13, with
14%, 50%, 25%, and 10% in levels 1 to 4, respectively. In adjusted analysis,
older age and having diabetes were associated with lower activation, whereas
higher educational levels and female gender were associated with higher scores.
Significant variation in activation was observed among participants from
different centers even after adjustment for other variables. In conclusion, low
activation is common among prevalent HD patients.
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Affiliation(s)
- Wael F Hussein
- Satellite Healthcare, San Jose, CA, USA
- Department of Medicine, Division of Nephrology, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Paul N Bennett
- Satellite Healthcare, San Jose, CA, USA
- Clinical and Health Sciences, University of South Australia, Adelaide, Australia
| | | | | | | | | | - Brigitte Schiller
- Satellite Healthcare, San Jose, CA, USA
- Department of Medicine, Division of Nephrology, Stanford University School of Medicine, Palo Alto, CA, USA
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Gholami M, Abdoli Talaei A, Tarrahi MJ, Mirzaei Taqi F, Galehdar N, Pirinezhad P. The effect of self-management support program on patient activation and inner strength in patients with cardiovascular disease. PATIENT EDUCATION AND COUNSELING 2021; 104:2979-2988. [PMID: 33972129 DOI: 10.1016/j.pec.2021.04.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 04/08/2021] [Accepted: 04/21/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE The aim of the present study was to evaluate the effect of a self-management program on activation and inner strength in patients with cardiovascular diseases (CVDs). METHODS This study assigned 86 patients with CVDs to an experimental and a comparison group utilizing alternate allocation based on a quasi-experimental design. The experimental group participated in a self-management program based on a theoretical framework in three stages, i.e. orientation-recognition, reinforcing-engaging and monitoring-follow-up; whereas the comparison group received routine care. The supportive program was administered through holding five individual face-to-face sessions, providing educational booklets and performing four phone-call follow-ups during three months after discharge. The outcomes were measured using the patient activation measure (PAM) and the inner strength scale (ISS). RESULTS The between group analysis indicated a statistically-significant difference in the mean score of patient activation (P < 0.001) in the two groups. Nevertheless, there was not a statistically-insignificant difference in the mean score of inner strength between the two groups (P < 0.104). CONCLUSION Although a three-month nurse-led self-management support program was found to improve patient activation levels, it was ineffective in promoting inner strength. PRACTICE IMPLICATIONS Psychosocial dynamics should be integrated in providing self-management program by nurses. To promote patient activation, tailored consultations is recommended.
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Affiliation(s)
- Mohammad Gholami
- School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad 6814993165, Iran.
| | - Arefeh Abdoli Talaei
- Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran.
| | - Mohammad Javad Tarrahi
- Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
| | | | - Nasrin Galehdar
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran.
| | - Pezhman Pirinezhad
- Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran.
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Liu S, Yang BX, Gong X, Chen J, Liu Z, Zhang J, Wang XQ. Prevalence and Influencing Factors of Depression Self-Management Among Chinese Community Residents: A Cross-Sectional Study. Front Psychiatry 2021; 12:559844. [PMID: 34025464 PMCID: PMC8138045 DOI: 10.3389/fpsyt.2021.559844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 04/06/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: This study aimed to investigate the current status of depression self-management (DSM), and to identify influencing factors of DSM among Chinese community residents. Methods: Stratified random sampling methodology was adopted in this cross-sectional survey. Respondents completed a collection of self-administered questionnaires Results: The majority of participants were female (72.2%), having a mean age of 39 years (SD = 17.3). The total mean score on the DSSM was low (31.63 ± 4.69). Using multiple linear regression analysis, age ranging from 25 to 64 years old (Beta = -0.176, p = 0.008), having personal stigma (Beta = -0.143, p = 0.020) and perceived stigma (Beta = 0.127, p = 0.037), and having a nuclear family structure (Beta = -0.313, p = 0.046), good family function (Beta = 0.278, p < 0.001) and good help-seeking attitude (Beta = 0.159, p = 0.008) were associated with DSSM-knowledge. Older age (≥65 years) (Beta = -0.152, p = 0.034), higher CES-D scores (Beta = -0.162, p = 0.005), having a father with a bachelor's degree or higher level of education (Beta = -0.134, p = 0.047), being female (Beta = 0.147, p = 0.012), indicating a religious preference (Beta = 0.145, p = 0.017) and having good family function (Beta = 0.247, p = 0.001) were significantly associated with DSSM-activities. Conclusions: Reducing stigma related to depression and enhancing help-seeking attitudes may be potential strategies for managing depressive symptoms among Chinese community residents.
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Affiliation(s)
- Shuo Liu
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Bing Xiang Yang
- School of Health Sciences, Wuhan University, Wuhan, China.,Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xuan Gong
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jie Chen
- School of Nursing, University of Connecticut, Storrs, CT, United States
| | - Zhongchun Liu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jun Zhang
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Xiao Qin Wang
- School of Health Sciences, Wuhan University, Wuhan, China
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Patient-Reported Outcome Measures and Patient Activation: What Are Their Roles in Orthopedic Trauma? J Orthop Trauma 2019; 33 Suppl 7:S38-S42. [PMID: 31596783 DOI: 10.1097/bot.0000000000001612] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The rise of patient-reported outcome (PRO) measurement across medicine has been swift and now extends to the world of orthopedic trauma. However, PRO measures (PROMs) applied to trauma patients pose special considerations; measuring "episodes of care" is less straightforward, injuries are heterogeneous in their severity, and the patient's initial visit is "postinjury." Obtaining baseline scores and assessing the impact of a traumatic event on mental health are key considerations. Currently, few, if any, trauma registries include PROs; though general and condition-specific PROMs plus the patient empowerment measure of Patient Activation represent meaningful inputs for the clinical decision-making process. To be useful in trauma care, PROMs should be psychometrically sound and validated, be used for capturing function, screen for mental state and substance use, and give the clinician a sense of the patient's "activation" (engagement in their own health). Although the implementation of routine PRO collection can seem daunting, clinicians can use a multitude of electronic resources to access validated measures and simplify the implementation process. Computer-adaptive testing has evolved to help minimize patient burden, and PROM collection must maximize efficiency. Once established as part of your practice, PROs become an important tool to track recovery, identify mental health issues, engage in the prevention of future injury, and enable care of the whole patient.
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