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Relevant bibliographies by topics / Self-care management

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Academic literature on the topic 'Self-care management'

Author: Grafiati

Published: 4 June 2021

Last updated: 26 January 2023

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Journal articles on the topic "Self-care management"

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Sousa, Valmi D., Jaclene A. Zauszniewski, Carol M. Musil, Patricia J. Price Lea, and Schenita A. Davis. "Relationships Among Self-Care Agency, Self-Efficacy, Self-Care, and Glycemic Control." Research and Theory for Nursing Practice 19, no. 3 (September 2005): 217–30. http://dx.doi.org/10.1891/rtnp.2005.19.3.217.

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Costly complications of diabetes often arise from poor glycemic control. Appropriate diabetes self-care management may improve control. This study examined whether self-care management affects glycemic control and mediates relationships between self-efficacy and self-care agency with glycemic control. In a cross-sectional correlational design, data from a prior study of 141 insulin-requiring adults with type 1 or type 2 diabetes were examined using descriptive statistics, Pearson’s correlation, and multiple hierarchical regression. Findings indicated that greater self-care agency and self-efficacy lead to greater self-care management, in turn leading to better glycemic control. Self-care management did not mediate between self-efficacy or self-care agency and glycemic control. Thus, beliefs or capabilities for self-care are insufficient to improve glycemic control; doing so requires self-care management.

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Maruca, Annette T., Kimberly Dion, Adrial A. Lobelo, Olivia Ampiah-Bonney, Chunfang Chen, Kirk Sanger, and Donna Zucker. "Self-Care Management in Corrections." Journal of Forensic Nursing 13, no. 3 (2017): 126–34. http://dx.doi.org/10.1097/jfn.0000000000000162.

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Duncan, Deborah Louise, and Gillian Lyall. "Psoriasis: Management and self-care." British Journal of Child Health 1, no. 1 (March 2, 2020): 14–19. http://dx.doi.org/10.12968/chhe.2020.1.1.14.

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Psoriasis is a common skin condition that affects an estimated 3% of the population. In one third of cases, psoriasis will develop during childhood or adolescence. Juvenile psoriasis is also associated with other co-morbidities such as hyperlipidaemia, obesity, hypertension, diabetes mellitus, rheumatoid arthritis and Crohn's disease. Understanding this illness means that health-care professionals such as school nurses can help by providing schools with appropriate information about the condition, improving its management and providing education to help reduce stigma.

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Thoonen, B. "Self management in asthma care." BMJ 321, no. 7275 (December 16, 2000): 1482–83. http://dx.doi.org/10.1136/bmj.321.7275.1482.

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Corner, Jessica. "Self management in palliative care." International Journal of Palliative Nursing 8, no. 11 (November 2002): 516. http://dx.doi.org/10.12968/ijpn.2002.8.11.10892.

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Lillyman, Sue, and Natalie Farquharson. "Self-care management education models in primary care." British Journal of Community Nursing 18, no. 11 (November 2013): 556–60. http://dx.doi.org/10.12968/bjcn.2013.18.11.556.

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Porter-O’Grady, Tim. "Self-care promotes good care." Nursing Management (Springhouse) 34, no. 2 (February 2003): 48–50. http://dx.doi.org/10.1097/00006247-200302000-00017.

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Gharaibeh, Besher, Byron J. Gajewski, Ahmed Al-smadi, and Diane K. Boyle. "The relationships among depression, self-care agency, self-efficacy and diabetes self-care management." Journal of Research in Nursing 21, no. 2 (February 2016): 110–22. http://dx.doi.org/10.1177/1744987115621782.

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GB, Manjula. "A Paradigm Shift In Self Care Management Of Diabetes Mellitus - A Review." International Journal of Trend in Scientific Research and Development Volume-1, Issue-6 (October 31, 2017): 1253–56. http://dx.doi.org/10.31142/ijtsrd5800.

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Grewe, Jennifer, Xiaomeng Xu, and Ahva R. Mozafari. "Self-Care Tips for Stress Management." Eye on Psi Chi Magazine 24, no. 3 (2020): 34–35. http://dx.doi.org/10.24839/2164-9812.eye24.3.34.

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Dissertations / Theses on the topic "Self-care management"

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

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DeMartini, Mikaela. "Exploring Self Care Programs in Hospitals." Thesis, Mills College, 2019. http://pqdtopen.proquest.com/#viewpdf?dispub=13426861.

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Self care is more than a requirement for life. Working in a high stress hospital environment lends itself to having many personal and professional stressors that go beyond medical professionals job requirements. The purpose of this study was to explore how hospitals support medical staff through self care programs. Data was collected through semi-structured interviews of five medical professionals who work in various specialties. Results of this study indicated that self care was represented in various unstructured formats. Additionally, this study demonstrates the need for more support in the medical field to allow for more opportunities for self care to take place. Furthermore, this analysis of self care explains the importance of this practice to be implemented by medical professionals as it helps to reduce the high rates of burnout and compassion fatigue.

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Matthie, Nadine. "Sickle Cell Disease: The Role of Self-Care Management." Scholar Commons, 2013. http://scholarcommons.usf.edu/etd/4538.

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Abstract Sickle cell disease is the most common genetic disorder in the United States. Approximately 90% of the hospitalizations in this patient population occur due to the most common complication, pain crises. Prevention of these crises is therefore essential and requires the patient to assume an active role in his or her disease management. Studies suggest that further research is needed to examine the self-care management process and to identify factors influencing self-care behaviors. The relationships among these factors must be clearly defined before interventions to improve self-care management can be determined. The aims of the study were threefold. The first aim was to evaluate the relationships among psychosocial variables (SCD self-efficacy and social support) and socio-demographic variables (age, gender, education, employment status, income, and living situation) in understanding individual differences in self-care management variables (perceived self-care ability and self-care actions). It was hypothesized that higher SCD self-efficacy, greater social support, being employed, living with family or friends, increased age, more years of education, higher income, and being male are each associated with having higher perceived self-care ability and more frequent self-care actions. The second aim was to evaluate the relationships among psychosocial variables (SCD self-efficacy and social support), socio-demographic variables (age, gender, education, employment status, income, and living situation), and self-care management variables (perceived self-care ability and self-care actions) in understanding hospital visits for crises. It was hypothesized that higher perceived self-care ability and more frequent self-care actions are associated with fewer hospital visits for crises. The third aim was to evaluate the mediational role of perceived self-care ability and self-care actions in the relationships among psychosocial variables (SCD self-efficacy and social support), socio-demographic variables (age, gender, education, employment status, income, and living situation), and the number of hospital visits for crises. It was hypothesized that SCD self-efficacy, social support, and the socio-demographic variables have both a direct and an indirect relationship with the number of hospital visits for crises. In 103 young Black adults (ages 18-30) with sickle cell disease (SCD), an exploratory , correlational study was conducted, via secondary analysis of data, to examine the relationships among SCD self-efficacy, social support, socio-demographic variables, self-care management (self-care ability and self-care actions), and the number of hospital visits for crises. Bivariate correlations and regression analyses were conducted to evaluate the relationships among the variables and to examine the mediational role of self-care management. Sickle cell disease self-efficacy, social support, years of education, and income were significantly related to perceived self-care ability and self-care actions. Social support accounted for the majority of the variance in each self-care management variable. The hypothesis that higher SCD self-efficacy and greater social support are associated with higher perceived self-care ability and more frequent self-care actions was supported. Education was also associated with higher perceived self-care ability and self-care actions as hypothesized. The overall model with SCD self-efficacy, social support, years of education, income, perceived self-care ability, and self-care actions was not significant in predicting the number of hospital visits for crises. There were no significant associations noted among age, annual household income, living situation, employment status, and the self-care management variables. The hypothesis that higher perceived self-care ability and more frequent self-care actions are associated with fewer hospital visits for crises was not supported. Further, there was no adequate evidence to support a direct relationship between SCD self-efficacy, social support, years of education, and the number of hospital visits for crises. The indirect relationship, through self-care management, among the variables was also non-significant. There was however a significant direct relationship noted between income and the number of hospital visits for crises. The outcomes of the study may be important for clinical care, patient education, and health outcomes in the SCD population. Findings may be used to conduct larger confirmatory studies and to develop interventions that may be used to supplement therapy in the clinical setting and to enhance patient self-care management at home. Additional studies are needed, however, to clarify what additional variables may affect the number of hospital visits for crises and to identify specific pain prevention and management strategies used by SCD patients.

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Sarkadi, Anna. "The borderland between care and self-care." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2001. http://publications.uu.se/theses/91-554-4901-8/.

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Ashford, Dimitri Shabree. "BELIEFS ABOUT SELF-CARE AMONG ONCOLOGY PROVIDERS." CSUSB ScholarWorks, 2014. https://scholarworks.lib.csusb.edu/etd/54.

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The research question in this project explores self-care practices that oncology providers utilize to manage stress, burnout, and compassion fatigue in their work environment. As an exploratory study, this research project examines self-care practices among the oncology providers and how self-care relates to the quality of patient care. The survey provided to the participants focused on the individual well-being such as spiritual, social support, physical, and emotional support. Findings from this study indicated that oncologist utilize spiritual self-care more than any other medical professional. The older adults utilize their social support systems more than the younger adults. Individuals with three or more children are better at utilizing their social support, physical self-care, and emotional support systems than individuals with two or less children.

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Saenz, Mia Nicole, and Mia Nicole Saenz. "Home Care Nurse Practitioner Knowledge of Self-Care Management in Patients with Heart Failure." Diss., The University of Arizona, 2016. http://hdl.handle.net/10150/622940.

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Objective: The purpose of this project is to explore the depth of HF self-care management knowledge of home care NPs that will help improve patient HF management in New Mexico. Methods: A quantitative descriptive study design was used. Home care NPs (n=6) were recruited from the New Mexico Nurse Practitioner Council to participate in a 22-item survey on HF self-care management topics administered to participants via email. Results: Home care NPs' scores demonstrated at 74% knowledge base in overall heart failure self-care management education topics. NPs scored the lowest (0% answered correctly) in recognition of signs and symptoms of a worsening condition, sodium restrictions (50% answered correctly), weight gain (50% answered correctly), and hospital follow-up (50% answered correctly). Limitations of the study include a small sample size with inability to generalize results. Conclusions: Findings suggest that home care NPs may not be sufficiently knowledgeable in evidence-based HF self-care management education topics. Development of educational programs may be warranted to aid in the management of HF patients ultimately resulting in quality education for the patient. Further research is warranted to identify specific deficits and whether educational programs would enhance and maintain home care NPs knowledge of HF self-care management education.

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Krouse, Robert S., Marcia Grant, Ruth McCorkle, Christopher S. Wendel, Martha D. Cobb, Nancy J. Tallman, Elizabeth Ercolano, Virginia Sun, Judith H. Hibbard, and Mark C. Hornbrook. "A chronic care ostomy self-management program for cancer survivors." WILEY-BLACKWELL, 2016. http://hdl.handle.net/10150/615618.

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Individuals with ostomies experience extensive changes in health-related quality of life (HRQOL) and daily routine. Patients and families are typically forced to use trial and error to improve self-management.

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Kennedy, Michael G. "Relapse in Schizophrenia : the relationships among insight, symptom recognition, symptom self-management, and perceived effectiveness of symptom self-management at the time of hospitalization /." Thesis, Connect to this title online; UW restricted, 1994. http://hdl.handle.net/1773/7372.

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Buford, Terry A. "Transfer of responsibility for asthma self-management from parents to their school-age children /." free to MU campus, to others for purchase, 2001. http://wwwlib.umi.com/cr/mo/fullcit?p3036810.

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

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Books on the topic "Self-care management"

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Harvey, Peter William. Self-management and the health care consumer. Hauppauge, N.Y: Nova Science Publishers, 2010.

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1944-, Holroyd Kenneth A., and Creer Thomas L, eds. Self-management of chronic disease: Handbook of clinical interventions and research. Orlando: Academic Press, 1986.

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Chronic physical illness: Self-management and behavioural interventions. Maidenhead: Open University Press, 2009.

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Advanced practice nursing: Ethics in chronic disease self-management. New York: Springer, 2013.

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1944-, Ellis Richard, and Broomfield Sinclair, eds. Health and social care management: A guide to self-development. London: Arnold, 1996.

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Bullemer, Faye E. Coronary artery disease: A self-management program. 2nd ed. San Bruno, CA: StayWell Co., 2004.

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Self-managed work teams in health care organizations. Chicago, IL: American Hospital Pub., 1994.

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The everything guide to stress management with CD. Avon, Mass: Adams Media, 2011.

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Clever, Linda Hawes. The fatigue prescription: Four steps to renewing your energy, health, and life. San Francisco, Calif: Viva Editions, 2010.

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service), SpringerLink (Online, ed. Self Management of Chronic Disease: Alzheimer’s Disease. Berlin, Heidelberg: Springer Berlin Heidelberg, 2009.

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Book chapters on the topic "Self-care management"

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Foster, Claire. "Survivorship and Self-Management in Cancer Care." In Cancer and Cancer Care, 343–53. 1 Oliver’s Yard, 55 City Road London EC1Y 1SP: SAGE Publications Ltd, 2015. http://dx.doi.org/10.4135/9781473920620.n23.

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Wickramasinghe, Nilmini, Indrit Troshani, and Steve Goldberg. "A Pervasive Technology Solution for Supporting Diabetes Self-Care." In Pervasive Health Knowledge Management, 161–71. New York, NY: Springer New York, 2012. http://dx.doi.org/10.1007/978-1-4614-4514-2_13.

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Peeples, Malinda, and Bhagyashree (Disha) Maity. "Digital Health in Chronic Care and Self-Management." In Health Informatics, 209–22. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-031-07912-2_14.

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Buzalaf, Marília Afonso Rabelo, Cristiane de Almeida Baldini Cardoso, Ana Carolina Magalhães, and Bennett T. Amaechi. "Prevention and Control of Dental Erosion: Patient Self-Care." In Dental Erosion and Its Clinical Management, 133–50. Cham: Springer International Publishing, 2015. http://dx.doi.org/10.1007/978-3-319-13993-7_8.

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Jenkins, Melinda L., and Barbara J. Shelton. "The Effectiveness of Self-Care Actions in Reducing “Morning Sickness”." In Management of Pain, Fatigue and Nausea, 267–72. London: Macmillan Education UK, 1989. http://dx.doi.org/10.1007/978-1-349-13397-0_33.

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Quinn, Tom M., and Adam T. Hill. "Severity of the Disease, Site of Care and Self-Management." In Bronchiectasis, 147–55. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-61452-6_11.

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Mansmann, Herbert C., and Paris T. Mansmann. "Self-Care Management for the Patient with Normomagnesemia Magnesium Deficiency." In Magnesium: Current Status and New Developments, 105–8. Dordrecht: Springer Netherlands, 1997. http://dx.doi.org/10.1007/978-94-009-0057-8_24.

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Jiang, Ying, and Wenru Wang. "Health Promotion and Self-Management Among Patients with Chronic Heart Failure." In Health Promotion in Health Care – Vital Theories and Research, 269–85. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-63135-2_19.

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AbstractHeart failure is a chronic and complex clinical syndrome. It is one of the common causes of hospitalization and readmission among the older population. Patient self-management is essential to maintaining health and avoiding disruption of life caused by frequent hospitalizations. However, many patients lack self-care skills. This chapter provides a review on evidence for the importance of self-management and strategies to educate patients and promote self-care while living with the limitations on physical function.

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Alti, Elisabetta, and Alessandro Mereu. "Community and Primary Care." In Textbook of Patient Safety and Clinical Risk Management, 365–74. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-59403-9_26.

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AbstractWHO defined primary care “as socially appropriate, universally accessible, scientifically sound first level care provided by a suitably trained workforce supported by integrated referral systems and in a way that gives priority to those most needed, maximizes community and individual self-reliance and participation and involves collaboration with other sectors, including health promotion, illness prevention, care of the sick, advocacy and community development” [1].

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Schulmeyer, Christian, and Frank Keuper. "Morphological Psychology and its Potential for Derivation of Requirements from Web Applications using Examples of Customer Self Care Instruments." In Application Management, 217–64. Wiesbaden: Gabler, 2011. http://dx.doi.org/10.1007/978-3-8349-6492-2_9.

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Conference papers on the topic "Self-care management"

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Yunli Wang and Zhenkai Liu. "A Workflow Based Self-care Management System." In 2005 IEEE Engineering in Medicine and Biology 27th Annual Conference. IEEE, 2005. http://dx.doi.org/10.1109/iembs.2005.1616472.

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Puustjarvi, J., and L. Puustjarvi. "Practicing information therapy in self-care: A solution to the rise in health care costs." In 2016 IEEE International Conference on Industrial Engineering and Engineering Management (IEEM). IEEE, 2016. http://dx.doi.org/10.1109/ieem.2016.7797884.

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Licskai, Christopher, Madonna Ferrone, Natalie Malus, Larry Stitt, Tim O'Callahan, Zofe Roberts, Laura Johnson, Jim Samson, and Lisa Durocher. "COPD collaborative self-management in primary care: A randomized controlled trial." In ERS International Congress 2016 abstracts. European Respiratory Society, 2016. http://dx.doi.org/10.1183/13993003.congress-2016.oa1994.

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George, V., N. Russell, A. Sundaralingam, B. Kulendrajah, E. Bedawi, R. Banka, M. Ellayeh, R. Hallifax, and N. Rahman. "Caring for indwelling pleural catheters: self-management vs district nursing care." In ERS International Congress 2022 abstracts. European Respiratory Society, 2022. http://dx.doi.org/10.1183/13993003.congress-2022.2668.

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Nikoviotis, Rafail, and Dimitrios Ringas. "Self-care Diabetes: a diabetes self-management application based on the seven self-management areas (AADE7) of the American Association of Diabetes Educators." In PCI 2021: 25th Pan-Hellenic Conference on Informatics. New York, NY, USA: ACM, 2021. http://dx.doi.org/10.1145/3503823.3503910.

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Cook, Ros, and Philippa Sellar. "P-162 Supported self-management in young adults with palliative care needs." In Dying for change: evolution and revolution in palliative care, Hospice UK 2019 National Conference, 20–22 November 2019, Liverpool. British Medical Journal Publishing Group, 2019. http://dx.doi.org/10.1136/bmjspcare-2019-huknc.184.

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Sultan, Salys, and Permanand Mohan. "A Peer-Facilitated Diabetes Self-Care Management Support System using Mobile Telephony." In 6th International Conference on Pervasive Computing Technologies for Healthcare. IEEE, 2012. http://dx.doi.org/10.4108/icst.pervasivehealth.2012.248708.

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Indra, Zul, Liza Trisnawati, and Luluk Elvitaria. "An Integrated Framework for Social Contribution of Diabetes Self-care Management Application." In The Second International Conference on Science, Engineering and Technology. SCITEPRESS - Science and Technology Publications, 2019. http://dx.doi.org/10.5220/0009106100680073.

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Ouellet, Isabelle, Isabelle Drouin, Celia Lombardo, Alexandre Joubert, France Paquet, Paul Arthur, Danielle Beaucage, and Jean Bourbeau. "Effect Of An Integrated Care Approach With Self-Management In Patients With COPD." In American Thoracic Society 2011 International Conference, May 13-18, 2011 • Denver Colorado. American Thoracic Society, 2011. http://dx.doi.org/10.1164/ajrccm-conference.2011.183.1_meetingabstracts.a3977.

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Casida, Jesus M. "6 Using mobile app to empower care and self-management in LVAD patients." In 2nd Asia Pacific Advanced Heart Failure Forum (APAHFF 2018), 16th November 2018, Hong Kong. BMJ Publishing Group Ltd, British Cardiovascular Society and Asia Pacific Heart Association, 2019. http://dx.doi.org/10.1136/heartasia-2019-apahff.6.

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Reports on the topic "Self-care management"

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Swinson Evans, Tammeka, Suzanne West, Linda Lux, Michael Halpern, and Kathleen Lohr. Cancer Symptoms and Side Effects: A Research Agenda to Advance Cancer Care Options. RTI Press, July 2017. http://dx.doi.org/10.3768/rtipress.2017.rb.0016.1707.

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Cancer survivors have unique physical, psychological, social, and spiritual health needs. These can include symptoms and side effects associated with cancer and cancer treatment, such as pain, cognitive dysfunction, insomnia, and elevated anxiety and depression. This research brief summarizes a landscape review done for the Patient Centered Outcomes Research Institute (PCORI) to develop a clear, comprehensive understanding of the state of research as of the mid-2000s. We conducted a targeted search strategy to identify projects funded by federal and commercial sources and the American Cancer Society (ACS) in addition to identifying funding opportunities released by the National Institutes of Health (NIH). We conducted additional review to identify studies focused on symptom and side-effect measures and five priority topic areas (selected by PCORI prior to the review) in the following five databases (from January 2005- through September 2015) with an inclusion criteria in an adapted PICOTS framework (populations, interventions, comparators, outcomes, time frames, and settings). We identified 692 unduplicated studies (1/2005 to 9/2015) and retained 189 studies about cancer symptom and side-effect management. Of these studies, NIH funded 40% and the ACS 33%. Academic institutions, health care systems, other government agencies, and private foundations or industry supported the remainder. We identified critical gaps in the knowledge base pertaining to populations, interventions, comparators (when those are relevant for comparative effectiveness reviews), and outcomes. We also discovered gaps in cross-cutting topics, particularly for patient decision-making studies, patient self-management of cancer symptoms and side effects, and coordinated care.

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Marsden, Eric. Risk regulation, liability and insurance: literature review of their influence on safety management. Fondation pour une culture de sécurité industrielle, September 2014. http://dx.doi.org/10.57071/337rrl.

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This document provides a short literature review on the complementarity (and antagonisms) between liability rules, safety regulation and insurance and their effect on safety management. It draws on a range of disciplines, with a focus on economic analysis of law and regulation theory. Some of the issues discussed are rather complex; this document attempts to provide simple explanations together with references to the professional literature for the interested reader. Some issues are the subject of ongoing debate between scholars; in such situations, we have attempted to present the various points of view. The document provides background information concerning the topics discussed during the NeTWork’2012 workshop, and draws on some of the contributions of workshop participants and the rich discussion which took place during the three days. The first chapter presents issues related to regulation, starting with the classical economic justifications for state intervention (presence of externalities, information failures and moral hazard). A number of obstacles to the effectiveness of safety regulation are presented. Finally, some alternatives or complements to regulation, including self-regulation, are briefly discussed. Chapter 2 presents an overview of liability law, starting with some introductory definitions. Factors which weaken the effectiveness of liability as an incentive to invest in prevention are discussed, as are negative effects of liability regimes on safety management. A number of case studies illustrating the liability of regulators are briefly presented. Chapter 3 discusses the impact of insurance and reinsurance on firms’ and individuals’ safety management. The last chapter briefly analyzes firms’ and individuals’ sources of motivation to take care.

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Muia, Esther G., and Joyce Olenja. Enhancing the use of emergency contraception in a refugee setting: Findings from a baseline survey in Kakuma refugee camps, Kenya. Population Council, 2000. http://dx.doi.org/10.31899/rh2000.1038.

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In August 1992, the International Rescue Committee (IRC) at the request of the United Nations, the United Nations High Commission for Refugees, and the Kenyan Government, initiated a primary health care program in the Kakuma Refugee Camp. Since then, the population of the camp has continued to grow, and activities have moved from a crisis to a maintenance phase. In January 1997, IRC assumed the additional responsibility of the camp hospital, bringing the entire health sector under their management. IRC's programs focus on maintaining and improving public health and promoting self-reliance, particularly of the most vulnerable communities. This project focuses on emergency contraception as an aspect of the reproductive health (RH) needs of refugee women and men of reproductive age. The project will especially target the large adolescent community currently resident in the camp. The objective is to contribute to the improved quality of RH services for refugees and the local Turkana population in Kakuma through operations research on the introduction of emergency contraception. This report presents findings from the baseline survey.

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Totten, Annette, Dana M. Womack, Marian S. McDonagh, Cynthia Davis-O’Reilly, Jessica C. Griffin, Ian Blazina, Sara Grusing, and Nancy Elder. Improving Rural Health Through Telehealth-Guided Provider-to-Provider Communication. Agency for Healthcare Research and Quality, December 2022. http://dx.doi.org/10.23970/ahrqepccer254.

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Objectives. To assess the use, effectiveness, and implementation of telehealth-supported provider-to-provider communication and collaboration for the provision of healthcare services to rural populations and to inform a scientific workshop convened by the National Institutes of Health Office of Disease Prevention on October 12–14, 2021. Data sources. We conducted a comprehensive literature search of Ovid MEDLINE®, CINAHL®, Embase®, and Cochrane CENTRAL. We searched for articles published from January 1, 2015, to October 12, 2021, to identify data on use of rural provider-to-provider telehealth (Key Question 1) and the same databases for articles published January 1, 2010, to October 12, 2021, for studies of effectiveness and implementation (Key Questions 2 and 3) and to identify methodological weaknesses in the research (Key Question 4). Additional sources were identified through reference lists, stakeholder suggestions, and responses to a Federal Register notice. Review methods. Our methods followed the Agency for Healthcare Research and Quality Methods Guide (available at https://effectivehealthcare.ahrq.gov/topics/cer-methods-guide/overview) and the PRISMA reporting guidelines. We used predefined criteria and dual review of abstracts and full-text articles to identify research results on (1) regional or national use, (2) effectiveness, (3) barriers and facilitators to implementation, and (4) methodological weakness in studies of provider-to-provider telehealth for rural populations. We assessed the risk of bias of the effectiveness studies using criteria specific to the different study designs and evaluated strength of evidence (SOE) for studies of similar telehealth interventions with similar outcomes. We categorized barriers and facilitators to implementation using the Consolidated Framework for Implementation Research (CFIR) and summarized methodological weaknesses of studies. Results. We included 166 studies reported in 179 publications. Studies on the degree of uptake of provider-to-provider telehealth were limited to specific clinical uses (pharmacy, psychiatry, emergency care, and stroke management) in seven studies using national or regional surveys and claims data. They reported variability across States and regions, but increasing uptake over time. Ninety-seven studies (20 trials and 77 observational studies) evaluated the effectiveness of provider-to-provider telehealth in rural settings, finding that there may be similar rates of transfers and lengths of stay with telehealth for inpatient consultations; similar mortality rates for remote intensive care unit care; similar clinical outcomes and transfer rates for neonates; improvements in medication adherence and treatment response in outpatient care for depression; improvements in some clinical monitoring measures for diabetes with endocrinology or pharmacy outpatient consultations; similar mortality or time to treatment when used to support emergency assessment and management of stroke, heart attack, or chest pain at rural hospitals; and similar rates of appropriate versus inappropriate transfers of critical care and trauma patients with specialist telehealth consultations for rural emergency departments (SOE: low). Studies of telehealth for education and mentoring of rural healthcare providers may result in intended changes in provider behavior and increases in provider knowledge, confidence, and self-efficacy (SOE: low). Patient outcomes were not frequently reported for telehealth provider education, but two studies reported improvement (SOE: low). Evidence for telehealth interventions for other clinical uses and outcomes was insufficient. We identified 67 program evaluations and qualitative studies that identified barriers and facilitators to rural provider-to-provider telehealth. Success was linked to well-functioning technology; sufficient resources, including time, staff, leadership, and equipment; and adequate payment or reimbursement. Some considerations may be unique to implementation of provider-to-provider telehealth in rural areas. These include the need for consultants to better understand the rural context; regional initiatives that pool resources among rural organizations that may not be able to support telehealth individually; and programs that can support care for infrequent as well as frequent clinical situations in rural practices. An assessment of methodological weaknesses found that studies were limited by less rigorous study designs, small sample sizes, and lack of analyses that address risks for bias. A key weakness was that studies did not assess or attempt to adjust for the risk that temporal changes may impact the results in studies that compared outcomes before and after telehealth implementation. Conclusions. While the evidence base is limited, what is available suggests that telehealth supporting provider-to-provider communications and collaboration may be beneficial. Telehealth studies report better patient outcomes in some clinical scenarios (e.g., outpatient care for depression or diabetes, education/mentoring) where telehealth interventions increase access to expertise and high-quality care. In other applications (e.g., inpatient care, emergency care), telehealth results in patient outcomes that are similar to usual care, which may be interpreted as a benefit when the purpose of telehealth is to make equivalent services available locally to rural residents. Most barriers to implementation are common to practice change efforts. Methodological weaknesses stem from weaker study designs, such as before-after studies, and small numbers of participants. The rapid increase in the use of telehealth in response to the Coronavirus disease 2019 (COVID-19) pandemic is likely to produce more data and offer opportunities for more rigorous studies.

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Asthma self-management programmes can reduce unscheduled care. National Institute for Health Research, June 2017. http://dx.doi.org/10.3310/signal-000424.

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Supported self-management for people with asthma is the most effective model of care. National Institute for Health Research, December 2020. http://dx.doi.org/10.3310/alert_43023.

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Patients, in theory, might prefer GP-led care to self-management for high blood pressure. National Institute for Health Research, November 2019. http://dx.doi.org/10.3310/signal-000840.

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