Dissertations / Theses: 'Supported self-management'

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Istead, Hannah. "Recovery in a mental health setting : an Interpretative Phenomenological Analysis of how an individual experiences a Peer-Supported Self-Management Intervention." Thesis, University of Leicester, 2015. http://hdl.handle.net/2381/33296.

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Peer support workers are people with lived experience of mental health distress who provide mental health interventions or services to people with mental health problems who are at an earlier stage in their recovery journey (Davidson et al., 2006). Disclosing personal strategies with a recipient is seen as one beneficial aspect of the peer support model. However minimal research has been conducted to explore how the individual experiences this relationship. This remains an important question due to the increase in recovery-orientated services operating peer support models in UK mental health settings. Literature Review: The act of self-disclosure (SD) within the peer model may be seen as a critical ingredient to the models success. Qualitative studies examining client’s perception of therapist SD were reviewed using the meta-ethnographic process. Seven studies were found to meet inclusion criteria. Themes identified were that SD could simultaneously strengthen and also impede the alliance formed between therapist and client. Findings overlap with the salient components of effective therapeutic alliance, but also that SD can trigger early unhelpful attachment experiences leading to alliance ruptures. Research Report: Little is known about the circumstances in which the peer support model works (Repper & Carter, 2011). Semi-structured interviews were conducted with seven individuals who had been in receipt of peer support self-management intervention as part of a Randomised Controlled Trial. Interviews were analysed using interpretative phenomenological analysis. Findings indicated that internal and external stigmatising attitudes and concealment of mental health identity contributed to ambivalent identification with the peer. Contrary to this, individuals also used the relationship to challenge stigmatising attitudes. Results are also considered in light of criticisms of the recovery model. Critical Appraisal: Critique of the research methodology and limitations are discussed. The trainee reflects on a psychology of humanistic values, counter to the experimental/positivist psychological tradition.

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Kossurok, Anke. "Making the invisible visible : a grounded theory study of female adult trauma survivors reconstructing reality with supportive others." Thesis, University of Edinburgh, 2018. http://hdl.handle.net/1842/31218.

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Violence against women and children is a pervasive challenge across the globe. Research has shown that survivors of interpersonal violence, such as child maltreatment and intimate partner violence, may develop a complex form of post-traumatic stress disorder accompanied by, for example, difficulties in regulating emotions and relating to others. Additional mental health and social problems contribute to survivors' long-term impairment. Therefore, it is imperative that we understand the key elements and processes that facilitate trauma recovery. The majority of research places survivors as individuals at the core of understanding trauma and recovery, which makes it an intrapsychic problem focused on, for example, the individual's cognitive bias, maladaptive interpersonal behaviour, or emotion dysregulation which need repairing, rather than considering appropriately the role of context, external factors and social processes. Thus, trauma recovery may be more complicated. The current study explored key elements and processes of trauma recovery in female adult survivors with a focus on emotional and interpersonal skills, within the narratives of individuals constructing their own recovery within an interpersonal context. Fifteen female adult survivors were recruited from a statutory clinical service and a third-sector community project. Participants were interviewed individually, and data were analysed qualitatively using grounded theory. The study constructed a framework of four key components. Women survivors initially disengaged from feelings, other people and themselves (1), gradually made hidden experiences visible (2) and examined these (3), and eventually reconstructed their reality (4). Although not always a linear process, this framework revealed a transition from self-guided to supported self-management. Women survivors sought out relationships, were impacted by relationships, and these relationships changed the way survivors responded. Thus, female trauma survivors reconstructed abuse, trauma and identity through various supportive others. Similarly, female survivors reframed emotional and interpersonal difficulties and gradually managed these through relationships. Future research as well as theories, practices and policies need to consider the multifaceted and relational nature of interpersonal trauma recovery. Guidelines and practices, for instance, could include community-focused strategies that provide a larger network of support to survivors and, thus, would offer multiple opportunities to experience positive interactions. Equally, mandatory training of health care staff about interpersonal violence and subsequent trauma as well as training in relating positively to survivors would make a real difference.

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Huang, Yan. "Investigation of decision support for self-management of chronic conditions." Thesis, University of Ulster, 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.558784.

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Chronic conditions are the leading cause of morbidity and mortality in the world. Traditional health care for people suffering from a chronic condition is expensive and consumes significant resources. This Thesis focuses on investigating novel applications of technologies and services to improve the support offered to patients in the self-management of their chronic conditions. A decision support framework for self-management is proposed. It combines three theoretical perspectives: utilizing information gleaned from behavioural, psychological and biological interventions. A personal self-management system (PSMS), developed within SMART2, utilizes such a framework. It facilitates the integration of activity information, self-reporting, vital signs and lifestyle monitoring data. Approaches have been developed and applied to analyse the information collected and provide feedback to the 'patient' to assist with self-management. An orientation free adaptive step detection (OF ASD) algorithm was developed, deployed and evaluated with a smart phone equipped with accelerometers to detect levels of activity in the form of human steps. The advantages of the OF ASD algorithm following evaluation were found to be the self adaptive nature of the approach for each individual and the orientation free notion for smart phone placement. The accuracy and sensitivity of the OF ASD algorithm achieved performance rates of 93.4% and 93.2%, respectively. Furthermore, an approach was considered involving the identification of a patient's health status through self-reporting. Several feature selection and classification methods were evaluated and the optimal combination for the purposes of classification was reported. The results have indicated that a Multi layer Perceptron (MLP) based classifier had the best classification performance on an optimised subset of 10 questions. Based on the study it has found that the analysis of the lifestyle of a patient produces relevant knowledge that can be used to inform and promote behavior change on the part of the patient and to support self-management. Overall, the results from the research have demonstrated that assistive technologies and suitable algorithms have the capability to facilitate self-management for people with chronic conditions.

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Rivera-Hernandez, Maricruz. "Self-Management, Social Support, Religiosity and Self-Rated Health Among Older Mexicans Diagnosed with Diabetes." Miami University / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=miami1366390281.

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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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Schwartz, Abby Jill. "Perceived social support and self-management of diabetes among adults 40 years and over." Connect to this document online, 2005. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=miami1117047583.

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Thesis (M.G.S.)--Miami University, Dept. of Sociology and Gerontology, 2005.
Title from first page of PDF document. Document formatted into pages; contains [1], vi, 69 p. Includes bibliographical references (p. 65-69).

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Bergenholm, Linnéa. "Modeling as a Tool to Support Self-Management of Type 1 Diabetes." Thesis, Linköpings universitet, Institutionen för medicinsk teknik, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-88499.

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Type 1 diabetes (T1D) is an auto-immune disease characterized by insulin-deficiency. Insulin is a metabolic hormone that is involved in lowering blood glucose (BG) levels in order to control BG level to a tight range. In T1D this glycemic control is lost, causing chronic hyperglycemia (excess glucose in blood stream). Chronic hyperglycemia damages vital tissues. Therefore, glycemic control must be restored. A common therapy for restoring glycemic control is intensive insulin therapy, where the missing insulin is replaced with regular insulin injections. When dosing this compensatory insulin many factors that affect glucose metabolism must be considered. Linkura is a company that has developed tools for monitoring the most important factors, which are meals and exercise. In the Linkura meal and exercise tools, the nutrition content in meals and the calorie consumption during exercise are estimated. Another tool designed to aid control of BG is the bolus calculator. Bolus calculators use input of BG level, carbohydrate intake, and insulin history to estimate insulin need. The accuracy of these insulin bolus calculations suffer from two problems. First, errors occur when users inaccurately estimate the carbohydrate content in meals. Second, exercise is not included in bolus calculations. To reduce these problems, it was suggested that the Linkura web tools could be utilized in combination with a bolus calculator. For this purpose, a bolus calculator was developed. The bolus calculator was based on existing models that utilize clinical parameters to relate changes in BG levels to meals, insulin, and exercise stimulations. The bolus calculator was evaluated using data collected from Linkura's web tools. The collected data showed some inconsistencies which cannot be explained by any model. The performance of the bolus calculator in predicting BG levels using general equations to derive the clinical parameters was inadequate. Performance was increased by adopting an update-algorithm where the clinical parameters were updated daily using previous data. Still, better model performance is prefered for use in a bolus calculator. The results show potential in developing bolus calculator tools combined with the Linkura tools. For such bolus calculator, further evaluation on modeling long-term exercise and additional safety features minimizing risk of hypoglycemia are required.

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Jutterström, Lena. "Illness integration, self-management and patient-centred support in type 2 diabetes." Doctoral thesis, Umeå universitet, Institutionen för omvårdnad, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-67847.

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Background: Type 2 diabetes is a serious disease that is increasing globally. The focus of diabetes care has been to prevent diabetes related complications and thereby reduce mortality. An older population, the disease progression and decreased ability to perform self-management activities increases the risk for complications. Group education and patient-centred care are recommended to improve self-management through increased patient empowerment. Despite these recommendations, professionals have been reluctant to adopt these methods referring to lack of knowledge, time and tools to deliver patient-centred care in diabetes. Focusing on the patient’s illness integration process has in the literature been suggested to improve self-management and metabolic balance. Aim: The overall aim of the thesis was to describe the experiences of illness integration, self-management and support in type 2 diabetes and to evaluate the metabolic effects of a nurse-led patient-centred model for self-management support. Methods: The study setting was primary health care in Västerbotten County, Sweden. In total, 21 diabetes nurses (Study I) and 257 patients (Studies II-IV) participated in the four studies (Study II, n=44; Study III, n= 18; Study IV, n= 195). Data consisted of focus group interviews (Study I), individual semi-structured interviews (Studies II-III) and laboratory measurements (Study IV). Methods for analyses were qualitative content analysis (Studies I-III) and statistics (Study IV). Results: Study I revealed that diabetes nurses found the ideal diabetes care complex to achieve. Conflicting paradigms, power relations and departmentalisation of work were described. Study II describes a process whereby illness integration and self-management in type 2 diabetes develop simultaneously. When a turning-point occurs, people view self-management as both necessary and feasible. In study III, turning points in self-management are illuminated. Turning-point transitions include existential and emotional aspects that increase inner motivation and power for lifestyle change. Study IV evaluates the effects of a nurse-led intervention in which haemoglobin A1c (HbA1c) was significantly decreased at 12 months’ follow-up. Group intervention and individual intervention were both effective compared to traditional diabetes care. Conclusions: There is a potential for improvement of type 2 diabetes care. Increased patient-centredness is important to support patients towards illness integration and self-management. Focusing on the patients’ illness experiences, including the existential and emotional aspects of having and managing type 2 diabetes, in counselling can lead to improved self-management and glycaemic control. Patients’ experiences of illness are central to their inner motives for change, and patient-centred self-management support and patient education preferably emanate from this perspective.
Bakgrund: Typ 2 diabetes är en allvarlig sjukdom som ökar globalt. Fokus i diabetesvården har varit att förebygga diabetesrelaterade komplikationer och därmed minska dödligheten. En åldrande befolkning, progression av sjukdomen samt en begränsad förmåga att utföra egenvårdsaktiviteter ökar risken för komplikationer. Grupputbildning och patientcentrerad vård rekommenderas för att förbättra egenvården genom ökad empowerment. Trots dessa rekommendationer har läkare och sjuksköterskor rapporterats vara tveksamma till dessa metoder och hänvisat till bristande kunskap, tidsbrist och avsaknad av verktyg. Att fokusera på patienters sjukdomsintegrationsprocess har i litteraturen föreslagits förbättra såväl egenvård som metabol balans. Syfte: Avhandlingens övergripande syfte var att beskriva erfarenheter av sjukdomsintegration, sjukdomshantering och support vid typ 2 diabetes samt att utvärdera effekter av en sjuksköterskeledd patientcentrerad modell för egenvårdssupport. Metod: Studierna genomfördes inom primärvården i Västerbottens läns landsting. Totalt deltog 21 diabetessjuksköterskor (Studie I) och 257 patienter (Studie II-IV), i de fyra studierna (Studie II, n=44; Studie III, n= 18; Studie IV, n= 195). Data bestod av fokusgruppsintervjuer (Studie I), individuella halvstrukturerade intervjuer (Studie II-III) och laboratoriemätningar (Studie IV). Analysmetoderna var kvalitativ innehållsanalys (Studie I-III) och statistik (Studie IV). Resultat: Studie I visade att en ideal diabetesvård är svår att uppnå enligt diabetessjuksköterskorna. Paradigmkrockar, maktrelationer och splittrade arbetsuppgifter beskrevs. Studie II beskriver en modell där sjukdomsintegration och sjukdomshantering utvecklas samtidigt. När en ”turning point” nåddes såg patienterna sjukdomshanteringen som både nödvändig och möjlig att genomföra. I studie III belystes ”turning points” och som omfattar både existentiella och emotionella aspekter som kan öka inre motivation och egenkraft att utföra livsstilsförändringar. Studie IV utvärderade 12-månaderseffekterna av en sjuksköterskeledd intervention och HbA1c sänktes signifikant. Gruppintervention och individuell intervention visades vara effektiva metoder i jämförelse med traditionell diabetesvård. Slutsatser: Det finns en förbättringspotential inom diabetesvården och ökad patientcentrering är viktig för att stödja patienter att integrera sjukdom och egenvård i livet. Att i diabetesvården fokusera på patienters sjukdomsupplevelser inklusive de existentiella och emotionella aspekterna av att leva med och hantera en sjukdom kan innebära förbättrad sjukdomshantering och metabol balans. Patienters sjukdomsupplevelser är centrala för deras inre motiv till förändring och patientcentrerad egenvårdssupport och patientutbildning bör utgå från detta perspektiv.

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Muller, Ingrid. "The therapeutic relationship in remote support for self management of chronic dizziness." Thesis, University of Southampton, 2012. https://eprints.soton.ac.uk/358930/.

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Telephone-delivered therapy is often used to deliver support as it can help overcome barriers that may previously have prevented patients with chronic illness from accessing key services. Very little research has looked at the therapeutic relationship during telephone support for people self-managing a chronic illness. the empirical work in this thesis is nested within a randomised controlled trial (RCT) of self-management of chronic dizziness, a condition that can be debilitating with serious consequences. This thesis explored the role of the therapeutic relationship during telephone support for using booklet-based vestibular rehabilitation (VR) to self-manage chronic dizziness. A meta-analysis of telephone delivered therapy for chronic illness was conducted to examine whether or not telephone therapy can affect physical health outcomes. Eight RCTs (1093 patients) were included, and the results found that telephone delivered therapy significantly improved physical health outcomes in people with chronic illness (d = 0.225, 95% Cl = 0.105, 0.344). A qualitative study of people's experiences of self-managing chronic dizziness using booklet-based VR with or without telephone support (n=33) identified themes characterising people's experiences, thoughts and feelings about these models of VR delivery. Findings indicated that participants valued telephone support. Quantitative analysis examining predicators of outcome (n=112) found that the therapeutic relationship predicted change in handicap, and was related to greater enablement, although it was not related to change in dizziness symptoms. A final mixed methods study aimed to evaluate the development of the therapeutic relationship using Roter Interaction Analysis System to examine recorded therapy sessions. This study found patient centredness during therapy to be related to the therapeutic relationship. Exploratory analyses indentified specific features of patient-centredness that may be related to better and worse alliance. A qualitative analysis of high and low patient centred therapy sessions found that high patient centredness sessions were more likely to include general chat, encouragement, reassurance, and therapists were more responsive to participant cues. Low patient centred sessions were more likely to include participant concerns and therapists not responding to participant cues. This thesis indentified a number of potential elements of telephone support that may be important for the development of the therapeutic relationship in patients self-managing dizziness.

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Lean, M. L. "Self-management and peer support interventions for people with Severe Mental Illness." Thesis, University College London (University of London), 2017. http://discovery.ucl.ac.uk/10024652/.

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This thesis investigates the effectiveness of self-management interventions for people with severe mental illness. Part one is a systematic review and meta-analysis of self-management interventions for those with severe mental illness. Part two reports on resilience outcomes in a randomised controlled trial of a peer-delivered self-management program for people recently discharged from crisis care (ISRCTN registration: http://www.isrctn.com/ISRCTN01027104). It also investigates baseline predictors of resilience. Part three, the critical appraisal, examines the concepts of self-management and resilience. It also considers the methodological and conceptual challenges of conducting randomised controlled trials of complex mental health interventions, particularly in populations where outcomes are largely socially determined.

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Pouladi, Fatemah Ali RN. "Diabets Knowledge, Self-Effecacy, Social Support, and Diabetes Self-management Affecting Type II Diabetes Outcomes In Qataris." Case Western Reserve University School of Graduate Studies / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=case151512792425253.

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Gibson-Scipio, Wanda. "The association of perceived emotional support self-regulation and asthma health related outcomes." Diss., Connect to online resource - MSU authorized users, 2006.

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Burling, Diane. "Nursing Faculty Perspectives on Support in Technology, Learning Management Systems, and Self-efficacy." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/4777.

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Past literature has shown that nursing programs reported educators were at the novice or beginner level regarding use of technology and that there was a critical need for faculty development. There was a lack of current information on the perspectives of nurse faculty utilizing learning management systems. Learning management systems are being used within nursing education, faculty should be proficient implementing the technology, if not, students and faculty suffer. The purpose of this study was to understand how nursing faculty perceive the use and support for integrated online Learning Management System (LMS) technology, along with levels of self-efficacy, at the institution in which they work. The Bandura self-efficacy conceptual framework was used to explore nursing faculty perspectives on the use of LMS technology. A case study approach was used for this study to aid in identifying the perspective of nursing educators who have utilized LMS technology. Participants included 8 nursing faculty from 3 Southeastern Pennsylvania nursing program. Data sources consisted of online survey questions and telephone interviews. Survey data results were analyzed by means of central tendency. Transcriptions of interviews were analyzed using NVivo software for coding and identification of themes and patterns. The results revealed that nursing faculty did not seem to like their LMS platform; however, the majority of the faculty did consider the LMSs useful in providing materials to students and for posting grades, although faculty stated a desire for additional training and regular workshops on using LMSs. This research can contribute to positive social change by assisting stakeholders in best implementation of LMSs in student instructional practices.

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Kaldis, Emmanuel. "Designing a knowledge management architecture to support self-organization in a hotel chain." Thesis, University of Manchester, 2014. https://www.research.manchester.ac.uk/portal/en/theses/designing-a-knowledge-management-architecture-to-support-selforganization-in-a-hotel-chain(d7e51581-b634-49e1-8d34-4bb29b958774).html.

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Models are incredibly insidious; they slide undetected into discussions and then dominate the way people think. Since Information Systems (ISs) and particularly Knowledge Management Systems (KMSs) are socio-technical systems, they unconsciously embrace the characteristics of the dominant models of management thinking. Thus, their limitations can often be attributed to the deficiencies of the organizational models they aim to support. Through the case study of a hotel chain, this research suggests that contemporary KMSs in the hospitality sector are still grounded in the assumptions of the mechanistic organizational model which conceives an organization as a rigid hierarchical entity governed from the top. Despite the recent technological advances in terms of supporting dialogue and participation between members, organizational knowledge is still transferred vertically; from the top to the bottom or from the bottom to the top. A number of limitations still exist in terms of supporting effectively the transfer of knowledge horizontally between the geographically distributed units of an organization. Inspired from the key concepts of the more recent complex systems model, referred frequently as complexity theories, a Knowledge Management Architecture (KMA) is proposed aiming to re-conceptualize the existing KMSs towards conceiving an organization as a set self-organizing communities of practice (CoP). In every such CoP, order is created from the dynamic exchange of knowledge between the structurally similar community members. Thus, the focus of the KMA is placed on capturing systematically for reuse the architectural knowledge created upon every initiative for change and share such knowledge with the rest of the members of the CoP. A KMS was also developed to support the dynamic dimensions that the KMA proposes. The KMS was then applied in the case of the hotel chain, where it brought significant benefits which constitute evidence of an improved self-organizing ability. The previously isolated hotel units residing in distant regions could now trace but also reapply easily changes undertaken by the other community members. Top-management’s intervention to promote change was reduced, while the pace of change increased. Moreover, the organizational cohesion, the integration of new members as well as the level of management alertness was enhanced. The case of the hotel chain is indicative. It is believed that the KMA proposed can be applicable to geographically distributed organizations operating in different sectors too. At the same time, this research contributes to the recent discourse between the fields of IS and complexity by demonstrating how fundamental concepts from complexity such as self-organization, emergence and edge-of-chaos can be embraced by contemporary KMSs.

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Sepulveda, Refugio, and Refugio Sepulveda. "Management Information & Decision Support Epilepsy Tool (Mindset): Development of a Self-Management Tool for the Hispanic Community." Diss., The University of Arizona, 2017. http://hdl.handle.net/10150/626317.

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Background: Hispanic people with epilepsy, especially those who are primarily Spanish speaking, may be at an increased risk of disparities in managing their epilepsy. This may be due to limited communication between patients and healthcare providers (HCPs) and/or the scarcity of epilepsy self-management tools available to them. Self-management has been shown to help people with epilepsy increase their self-confidence and better cope with their disease. Despite advances in the field, educational interventions for epilepsy self-management are still limited. To help mitigate these challenges, this study renovated and translated into Spanish an existing epilepsy self-management support tool known as Management Information and Decision Support Epilepsy Tool (MINDSET). MINDSET is a tablet-based clinical aid designed for use by both patients and their HCPs to promote shared informed treatment and behavioral change decision-making. MINDSET uses information that the patient enters into a tablet-based application to create a patient profile and an action plan tailored to the patient’s self-management “at-risk” behaviors for review by the patient and their HCP during consultation. Purpose: The overarching goal of this study was to develop a theoretically-enhanced and empirically tested Spanish version of the MINDSET program tailored to the Hispanic community, taking into consideration a series of social, cultural, and economic factors unique to the community. This tool has been culturally tailored to help improve care to underserved Hispanics and address disparities in epilepsy care. A Spanish version of MINDSET will provide Hispanic patients with epilepsy with a tool that can help them acquire a better awareness of their health condition and to learn new skills to help them improve their epilepsy self-management, ultimately resulting in improved treatment compliance, fewer seizures, and reduced health care related costs. Methods: The usability study of this project consisted of two parts. Part 1 consists of the software development of the new Spanish version of MINDSET (both content and technical features). Part 2 consists of the usability testing of MINDET (i.e. the degree to which the program can be used by patients to achieve quantified objectives with effectiveness, efficiency, and satisfaction in its use). Part 1: The MINDSET assessment questionnaire (My Epilepsy) was revised by integrating systematic reviews from eight members of a research team composed of experts in communication technology, behavioral science, public health, and in the clinical management of epilepsy. MINDSET includes questions related to patient seizure history, seizure and medication management, and lifestyle management. A new module in the program (My Goals and Strategies) was created to list all of a patients’ at-risk items in each self-management domain and to identify items (i.e. Goals) for improvement. The patient is then asked to select from a list of behavioral strategies to meet their selected goals, estimate confidence to perform these behaviors; list any barriers for achievement, and brainstorm strategies to overcome any barriers. A new Action Plan is then created as a social contract between the patient and their doctor, where the patient commits to improving any self-management items that may need improvement. The Action Plan also serves as a communication tool to facilitate discussion between the patient and their doctor. Lastly, the new version of MINDSET was programmed for use. This step was completed by software programmers under contract with the research team. Once programmed into the computer tablets, the program was “alpha-tested” within the research team (i.e. a form of in-house acceptance testing) to identify any technical problems with the program before testing it with patients. Part 2: A usability study of the new version of MINDSET (4.1) was conducted with a sample of Hispanic patients (n=8) in four neurology clinics in Arizona and Texas. A usability rating scale and exit interview were used to collect quantitative and qualitative usability data after patients completed MINDSET. Prior to translating MINDSET into Spanish, the program was revised to address any comments and/or feedback provided by the patients during the first usability test of the program. MINDSET was then translated into Spanish, programmed into the tablets, and tested by a different group of Spanish-speaking patients (n=8) in four clinics in Arizona and Texas. Conclusion: The English and Spanish usability testing of MINDSET proved to be very effective. Patients participating in the usability study identified gaps and concerns with MINDSET and they provided their feedback and recommendations for improving the program (i.e. both content and interface). Overall, most of the patients perceived MINDSET as having a positive impact on managing their epilepsy (62.5-100%), found the program to be credible (87.5-100%) and found that the program was easy to use (87.5%). The new version of MINDSET (4.1) mark significant improvements over previous versions of the program in terms of its focus on prioritization and goal setting for self-management practice. The new Spanish version of the program (Span-MINDSET) will help address disparities in the care of epilepsy amongst Hispanic Spanish-speaking patients by making available a tool that will help them improve their knowledge, capacity, and better management of their epilepsy. Positive usability findings suggest that tablet-based Spanish language decision support is acceptable for Spanish speaking Mexican-American patients with epilepsy. These results also indicate a relationship between positive self-management behaviors and better health outcomes.

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Fazel, Maryam, Mohammad Fazel, Nora Bedrossian, Fernando Picazo, and Merri Pendergrass. "A student-implemented elective to improve medical student confidence in providing diabetes self-management support." DOVE MEDICAL PRESS LTD, 2016. http://hdl.handle.net/10150/621998.

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Background: The purpose of this study was to develop a preclerkship elective and assess its effectiveness in supplementing medical students' education. Methods: A group of medical students under the guidance of two faculty advisors developed an elective consisting of six sessions covering a variety of practical aspects of diabetes care/education taught by an interprofessional team. Following the course completion, a survey was emailed to the enrollees who attended at least one session. The results were analyzed using Wilcoxon signed-rank and descriptive analyses. Results: A total of 14 medical students were enrolled (nine first year and five second year). An average of 4.4 sessions/student was attended. Thirteen students attended at least one session and were surveyed. The survey response rate was similar to 62% (8/13). All eight students indicated that the course was valuable and would recommend it to their colleagues. A Wilcoxon signed-rank test revealed a statistically significant increase in students' confidence in all five areas assessed following participation in the course, P<0.05 with a large effect (r>0.5). Conclusion: This study suggests the feasibility of developing disease state-specific preclerkship elective courses and that such courses can be beneficial in supplementing medical student education with practical knowledge.

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Blakeman, Thomas Martin. "A qualitative study exploring support for self-management of long-term conditions in general practice consultations." Thesis, University of Manchester, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.525898.

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This doctoral study sought greater understanding of support for self-management in general practice consultations for people living with long-term conditions, and aimed to understand and help address the gap between policy and practice. Methods: Informed by a review of theoretical and methodological literature, a qualitative mixed methods study was undertaken, involving generation and comparative analysis of empirical data arising from three main sources: 1) observations of general practice consultations (n=86); 2) qualitative interviews with health professionals in general practice (n=17); and 3) qualitative interviews with patients with a long-term condition (n=12). Results: The thesis presents key discourse and discursive practices underpinning long-term condition management in general practice consultations. Coping with the disruption of living with a long-term condition was a key theme and identified to be of importance for both patients and health professionals. However, although a shared value, there was little evidence of this coping with the disruption being discussed during consultations. Patients and professionals had difficulty raising and addressing self-management topics whilst attempting to maintain social relations. Structural factors including the use computer templates as well as the division of labour among primary care professionals reinforced this tension. Discussion: In order for self-management support to become normalised into primary care, policy interventions concerning long-term condition management need to take into account of these tensions underpinning the care of patients with long-term conditions. A framework for embedding and integrating support for self-management of long-term conditions within primary care is proposed.

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Togba, Harrisson, and Hanna Richloow. "Support till tonåringar med diabetes typ 1. : En litteraturstudie." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-386423.

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Abstract Introduction: Diabetes type 1 is a chronic autoimmune disease requiring lifelong insulin therapy. Type 1 diabetes is one of the most common endocrine disorders affecting children and adolescents and the disease is often accompanied by severe complications. Treatment of type 1 diabetes is greatly facilitated by self-motivation to achieve good self-care and thereby reduce the risk of complications. It is important with good treatment and support to reach young people with type 1 diabetes for them to accept their illness and learn to live with it. Purpose: The purpose of this literature study is to describe the support young people with type 1 diabetes may need to live with their disease. Method: Literature review made up of current scientific journal articles and scientific reports published the last 10 years. The articles were searched on the databases PubMed and Cinahl. Results: Sixteen articles were found. In the analysis of the articles, 5 themes emerged: support from parents and family, support from healthcare, support from friends and support from others with diabetes. The result of the literature study shows that young people need positive support and feedback to manage their illness and self-care. Conclusions: The teenagers with type 1 diabetes need support to manage their illness. This is achieved through a good communication from health care, parents, family, friends and groups, and this in turn leads to a personal development which increases knowledge and gives them experience to take responsibility in their own care.

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Wingham, Jennifer. "Living with heart failure : self management, informed support and the role of the heart failure specialist nurse." Thesis, Exeter and Plymouth Peninsula Medical School, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.553683.

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People with heart failure frequently experience poor quality of life, often exacerbated by co-morbidities. This demands complex self-management activities, often supported by family members in care roles, and includes input from community Heart Failure Specialist Nurses (HFSNs) that is known to reduce hospital readmissions. There is, however, a paucity of knowledge about the perceptions of people living with heart failure concerning self-management strategies. Aim This thesis is a longitudinal study exploring emergent patterns and styles of self- management of persons with heart failure, the impact of family members and HFSNs. Method Thirty-one theoretically sampled participants with heart failure were recruited from a district general hospital between October 2004 and September 2006. The sample participated in home-based, audio-taped, semi-structured interviews prior to nurse intervention, describing how heart failure affected their lives, focusing on self-management strategies. The HFSNs conducted home visits and telephone contacts according to individual needs independent of the research. At five months, 23 participants completed a diary for 14 days. Twenty- seven participants (three died, and one withdrew) were interviewed at six 3 months to explore how self-management strategies had changed. The HFSNs participated in a focus group. Constructivist grounded theory and reflexive accounting informed data collection and analysis, leading to the inductive development of an explanatory framework for emergent themes, one of which, Informed Support, serves as an original and significant contribution to the literature. Results Successful management is a complex biopsychosocial activity, involving reconstructions of identity, symptom management, and relationship management, while living with a chronic and uncertain condition that severely compromises life activities. Central to successful management is Informed Support, where family members collaboratively develop a range of activities and attributes to augment self-management. This was perceived as most effective when the HFSNs were able to adopt a 'whole family' approach. Conclusion Heart failure self-management is a dynamic, complex and adaptive activity that can be positively and significantly shaped by Informed Support from family members. Community based HFSNs can influence, but need to recognise differing styles of, self-management.

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Hui, Chi Yan. "Developing, refining and feasibility study of mobile app to support asthma self-management (A4A - APP for Asthma)." Thesis, University of Edinburgh, 2018. http://hdl.handle.net/1842/31534.

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Background: Self-management with an action plan, as opposed to passive self-monitoring, improves health outcomes. However, engaging patients is challenging. Mobile technology, incorporating education, personalised asthma action plans and facilitating professional support, is an option for supporting asthma self-management. Clinical research has focussed on health-related outcomes rather than informing the features that patients want and will use in a self-management app. Technology developers focus on user engagement as opposed to developing telehealth based on clinical evidence, leaving patients struggling to choose safe telehealth to support their asthma self-management. Risk aversion results in legislation that can be a barrier to the development of asthma apps. Aims and objectives: Using phases of the MRC Framework for developing complex interventions, and the Oxford app roadmap to develop a prototype app, I aimed, from clinical, patient, technology and legislative perspectives to: •(Phase 1) Identify the evidence base •(Phase 2) Model key aspects of app development •(Phase 3) Explore the feasibility of a mobile app to support self-management. Methods: •(Phase 1) Systematic review, online social forum analysis, asthma apps review, and legislation regulation review were used to identify evidence. Results were analysed with reference to the PRISMS taxonomy of self-management support. •(Phase 2) Using results from phase 1, and with the advice of lay and professional advisory groups, I made decisions about the design of the prototype app and the feasibility study in phase 3. I also reviewed the legislative issues regarding self-management app development. •(Phase 3) I undertook a feasibility study of using asthma mobile apps. Within the three-month feasibility study, five practices in Lothian/Oxford and Asthma UK's social media invited adults with active asthma to try out our prototype app. I observed patient's download rate and app usage. Of the patients recruited from practices, I purposively sampled patients (based on age/sex, experience of asthma, current self-management and technology use) and interviewed them before and after using the app for one month about their preferred features. Interviews were transcribed, and thematically analysed with reference to the PRISMS taxonomy of self-management support. Results: •(Phase 1) Telehealth was at least as effective as traditional approaches to supported self-management. Most asthma patients using online social forums commented on self-monitoring features, such as logging peak flow and symptoms, as opposed to self-management features. No one explicitly discussed asthma action plans though some patients were positive to the apps which had incorporated an action plan. Similarly the most downloaded asthma apps offered self-monitoring features rather than action plans. Current medical device legislation is ambiguous: it is unclear if apps with an action plan are 'medical devices'. •(Phase 2) The final prototype app included the Asthma UK asthma action plan and monitoring features such as the morbidity questions of the Royal College of Physicians three questions, peak flow, use of reliever inhaler, other medication use and lifestyle status. A mixed method approach was chosen for the feasibility study. •(Phase 3) 111 asthma patients used the prototype app. The ownership of action plans increased 43% to 63% after the study. Most patients preferred digital to paper action plans though the digital format did not improve usage. Action plans and monitoring features were the most 'wanted' features by patients, GPs, asthma nurses and the administration staff in the practices. Some patients also 'wanted' more advanced features such as predictive exacerbation warnings, identifying precise triggers, learning about what caused/affected their asthma. Conclusions: Mobile apps are a feasible option to support asthma self-management. Ease of access to download is the key to adoption as well as sufficient motivation (e.g. personal invitation from their GP or asthma nurse). Motivation (specifically GP and asthma nurse's encouragement and perception of benefit) is the key to adherence, but it will be more effective if the app is easy to use. Action plans and self-management features were the most 'wanted' features by patients and professionals. Other features that patients 'wanted' varied; one size does not fit all. Advanced features might encourage on-going use of asthma apps to support self-management. Choice of features, service promotion and service deployment should be considered carefully when implementing mobile app in 'real world' setting. The key technological barriers were to provide seamless Wi-Fi and to connect the app with the practice's software platforms. 'Medical device' legislation is currently a barrier for self-management app development, further discussions with all stakeholders is needed to reach consensus on risks involved in incorporating action plans in an app.

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Contant, Éric. "Résultats d'une intervention multidisciplinaire randomisée contrôlé chez des patients avec multimorbidité et impact du statut socioéconomique sur les résultats." Mémoire, Université de Sherbrooke, 2018. http://hdl.handle.net/11143/12093.

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Contexte : Les interventions cliniques pour les patients avec multimorbidité sont complexes et l'effet du statut socioéconomique sur ces interventions est limité. Nous avons analyser l'effet d'une intervention multidisciplinaire chez des patients avec multimorbidité et l'effet du statut socioéconomique (SSÉ) sur les résultats de l'intervention. Méthodologie : Analyse secondaire de données d'une intervention multidisciplinaire pragmatique randomisée-contrôlée de patients avec maladies chroniques. Patients recrutés dans 8 cliniques médicales de première ligne. Les patients avec trois maladies chroniques et plus ou leurs facteurs de risques ont été analysés. Issu primaire : changement substantiel dans un des huit domaines du Health Education Impact Questionnaire (heiQ). Le statut socioéconomique (SSÉ) des participants a été mesuré au début de l'intervention. Une collecte de données additionnelles a été faite pour mesurer l'autoappréciation de la situation financière des participants. Des régressions logistiques univariées et multivariées ont été utilisées. Résultats : 281 participants ont été analysés, avec une moyenne de 5,5 maladies chroniques. 13.5% avaient un revenu annuel de moins de 20,000$ et 51% avaient un diplôme d'études secondaires ou moins. En analyses univariées, l'intervention a amélioré le heiQ dans 6 domaines (RC : 1.96-2.91, p<0,05). En contrôlant pour le SSÉ, le OR de quatre domaines a augmenté incluant un domaine qui est devenu statistiquement significatif (Positive and active engagement in life). Conclusion : L'intervention a été efficace pour améliorer les résultats du heiQ chez des patients avec multimorbidité. Après avoir corrigé pour le SSÉ, quatre domaines se sont améliorés, suggérant que le SSÉ avait un effet négatif sur les résultats.
Abstract : Background : Successful interventions for patients with multimorbidity are complex and the known impact of the socioeconomic status (SES) on these interventions is limited. We analyzed the effect of a multidisciplinary intervention on patients with multimorbidity and the effect of the SES on the results of the intervention. Methods : Secondary data analysis of a pragmatic randomized controlled trial relating to a multidisciplinary intervention on patients with chronic diseases in 8 primary care practices in Quebec, Canada. Participants with three or more chronic conditions or risk factors were included in the analysis. Primary outcome: self-management improvement assessed by a substantial change in one of the eight domains of the Health Education Impact Questionnaire (heiQ). Socioeconomic Status (SES) of participants was measured at baseline. Self-perceived financial status was also collected. Univariate and multivariate logistic regression were used. Results : 281 participants were included in the analysis, with a mean 5.5 chronic conditions or risk factors. 13.5% had an annual income <20,000$ and 51% had an high school degree or less. In the univariate analysis, the intervention improved 6 domains of the heiQ (RC : 1.96-2.91, p<0,05). After controlling for SES, the OR of 4 domains improved, including a domain that became statistically significant (Positive and active engagement in life). Interpretation : The intervention was effective at improving self-management of patients with multimorbidity. After correction for SES, the OR of domains improved, suggesting the SES had a negative effect on the results.

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Jones, Lisa Gale. "The Utility of the U.S. Diabetes Conversation Map as an Intervention to Promote Diabetes Self-Management Adherence." UKnowledge, 2014. http://uknowledge.uky.edu/nursing_etds/13.

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Diabetes has reached epidemic levels, to the currently estimated 29 million individuals who are living with diabetes. Those with diabetes must manage their disease through a combination of medication, physical activity recommendations, and nutritional guidelines. The consequences of non-adherence to recommendations include cardiovascular disease, kidney failure, vision loss, or ultimately, death. Despite the risks of non-adherence, individuals often do not adhere to recommended treatment. Researchers have attempted to identify strategies to promote diabetes self-management adherence, thereby decreasing complications related to the disease. Specific Aims: describe the factors that prohibit individuals from adhering from diabetes self-management behaviors as well as the factors that promote self-management adherence, compare adherence rates of individuals participating in an enhanced diabetes education program with the adherence rates of individuals that participated in enhanced diabetes education and also attended group social support sessions, evaluate the adherence to self-management behaviors of individuals participating in a diabetes care coordination program. Results: A review of research articles from 2009 through 2013 identified barriers to diabetes self-management adherence as complexity of self-management, low health literacy, the financial burden of adherence, availability of resources, and lack of knowledge. Factors that promote diabetes self-management adherence include diabetes self-management education, self-efficacy, social support, and goal setting. A retrospective chart review of participants in an employer-sponsored health program was performed to examine the effectiveness of a social support intervention administered through the health program to promote adherence to recommended diabetes treatment. Results of the study revealed that individuals who participated in the social support intervention, in addition to the employer-sponsored health program, demonstrated increased adherence to recommended diabetes treatment from baseline to 12 months, in comparison to those who participated in only the health program (p = .048). Additional chart review compared participants’ self-management behaviors at baseline with their self-management behaviors at 12 months after entry into the program. There was a significant improvement in adherence to self-management behaviors of receiving an influenza vaccination (p = .036), decreased reported use of alcohol (p = .002) and tobacco (p = .043), and fewer reports of skipped meals (p = .009).

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Monaghan, Jenni. "Experiences and perspectives of self-management for low back pain in clinical practice : implications for support and education." Thesis, Northumbria University, 2015. http://nrl.northumbria.ac.uk/28953/.

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Pain is multidimensional and self-management is advocated to manage the biopsychosocial impact of this on individuals’ lives. Thus, these individuals’ perspectives regarding self-management have been explored. This study aimed to firstly explore how self-management was understood in the context of low back pain through the experiences of people living with low back pain and physiotherapists’. This then led to informing the development of an education programme for physiotherapists to support self-management. The study used a mixed method approach, which involved three phases being carried out over a period of time with each informing the subsequent phase. Phase 1, a qualitative synthesis examined primary qualitative research focusing on people living with low back pain and physiotherapist experiences of self-management of low back pain. The synthesis informed phase 2, two qualitative studies addressing areas of paucity found within the literature. The final phase, a feasibility study involved the development of an education programme for physiotherapists who completed pre and post outcome measures. Focus groups were also used in evaluating the intervention. The qualitative synthesis revealed a limited amount of literature regarding physiotherapists’ views and experiences of self-management of low back pain. A large proportion of studies that related to physiotherapy focusing on people living with low back pain experiences of self-management concentrated on strategies, in particular exercise with limited relation of this to daily life. The primary qualitative studies highlighted some difficulties physiotherapists faced when supporting the management of the biopsychosocial impact of LBP. Further, at times self-management could be used as a last resort. In relation to this, half of the people interviewed living with low back pain found this to be restricting their daily activities and were fearful and concerned regarding worsening pain in the future. These findings suggested people were not managing the biopsychosocial impact of low back pain and physiotherapists at times viewed influences on the pain experience as separate rather than integrated. Pain neurophysiology education linked to clinical practice was used to demonstrate the integrated nature of the pain experience, be relevant to physiotherapists and ultimately facilitate biopsychosocial self-management through enhancing understanding of the multidimensional nature of pain. Collectively, this thesis has developed understanding of self-management from the physiotherapist perspective, illuminating the support required for physiotherapists and revealed physiotherapists value pain neurophysiology education linked to practice however further support is required to implement this in clinical practice.

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Shen, Huixia. "Effectiveness of a peer-led self-management program for older people with type 2 diabetes in China." Queensland University of Technology, 2008. http://eprints.qut.edu.au/20671/.

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Type 2 diabetes is a common chronic disease, which has a negative health impact and results in enormous economic burden. The prevalence of type 2 diabetes is increasing dramatically and it affects older people disproportionately. The healthcare system in China is faced with an overwhelming burden due to a large ageing population, high prevalence of diabetes and limited healthcare resources. Self-management has been widely accepted as the cornerstone of the clinical management of type 2 diabetes. Since self-management usually involves complex behaviour change and can be emotionally challenging, effective education is essential to facilitate this transition. However, there has been no existing program of type 2 diabetes self-management for older patients in China until now. Furthermore, the generalisation of any health education programs is often hampered due to limited healthcare resources in China. The primary purpose of this study was to develop a socially and culturally suitable self-management program, which addressed self-efficacy and social support to facilitate behaviour change and subsequent health improvement, for older people with type 2 diabetes living in the community in China. The secondary purpose was to test a feasible delivery model of the program through involvement of peer leaders and existing community networks. This study was conducted in three phases. Phase one gathered information about barriers related to self-management behaviours and help needed to address them, from the perspective of older people with type 2 diabetes and community health professionals, through focus group discussion. Data from Phase One, together with guidelines of the selected theoretical frame work, results from an extensive literature review, and experiences of previous relevant studies provided the basis for development of a peer-led type 2 diabetes self-management program (Phase Two). Phase Three involved a pre-test, post-test non-equivalent control group design to test the effectiveness of the self-management program on older people with type 2 diabetes in the community. The impact of the program on peer leaders was examined using a one group pre-test, post-test design. In addition, evaluation of the program from peer leaders’ and older people’s perceptions was conducted through a post-test questionnaire. Older people with type 2 diabetes and health professionals expressed broadly the same concerns, which were: social support; confidence to practice self-management behaviours; self-management behaviours; barriers to self-management behaviours; and advice for ongoing health education. However, their points of view were not always identical and different emphases were identified. The peer-led program produced significant improvement in social support, self-efficacy, self-management behaviours and depressive status in the experimental group, as compared to the non-equivalent control group. However, there was no significant effect on quality of life nor health care utilisation. Therefore, the effectiveness of the program among older people with type 2 diabetes was partially confirmed. In addition, the participants were supportive, giving positive feedback about the program. Suggestions for future improvement were provided as well. After receiving specific peer leader training and assisting in most of the delivery process of the program, the peer leaders improved, significantly, in overall self-management behaviours and in specific areas of social support and self-efficacy, though they did not improve in depressive status, quality of life and health care utlisation. In addition, these peer leaders enjoyed being peer leaders, and gave very positive feedback about the whole program. In conclusion, this study has implications for understanding and facilitating self-management behaviours for older people with type 2 diabetes in China. The peer-led self-management program was effective in improving levels of self-efficacy, social support, self-management behaviours and depressive status among older people with type 2 diabetes living in the community in China. The delivery process involving peer leaders was deemed feasible to implement within the health care system in China. The program is suitable to be used by community health professionals in their practice in China. The study also has potential wider benefit to nursing practice and global health practice.

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Wilson, Valerie Lynn. "Information, education and support needs of people with type 1 diabetes to enable effective self-management of the condition." Thesis, University of Kent, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.499704.

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Wu, Shu Fang. "Effectiveness of self-management for persons with type 2 diabetes following the implementation of a self-efficacy enhancing intervention program in Taiwan." Queensland University of Technology, 2007. http://eprints.qut.edu.au/16385/.

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Objective The aim of this study firstly, was to translate and test the validity and reliability of two diabetes-specific self-efficacy instruments (the Diabetes Management Self-Efficacy Scale; DMSES and the Perceived Therapeutic Efficacy Scale; PTES) in a Taiwanese population. The main aim of this study was then to develop an intervention based on self-efficacy theory that was appropriate for the Taiwanese population and to examine the effects of a self-efficacy enhancing intervention program (SEEIP). Background In Taiwan, the prevalence, mortality rate and healthcare cost of diabetes has dramatically increased. People with diabetes have low participation rates in performing self-care activities, with some two-thirds of diabetic patients not controlling their disease appropriately. Moreover, few studies in Taiwan have conducted randomised controlled trials or had improvement in patient self-care or self-management as their primary goal and no instruments that measure self-efficacy related to the management of diabetes (especially for outcome expectations) have yet been found and appropriately used to measure the effectiveness of self-management. Therefore, there is a particular need for research on self-efficacy enhancing intervention programs for people with type 2 diabetes. Design A convenience sample survey (n=230) was used in order to test the validity and reliability of C-DMSES and C-PTES in a Taiwanese population. Moreover, a randomised controlled trial (RCT) (n=145; the intervention group (72); the control group (73)) design was conducted in the main study with pre (baseline) and post-testing (undertaken at 3 months and 6 months following baseline collection). Intervention Both the control group and intervention group received the standard diabetic educational program in the outpatient clinic. The intervention group participants received the standard diabetic educational program and the following additional interventions: (1) viewed a 10-minute DVD (2) received a "Diabetes Self-Care" booklet (3) participated in four efficacy- enhancing counselling intervention sessions, and (4) participated in telephone follow-up. The self-efficacy model was adapted from Shortridge-Baggett & van der Bijl (1996). Diabetes self-management principles were used in program development and evaluation. Main outcome measures Instruments used in data collection included 1) Self-efficacy towards management of type 2 diabetes (as measured by the Chinese version of the Diabetes Management Self-Efficacy Scale; C-DMSES and the Chinese version of the Perceived Therapeutic Efficacy Scale; C-PTES); 2) self management behavior (as measured by the Summary of Diabetes Self-Care Activities; SDSCA); 3) health-related quality of life for diabetes (as measured by the Short Form-12; SF-12); 4) psychosocial well-being (as measured by the Medical Outcomes Study (MOS), Social Support Survey (SSS) tool and the Center for Epidemiology Studies Short Depression Scale; CES-D) and 5) health care utilisation (as measured by health care utilisation self report instrument). Data analysis Data were double-entered for verification using SPSS® statistical software. Study I: Descriptive statistics, regression analysis, Pearson's correlation, Cronbach's alpha-coefficients, factor analysis and Bland-Altman plots with 95% limits of agreement (LOA) were performed to evaluate validity and reliability of C-DMSES and C-PTES. Study II: Descriptive analysis was used to examine demographic variables and outcome variables. T-tests were used to analyse differences on continuous data between mean scores for the intervention and control groups. Categorical data were analysed using Chi-square statistics to test the significance of different proportions. To assess the group differences of dependent variable changes, repeated measures ANOVA/ ANCOVA were used. Results Study I: Convergent validity showed that C-DMSES correlated well with the validated measure of the General Self-Efficacy Scale (GSE) in measuring self-efficacy. Criterion-related validity showed that the C-DMSES was a significant predictor of the Summary of Diabetes Self-Care Activities (SDSCA) scores. Factor analysis supported the C-DMSES being composed of four subscales with good internal consistency (Cronbach's alpha=.77 to .93) and stability (ICC=.82). Similarly, significant criterion-related validity was demonstrated between the C-PTES and SDSCA scores. Convergent validity was confirmed as the C-PTES converged well with the GSE Scale in measuring self-efficacy. Construct validity of the C-PTES was confirmed through factor analysis and a single subscale formed. Internal consistency with a Cronbach's alpha was .95 and the test-retest reliability (ICC) was .77 and a Bland-Altman plot showed 97% of the subjects were within 2 standard deviations of the mean. Study II: The 3- and 6-month benefits of the intervention over usual care were increases in self-efficacy, outcome expectation, self-care activities, and social support. However, the results of the health-related quality of life and depression scores indicated that the change over time was not different in the two groups. A smaller proportion of the participants significantly in the intervention group, had been hospitalised and visited the emergency room than participants who were in the control group at the 6-month period. However, health-related quality of life and depression were not significantly increased in the intervention group at the 3- and 6-month compared to the control group. Conclusion Results of Study I support the psychometric properties of C-DMSES and C-PTES in providing a measure for self-efficacy specific to persons with type 2 diabetes in Taiwan. The main study revealed that the SEEIP for type 2 diabetes based on self-efficacy theory was culturally acceptable to Taiwanese people with diabetes and that the SEEIP was effective in the self-management of people with type 2 diabetes.

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Leung, Nelson K. Y. "Turning user into first level support in help desk development of a web-based user self-help knowledge management system /." Access electronically, 2006. http://www.library.uow.edu.au/adt-NWU/public/adt-NWU20060720.103131/index.html.

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Hamilton, Dorothy Jean. "The Lived Experience of Homeless Individuals with Type 2 Diabetes Mellitus." Kent State University / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=kent160623154767295.

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Boyer, Stefanie Leigh. "Self-Directed Learning: Measures and Models for Salesperson Training and Development." Scholar Commons, 2008. http://scholarcommons.usf.edu/etd/3878.

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Academic researchers and marketing practitioners are exploring methods to improve salesperson training. Recently, self-directed learning projects were proposed as a new paradigm for learning to take place in the sales domain (Artis & Harris, 2007). Current conceptual work provides a strong foundation for understanding salesperson self-directed learning; however, prior to quantitatively testing proposed models, scales must be created and modified to address salesperson specific learning endeavors. The purpose of this dissertation is: 1) to develop scales to measure salesperson willingness to use self-directed learning projects (SDLP's), 2) to develop a conceptual model of salesperson self-directed learning, 3) to modify current scales to specifically examine salesperson self-directed learning, and 4) to test this model empirically. To accomplish this, the relevant theories and literature were analyzed to create a theoretical model that would test the following research questions: 1.What factors contribute to salesperson willingness to use SDLP's? 2.What is the relationship between salesperson willingness to use SDLP's and salesperson use of SDLP's? 3.What is the relationship between salesperson use of SDLP's and salesperson performance? Two conceptual models were created to account for two categories of learning projects, induced and synergistic SDLP's. The following variables reflect the conceptual models: willingness to use induced/synergistic SDLP's, use of induced/ synergistic SDLP's, perceived supervisor/organizational support for induced/synergistic SDLP's, and self-regulation training and performance. Data from 392 salespeople within the financial services industry fit the measurement model and suggest that use of synergistic (non-mandatory) SDLP's positively impacts performance (.396) and use of induced (mandatory) SDLP's does not impact performance. Willingness to use synergistic SDLP's positively impacts use of synergistic SDLP's. Support from the organization and supervisor positively impact willingness to use induced and synergistic SDLP's. Surprisingly, training in self-regulation did not positively impact salesperson willingness to use induced or synergistic SDLP's. The new measures for all constructs exhibit Cronbach's alpha reliability statistics over .7 and acceptable confirmatory factor analysis results. The study provides reliable measurement scales and empirical support for the future study of self-directed learning in a sales context.

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Gur, Gulbir. "A Study On The Preductors Of Teachers&#039." Master's thesis, METU, 2008. http://etd.lib.metu.edu.tr/upload/12609976/index.pdf.

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The purpose of this study was to examine the predictors of teachers&rsquo
sense of efficacy including gender, teaching field, years of teaching experience, satisfaction with performance, support from colleagues, support from parents, and support from administration, and teaching resources. The present study was conducted in the 2006-2007 academic year. The study included a total of 383 science, mathematics, and classroom teachers from 62 elementary schools of Ç
ankaya district in Ankara. Data were collected through Teachers&rsquo
Sense of Efficacy Scale (Tschannen-Moran &
Woolfolk Hoy, 2001). In the present study, data were analyzed by utilizing four separate hierarchical regression analyses. Results showed that gender, teaching field, and years of teaching experience variables were not significant predictors for overall teacher efficacy, efficacy in instructional strategies, efficacy in classroom management, and efficacy in student engagement, whereas satisfaction with performance variable made significant contribution to all dependent variables. Parental support and teaching resources predicted only efficacy in student engagement.

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Mullen, J. M. "The relationship between empathy and Self-Management Support in general practice consultations in areas of high and low socio-economic deprivation." Thesis, University of Glasgow, 2013. http://theses.gla.ac.uk/4533/.

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Aim: Empathy is widely regarded as an important attribute of healthcare professionals, and has been linked to higher patient satisfaction, enablement, and some health outcomes. The ‘mechanism of action’ of clinical empathy is not well understood. An ‘effect model’ of empathic communication in the clinical encounter has been proposed by Neumann et al (2009). In this model, clinician empathy is seen as having a positive effect in encouraging patients to tell more about their symptoms and concerns (for example, by picking up on emotional cues and responding in an encouraging way). This can result in ‘affective-oriented effects’ (such as the patient feeling listened to and understood) or ‘cognitive/action-oriented effects’ which include the clinician collecting more detailed information (medical and psychosocial), gaining a more accurate perception of the problem (and possible diagnosis) and enhanced understanding and responses to the patients’ individual needs. Such responses may include Self-Management Support of various kinds, which help enable the patients to better manage their condition(s), leading to improved outcomes. Recent Government policy in Scotland has focused on Self-Management Support and Anticipatory Care as key priorities in primary care, in response to the rise in chronic disease and health inequalities. However, the amount and type of Self-Management Support and Anticipatory Care that occurs in routine consultations in primary care is not known, nor their relationship with empathy and patient enablement. Thus the ‘effect model’ of empathy as proposed by Neumann, which postulates a relationship between empathy, Self-Management Support, and outcomes in the consultation remains largely theoretical. The aim of this thesis was to examine the relationships between patients’ perceptions of doctors’ empathy, patient enablement, health outcomes and the amount and the type of Self-Management Support (including Anticipatory Care) in general practice consultations. Due to the wide health inequalities that exist in Scotland, and the continuing operation of the ‘inverse care law’, a comparison was made between consultations in areas of high or low socio-economic deprivation to establish whether the relationships varied by deprivation. The thesis had the following research objectives; • To assess the nature, type and frequency of Self-Management Support (including Anticipatory Care) in general practice consultations in high and low deprivation groups • To determine whether patients’ perceptions of GP empathy is related to Self-Management Support (including Anticipatory Care) in consultations in high and low deprivation groups • To explore the effects of Self-Management Support (including Anticipatory Care) on patient enablement and health outcomes in high and low deprivation groups • To assess patients’ perception of empathy in terms of the nature, type, and frequency of emotional Cues and responses by GPs rated as high or low in empathy by their patients in consultations in high and low deprivation groups Methods: The research objectives were investigated by a secondary analysis of data collected between 2006-2008 by Mercer and colleagues in the Section of General Practice and Primary Care at the University of Glasgow. These data were collected as part of a research project in general practice in areas of high and low deprivation funded by the Chief Scientist Office of the Scottish Government. The research produced database, includes 659 videoed baseline consultations, with patient rated experience measures, including the Consultation and Relational Empathy (CARE) Measure, the Patient Enablement Instrument (PEI) and outcomes (self-reported symptom change and well-being) at 1 month post-consultation available on 499 patients. An observer-rated method of assessing Self-Management Support and Anticipatory Care was sought from the literature to answer objectives 1-3. However, there were a lack of validated observer-rated tools available that were specifically designed to measure these constructs. As such, the Davis Observation Code was identified as a validated system of coding primary care consultations across a broad range of consultation components which included items deemed to relate to Self-Management Support and Anticipatory Care. The process of selecting the Davis coding system, and the rejection of alternative coding systems is discussed in detail in Chapter 5. The Davis coding system was also considered feasible given the large size of the database. Self-Management Support and Anticipatory Care were then measured by using combinations of seven codes deemed relevant to Self-Management Support within the consultation setting. Four additional codes were added to the Davis system, in order to include tasks relevant to UK general practice consultations. These additional codes were not part of Self-Management Support or Anticipatory Care but were added to achieve a complete coding system of activities within the consultations. The Verona coding system measured emotional cues, concerns and health provider responses that were observed within the consultations. As such, this system was used to answer objective 4. The choice of this system reflected a desire to use an observer-rated measure to help ‘validate’ the patient-rated empathy measure (the CARE Measure) in terms of the first part of the Neumann et al (2009) model, i.e. eliciting concerns and symptoms, separate from the cognitive/action oriented effects relating to Self-Management Support. Results: Reliability of the objective coding systems Preliminary work was carried out on both coding systems in order to establish reliability in the application of the codes. This was a lengthy process, involving several cycles of coding by two coders (the author and one of her supervisors) but resulted in acceptably high levels of inter-rater reliability (kappa > 0.7 for the Davis coding system, and > 0.9 for the Verona coding system). Objective 1: The nature, type and frequency of Self-Management Support (including Anticipatory Care) in general practice consultations in high and low deprivation groups In both the high and low deprivation groups, time was predominantly allocated to gaining information about the patient’s complaint, conducting physical examinations and planning treatment. There was no difference observed in the amount of Self-Management Support overall in the consultations between high and low deprivation areas. However, there were significant differences in the nature, type and frequency of certain aspects of Self-Management Support, with significantly more Anticipatory Care in the consultations in the high deprivation areas. The results also showed that patients in the high deprivation group tended to experience a more direct biomedical focused consultation that featured practical tasks such as physical examinations and discussion of substance misuse. In the low deprivation group, a biopsychosocial approach was more common, which involved more time spent within the consultation discussing treatment effects, compliance or discussing how previous interventions had impacted on the patient’s health. For both groups, little time was allocated to gathering family information or counselling, answering patient questions or discussing health knowledge. Objective 2: Patients’ perception of GP empathy and relationship with Self-Management Support (including Anticipatory Care) in consultations in high and low deprivation areas. The relationship between empathy and Self-Management Support was explored using the Consultation and Relational Empathy Measure (CARE) and the Davis observation code respectively. Potential confounding variables were taken into account. Patients' perceptions of their GP's empathy were significantly associated with Self-Management Support in the low deprivation group, but not the high deprivation group.

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Buttigieg, Norma Josephine. "Support needs for diabetes self-management : exploring the views of Maltese individuals with type 2 diabetes using a grounded theory approach." Thesis, University of Hull, 2016. http://hydra.hull.ac.uk/resources/hull:15431.

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Diabetes is a long-term condition which causes significant public health concern in view of its increasing prevalence and associated morbidity. Notwithstanding this, effective management has been shown to prevent or delay the onset of diabetes complications, thereby improving prognosis. Diabetes has a high self-management demand. This involves behaviour modification together with psycho-social adjustments required to overcome challenges with integrating diabetes management in one’s life. Such challenges often originate from the socio-cultural context and it is recognised that support for diabetes self-management should target these challenges. The purpose of this study was therefore to explore how Maltese individuals with Type 2 diabetes believe they can be supported to manage their condition, as well as to examine whether, and if so how such views may be shaped by the Maltese socio-cultural environment. The study used a qualitative design guided by a Grounded Theory approach. Data were collected by in-depth focus group and one-to-one interviews, carried out amongst 52 adults with Type 2 diabetes recruited from an outpatient hospital clinic and community-based diabetes clinics in Malta. A total of six focus groups and twelve one-to-one interviews were conducted. Theoretical sampling was used and data analysis involved constant comparison of data, together with conceptualising and organising the data into categories. Generated categories were linked by exploring relationships between them, in the process of developing a substantive theory. The emergent theory describes how participants viewed diabetes self-management as involving the implementation of skills in thought and behavioural management. These skills were found to be key to coping and consisted of flexibility, proactive management, stress management and developing a positive mind-set towards diabetes. Furthermore, the theory outlines how aspects of Maltese culture, including those related to stigma, family, food and health services were seen to influence diabetes self-management directly, or through their impact on the development of such skills. A basic social process emerged representing individuals’ movement across the coping continuum, characterising transition to a higher/lower level of coping, during particular episodes in life. This process reinforced the identified relationship between the socio-cultural context and patient’s agency, demonstrating how such movement coincided with negative/positive experiences of socio-cultural influence. These findings have contributed new knowledge about the relationship between culture and diabetes-related coping. They suggest that patients may be supported in managing their diabetes by addressing cultural factors which influence the development of specific self-management skills. In Malta, this may involve new ways of delivering culturally sensitive care and education.

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Rye, Amanda. "Nurses’ experiences of good self-management among patients diagnosed with type 2 diabetes : An interview-based study with nurses’ in Kerala, India." Thesis, Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:esh:diva-7969.

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Background: India's growing economy has led to radical lifestyle changes and one of the consequences is an unexpected explosion of non-communicable diseases, such as Type 2 Diabetes. The prevalence of Type 2 Diabetes has more than doubled since 1980 from four to over eight percent in 2016. India has today the second largest adult population affected by Type 2 Diabetes in the world. 72.9 million adults had diabetes in India 2017 and by year 2035 this number is predicted to rise to 109 million. To cope with this epidemic, patients will need to perform adequate self-management. Nurses’ may have a major part in providing the support and knowledge patients require to be able to perform this. Aim: The aim of the study is to describe nurses’ experience of good self-management among patients diagnosed with T2D. Method: The study has a descriptive and qualitative design. Semi structured interviews with open-ended questions were carried out at a hospital setting in Kerala, India. Results: The analysis from the interviews resulted in three sub-themes and one main theme. The three sub-themes are Support from the family is fundamental for the patient's well-being, The importance of individualized care and The importance of teaching patients how to manage their condition. The three sub-themes resulted in the main theme Three Cornerstones for good self-management. Discussion: The result demonstrates that the nurses’ finds individualized care as an important matter. The participants declare that patients have different knowledge regarding Type 2 Diabetes, and how individualized care is a way to provide what the patient requires in order to perform self-management. The nurses also express how they always involve the patients' family, since their experience is that the absence of the family impairs the patient's condition.

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St, Clair Russell Jennifer J. "Development and Evaluation of a Peer-to-Peer Intervention to Increase Self-Management among Adult In-Center Hemodialysis Patients." VCU Scholars Compass, 2016. http://scholarscompass.vcu.edu/etd/4360.

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Background: Peer-to-peer (P2P) support programs have the potential to assist ESRD patients in managing their disease and improve outcomes. Yet, there is little research examining P2P programs’ impact on psychosocial outcomes and disease management behaviors. Methods: A 4-month P2P mentoring intervention was designed and piloted in a facility serving 249 in-center hemodialysis patients in Lynchburg, Virginia. Preceded by a social marketing effort, which included a program naming contest and participant recruitment, the intervention included: (1) mentor training, (2) pairing of mentees and mentors, (3) kick-off social mixers, (4) ongoing meetings between mentees and mentors, (5) mentor training booster, and (6) a final celebration. A single arm quasi-experimental study with repeated measurements at three time points was used with data collection over four months. The hypotheses that the intervention would result in improvements for both mentees and mentors (i.e., self-efficacy, knowledge, perceived social support, dialysis social support (i.e., support from peers within the dialysis setting), and self-management behaviors) were tested using repeated measures ANOVA or the Friedman’s test for nonparametric data. Results: Mentees experienced increases in self-efficacy, F(2,22)=8.15, p<.01; knowledge, F(2,44)=6.62, p<.01; perceived social support, F(2,22)=7.30, p<.01; and dialysis social support, F(2,44)=4.79, p=.01. Mentors experienced increases in knowledge, F(2,22)=11.88, p<.01; dialysis social support, F(2,42)=3.19, p=.05; and dialysis self-management, χ2(2) = 7.65, p =.02. Conclusion: A P2P mentoring program for in-center hemodialysis patients can be beneficial for both mentees and mentors. Future research should focus on larger groups of patients using more rigorous research designs.

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Sonsona, Jocelyn B. "Factors Influencing Diabetes Self-Management of Filipino Americans with Type 2 Diabetes Mellitus: A Holistic Approach." ScholarWorks, 2014. https://scholarworks.waldenu.edu/dissertations/1.

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There is an increasing prevalence of Type 2 diabetes mellitus among Filipino Americans. However, how well Filipino Americans with diabetes self-manage their disease and what factors influence their diabetes self-management behaviors remain unknown. Based on a holistic approach, this quantitative study was designed to investigate the diabetes self-management behaviors of this population and the factors influencing their self-management behaviors. The combined roles of diabetes knowledge, diabetes self-efficacy, spirituality, and social support were examined in predicting diabetes self-care behaviors. A convenience sample of 113 Filipino Americans with Type 2 diabetes mellitus completed the Diabetes Knowledge Test, Self-Efficacy for Diabetes Test, Daily Spiritual Experience Scale, Diabetes Social Support Questionnaire-Family Version, Summary of Diabetes Self-Care Activities (Expanded), and a researcher-designed sociodemographic survey. A single samplet -test determined that the participants engaged well in diabetes self-management practices. Multiple regression analyses revealed self-efficacy, spirituality, and social support were predictive of diabetes self-management behaviors, even after controlling for the effect of the confounding variables (e.g., acculturation, socioeconomic status, health-related data, immigration status, education). Diabetes knowledge did not have a significant relationship to self-management. The implications for positive social change include the potential impact of educating clients with diabetes and their family members about the connections between self-efficacy, spirituality, and family social support in the self-management of diabetes. Furthermore, the use of a holistic approach by health professionals would improve diabetes self-management practices of Filipino American population with Type 2 diabetes mellitus.

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Maclean, Kerstin, and Sandra Eriksson. "The psychosocial effects of living with type 1 diabetes : A literature review." Thesis, Karlstads universitet, Avdelningen för omvårdnad, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-72161.

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Introduction: Diabetes mellitus is an incurable, widespread disease increasing globally. 2017 there were 425 million people with the diagnosis, and circa 10% of these have type 1 diabetes mellitus. Diabetes mellitus is a disease which requires a lot of self-management. Living with a chronic disease may impact the patient’s mental and psychosocial health. Aim: The aim of this literature review was to describe how living with type 1 diabetes mellitus may affect the patient’s psychosocial health. Method: The study was conducted as a literature review using Polit and Beck’s (2017) nine steps. Data was collected using two databases, PubMed and CINAHL. The articles chosen were critiqued according to Polit and Beck’s (2017, p. 102-109) “Guide to an Overall Critique of a Qualitative Research Report” and “Guide to an Overall Critique of a Quantitative Research Report”. Twelve articles in total were chosen for the result, six quantitative and six qualitative. Results: Two main themes and seven subthemes were developed based on the results. Conclusion: Healthcare professionals did not take these patients’ psychosocial health into consideration. Many patients also felt that they could not self-manage their disease in public due to others’ perception of them. This could result in complications.

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Price, Vida. "Behavior intervention support teams : (BIST) and student attendance, achievement and self-esteem /." free to MU campus, to others for purchase, 1998. http://wwwlib.umi.com/cr/mo/fullcit?p9924915.

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Annesley, Sarah H. "A qualitative study of policy and action : how the Scottish Government has implemented self-management support for people with long-term conditions (LTCs)." Thesis, University of Stirling, 2015. http://hdl.handle.net/1893/22370.

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Objective: The promotion of self-management support for people with LTCs is a health policy priority across the UK (LTCAS 2008; DoH 2012). Self-management support is designed to change and improve care for people with LTCs, who form an increasing proportion of the population requiring healthcare and treatment. For health organisations models of care, which support self-management, require greater emphasis on person-focused rather than disease-focused manifestations of health and represents a new model of care delivery requiring changes in practice. Current research demonstrates that health policies are increasingly complex, involve multiple organisations and often fail to translate into effective practice (Noyles et al. 2014). The deficit between what works and what happens in practice is referred to as the “implementation deficit” (Pressman and Wildasky 1984) and traditionally it has been difficult to breakaway from the idea that the policy process is best viewed from the top-down (Barett and Fudge 1981). However, there remains a need to understand the processes of implementation, which takes account of the variation, the multiple layers and interactions which takes place between policy-maker and -implementer as policy becomes practice (Hupe 2011). Implementation of self-management is a contemporary focus in UK health policy and this thesis explains what processes are used to implement self-management policy for people with LTCs into everyday practice in one health board. Methods: A case study approach was used to investigate the policy process with data collected using thirty-one semi-structured interviews with policy-makers and regional and local policy-implementers plus eight hours of observation of national and regional policy meetings. To provide context to the implementation process data also included thirteen policy documents. Data analysis used the retrospective application of NPT as a theoretical framework with which to explore the implementation processes. NPT is an emerging theory that is being promoted as a means of understanding implementation, embedding and integration of new ideas in healthcare (McEvoy et al. 2014). The application of NPT focuses on four mechanisms, termed work (May and Finch 2009: 547), which promote incorporation of new ideas in practice. These areas of work are coherence, cognitive participation, collective action and reflexive monitoring (Mair et al. 2012). Findings: The findings suggest that there are a number of important influences operating behind or as part of the policy implementation process. These included the need for a shared understanding, getting stakeholders involved to drive forward policy, work promoting collaboration and participation was the most detailed and important in the process of policy implementation; the course of policy was affected by factors which facilitated or inhibited stakeholders acceptance of self-management; and NPT fosters key analytical insights. Conclusion: Understanding the process of policy implementation in healthcare and how practice changes as a result of policy is subject to a wide range of influences. What emerges are five key recommendations relating to understanding policy implementation. (1) understanding the concept of self-management is important in promoting policy implementation. This understanding benefits from dialogue between policy-makers and -implementers. (2) stakeholder involvement supports implementation particularly the role of clinical leadership and leadership through existing networks but also value in establishing new organisational structures to create a receptive context. (3) develop participation and collaboration through use of the patient voice which helped simplify the policy message and motivate change. (4) other resources help policy implementation and where these are evident then policy is implemented and where they are absent then implementation is not embedded. Lack of evidence was a particular area of constraint. (5) NPT has shown that social context is important, and provides for this. But in addition there is evidence that historical perspectives and previous experience are also important influence on receptivity to implementation. This research contributes to the development of theory and practice in the area of implementation science. The exploration of the policy implementation has revealed the action and work which policy-makers and -implementers are engaged in while implementing policy. It has tested the utility of NPT in a real-life setting using all four mechanisms.

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Kochendorfer, Logan B. "Interpersonal Competencies and the Quality of Emerging Adults' Experiences in Friendship." Kent State University / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=kent1626449005331554.

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Cameron, Dawn M. "Exploring the application of self-monitoring of blood glucose results in insulin-treated diabetes : a case study of patients, their support persons and health care practitioners." Thesis, University of Stirling, 2016. http://hdl.handle.net/1893/25311.

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Self-monitoring of blood glucose (SMBG) can be effective in preventing poor outcomes associated with diabetes mellitus but previous research has identified that SMBG is not being undertaken in line with current recommendations. Guidance informs health professionals to educate patients on how they should self-monitor but very little is know about how patients self-monitor in the real world. In this thesis, a quantitative scoping study is first presented. This study used routine data sources to examine the levels and patterns of self-montoring in different population groups and then proceeded to a larger qualitative study to explore and question what patients are doing in practice in relation to self-monitoring, and why. This involved a qualitative multi-case study of patients, their support people, health care practitioners (HCPs) and patient diaries. Ten individuals and their nominated support people and HCPs formed ten cases among whom 21 in-depth semi-structured interviews were carried out and six patient diaries analysed. The exploratory work was framed around Stones’ version of structuration theory and uncovered a complex linkage of individual motives for monitoring, associated responses and behaviours in relation to the motive, and the underpinning attitudes and beliefs behind the motive. The following key points emerged from the analysis. People have differing relationships with their diabetes and this links with the level of engagement they have with their condition. Resistance to support people and health services was commonly observed. Experiences of diabetes reviews were important, with an identified need for them to feel more like collaboration and less like surveillance. A significant factor was the gaps and limitations in knowledge and understanding around diabetes for patients, relatives, support people and HCPs; and, finally, there was a noted maintenance of blood glucose levels higher than recommended through SMBG in several participants, which stemmed from a fear of hypoglycemic episode. The analysis concluded that although self-monitoring of blood glucose, in theory, and when considered in isolation, is a simple process to undertake, its application in the wider context of self-management and the individual is much more complicated. The process is influenced by many complex factors and generates a variety of responses and behaviours, some not in keeping with good diabetes self-management. There was a significant lack of person-centered approaches to managing diabetes which was, in part, due to existing health systems and processes. Therefore, there is a need to raise awareness of the gaps that exist in terms of such approaches as well as the gaps in knowledge and understanding of individuals with diabetes and those caring for and supporting them. In more specific terms, it is essential to develop and evaluate individual approaches to patients in relation to their self-monitoring and associated self-management in the context of their own lives, which involves the assessment of engagement and understanding around self-monitoring.

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FERNANDES, Carla Patricia Pereira Goncalves. "Apoio mútuo, coletivismo e autogerstão no processo de gerenciamento de projetos em organizações de software e serviços de tecnologia da informação." Universidade Federal de Pernambuco, 2016. https://repositorio.ufpe.br/handle/123456789/18442.

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Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2017-03-28T12:58:59Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Carla Patrícia Pereira Gonçalves Fernandes_Dissertação_050820162301.pdf: 1508954 bytes, checksum: 9136bb28456e805922c2017ddd6b54f3 (MD5)
Made available in DSpace on 2017-03-28T12:58:59Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Carla Patrícia Pereira Gonçalves Fernandes_Dissertação_050820162301.pdf: 1508954 bytes, checksum: 9136bb28456e805922c2017ddd6b54f3 (MD5) Previous issue date: 2016-02-15
Percebeu-se através da literatura a necessidade e carência de estudos sobre anarquia e gerenciamento de projetos. Esta dissertação de mestrado tem por objetivo investigar como os conceitos da anarquia - apoio mútuo, coletivismo e autogestão - relacionam-se com os processos de gerenciamento de projetos, baseados no Guia Project Management Body of Knowledge (PMBOK), presentes no dia-a-dia dos profissionais da área de projetos. Portanto, foi conduzida uma revisão bibliográfica e um survey para atingir esse objetivo. A pesquisa inquiriu profissionais atuantes na área de gestão de projetos, em organizações de software e serviços de tecnologia da informação. Para tanto, o estudo foi desenvolvido de forma exploratória, dado que existia pouco conhecimento acumulado e sistematizado a respeito deste tema. A análise dos dados recolhidos na pesquisa conclui que tanto a pesquisa bibliográfica quanto o survey confirmam que há uma relação positiva significativa entre a anarquia e os processos de gerenciamento de projetos estudados. Almeja-se que o presente estudo possa servir de elemento prospectivo para outras pesquisas na área de gerenciamento de projetos, fomentando a realização de trabalhos e publicações científicas. Por fim, o trabalho propõe contribuir com a academia, gerando nova literatura com informações relacionadas ao tema.
It was realized through literature the need and the lack of studies on anarchy and project management. This master thesis aims to investigate how the concepts of anarchy - mutual support, collectivism and self-management - are related to the project management processes, based on Project Management Body of Knowledge (PMBOK), present in the day-to-day professional project. Thus, we conducted a literature review and a survey to achieve this goal. The survey asked professionals working in project management area, in software organizations and information technology services. Therefore, the study was developed in an exploratory way, since there was little accumulated and systematized knowledge about this topic. The analysis of the data collected in the survey concludes that both the literature and the survey confirm that there is a significant relationship between anarchy and the studied processes for project management. One hopes that this study can serve as a prospective element to further research in the project management area, fostering the realization of scientific works and publications. Finally, the work proposes to contribute to the area, creating new literature with information related to the topic.

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Thiagarajan, Kristina Diann Munoz-Flores. "Stress, social support, problem solving coping, acceptance of diabetes & self-management as predictors of metabolic control & quality of life among adults with insulin-dependent diabetes mellitus /." Thesis, Connect to this title online; UW restricted, 1998. http://hdl.handle.net/1773/7280.

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Carneiro, Viana Aline. "Putting data delivery into context: Design and evaluation of adaptive networking support for successful communication in wireless self-organizing networks." Habilitation à diriger des recherches, Université Pierre et Marie Curie - Paris VI, 2011. http://tel.archives-ouvertes.fr/tel-00653813.

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Ce document est dédié à mes travaux de recherche développés au cours des six dernières années sur la conception et l'évaluation de systèmes de réseaux sans fil et est le résultat d'un certain nombre de collaborations. En particulier, mon objectif principal a été le soutien à la livraison fiable de données dans les réseaux sans fil auto-organisés. La question centrale, qui a guidée mes activités de recherche, est la suivante: "quels sont les services réseaux sous-jacents à la bonne conception de stratégies de communication sans fil dans les systèmes de réseaux auto-organisés (fixe ou mobile)?". Les réseaux auto-organisés (WSONs) ont des caractéristiques intrinsèques et, par conséquent, nécessitent des solutions particulières qui les distinguent des réseaux traditionnels basés sur des graphes. Les différents types de WSONs nécessitent des services adaptatifs ciblés pour faire face à leur nature (i.e., la mobilité, la limitation des ressources, le manque de fiabilité des communications sans fil,. . .) et pour trouver une adéquation entre leur fonctionnement et l'environnement. Influencée par de telles observations, mes activités de recherche ont été guidées par l'objectif principal de fournir au niveau du réseau un soutien à la livraison fiable de données dans les réseaux sans fil auto-organisés. Les axes de recherche, que j'ai développés avec mes collègues dans ce contexte, sont classés comme étant des services adaptifs "au niveau noeud" et "au niveau réseau" et se distinguent par le niveau auquel l'adaptation est considérée. Mes contributions, liées à la première catégorie de service, reposent sur les services de localisation et de découverte de voisinage. En raison de la limitation de page, ce manuscrit est, cependant, consacré à la recherche que j'ai menée autour des services adaptatifs au niveau du réseau. Par conséquent, il est structuré en trois chapitres principaux correspondants à trois classes de services réseaux : des services de gestion de la topologie, des services de gestion des données et des services de routage et d'acheminement. Ma première contribution concerne des services de gestion de la topologie, qui sont réalisés grâce à l'adaptation des noeuds - en imposant une hiérarchie dans le réseau via la clusterisation ou en supprimant des noeuds du graphe du réseau en les éteignant - et par la mobilité contrôlée - qui affecte à la fois la présence de noeuds et de liens, ainsi que la qualité des liens dans le graphe du réseau. Se basant sur l'adaptation de noeuds, le protocole SAND, les systèmes VINCOS et NetGeoS qui portent respectivement sur la conservation d'énergie et sur l'auto-structuration des réseaux de capteurs sans fil (WSN) ont été proposés. Ensuite, se basant sur la mobilité contrôlée, des propositions, liées à la conception de trajectoire de Hilbert et du protocole Cover, ont été présentées. Elles se concentrent sur le déploiement de solutions pour la couverture de zone avec des noeuds mobiles et ont été conçues pour surveiller périodiquement une zone géographique ou pour couvrir des noeuds de capteurs mobiles (cibles). Considérant les services de gestion de données, mes contributions se rapportent à la collecte des données - qui implique des solutions de distribution de données avec des objectifs liés a l'organisation - et la diffusion des données - où les flux de données sont dirigés vers le réseau. Pour cela, les protocoles DEEP et Supple ont été conçus pour les réseaux de capteurs sans fil, tandis que FairMix et VIP delegation se concentrent sur la diffusion d'information dans les réseaux sans fil sociaux. En particulier, afin d'améliorer la diffusion des données, FairMix et VIP delegation, exploitent les similarités des intérêts sociaux des personnes ou des groupes dans les réseaux fixes ou l'aspect social de leurs interactions sans fil dans les réseaux mobiles. Finalement, mes travaux sur les services adaptatifs d'acheminement attaquent la problèmatique de la connectivité opportuniste dans les réseaux sans fil tolérants aux délais. Dans ce contexte, les protocoles Seeker et GrAnt ont été conçus et utilisent respectivement l'histoire du contact entre les noeuds (les schémas de contact et de communication) et les propriétés des réseaux sociaux de noeuds afin de prédire les futures rencontres et de mieux ajuster les décisions de transfert. Au regard des nouvelles possibilités de communication et du changement dynamique observé au cours des dernières années dans les réseaux sans fil, mes activités de recherche se sont progressivement orientés des réseaux auto-organisés connectés vers les réseaux connectés par intermittence et opportunistes. De cette façon, mes perspectives de recherche future sont: (1) tirer profit des schémas de mobilité incontrôlée des dispositifs mobiles pervasifs pour améliorer les efforts de perception collaborative; (2) regarder plus en profondeur les techniques de génération de graphes sociaux à partir des traces décrivant les contacts entre les noeuds; (3) étudier quels sont les facteurs ayant un impact (positif ou négatif) sur le succès de la diffusion de l'information dans les réseaux sociaux mobiles, et (4) étudier la possibilité d'adapter le codage réseau à la diffusion d'information dans les réseaux sociaux mobiles.

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Alsadoun, Ahmed. "EXAMINING THE INFLUENCE OF DEMOGRAPHIC CHARACTERISTICS AND PERCEIVED SOCIAL SUPPORT ON SELF-MANAGEMENT BEHAVIORS AND HEALTH RESPONSIBILITY IN SAUDI ARABIAN PEOPLE WITH DIABETES MELLITUS TYPE 2." Kent State University / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=kent1572451424708553.

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Leandri, Paul Nicholas. "Exploring Acceptable Alternatives to Psychotherapy for Distressed Clients in Integrated Primary Care." Antioch University / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=antioch1498826930342053.

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Lussari, Wilson Roberto [UNESP]. "Grupo de apoiadores e cooperlix em Presidente Prudente-SP, Brasil: modelo e evolução de suas relações durante quinze anos." Universidade Estadual Paulista (UNESP), 2016. http://hdl.handle.net/11449/138116.

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O desafio em dar-se um adequado destino aos resíduos sólidos urbanos (RSU) impõe a mobilização de toda a sociedade, visto o ser humano gerar um crescente volume de resíduos. Com o aumento do consumo e a limitação de recursos da Natureza, a reciclagem tem-se tornado uma necessidade, que é melhor viabilizada pela implantação da coleta seletiva. Para implantar a coleta seletiva é preciso que se desenvolva na sociedade uma cultura de reciclagem, para gerar resíduos sólidos recicláveis que permitam sua reinserção no ciclo produtivo, como matéria-prima. Na cidade de Presidente Prudente, Estado de São Paulo, Brasil, foi adotada uma estratégia de articulação social, que mobilizou diferentes instituições, a fim de construir a sustentabilidade ambiental no município, por meio da educação ambiental, junto à população, e implantação da coleta seletiva, a partir da inserção de catadores de resíduos do lixão em uma cooperativa de trabalhadores de produtos recicláveis. A pesquisa teve como objetivos: identificar o modelo de relação que foi estabelecido entre o grupo surgido da sociedade e a cooperativa, de forma a contemplar as diferentes necessidades sociais e que, ao mesmo tempo, legitimasse a implantação da coleta seletiva e da educação ambiental da população; discussão das dimensões sociais do trabalho nas cidades e dos desafios da sua precarização; discussão da dimensão entre trabalho e meio ambiente e da evolução social dos resíduos na demanda para a construção da sustentabilidade ambiental em Presidente Prudente; apresentação da institucionalização do Grupo de Apoiadores e dos desafios para a autogestão na Cooperlix; o processo de formação e a consolidação do Grupo de Apoiadores; e registro das trajetórias do Grupo de Apoiadores e da Cooperlix, ao longo de 15 anos, da criação de ambos, até a celebração do contrato entre a cooperativa e o poder público municipal. A hipótese adotada é que foi preciso engendrar-se um modelo de relacionamento que possibilitasse ao Grupo de Apoiadores dar suporte ao dia a dia da Cooperlix, a fim de evitar a sua paralisia ou o seu colapso, enquanto ela não conseguisse sustentar-se. Quanto aos resultados, foi identificado que o modelo de relação desenvolvido, a partir do modelo de gestão do Grupo de Apoiadores e da cooperativa, foi inclusivo e democrático junto às diferentes instituições existentes na sociedade, fundamentado no Cooperativismo, na Autogestão e na Economia Solidária, além de engendrar uma organização do trabalho que acolhia toda e qualquer instituição pública ou privada que desejasse participar, bem como contribuir para que a cooperativa oferecesse um território que abrigasse os catadores do lixão, o descarte seletivo de resíduos sólidos e a prática de educação ambiental pela reciclagem. O modelo identificado deriva da relação recíproca de interdependência entre Grupo de Apoiadores e Cooperlix. A representação é inovadora, porque mostra como pessoas comuns podem, coletivamente, tornar-se protagonistas de transformações sociais em larga escala.
The challenge to give a suitable destination to municipal solid waste (MSW) requires the mobilization of the whole society, as humans generate an increasing amount of waste. With the increase in consumption and the limited nature of resources, recycling has become a necessity, which is possible making the implementation of selective collection. To deploy the selective collection it is necessary to develop in society a culture of recycling to generate recyclable solid waste to enable their reintegration into the production cycle as raw material. In the city of Presidente Prudente, State of Sao Paulo, Brazil, a social joint strategy was adopted, which mobilized different institutions in order to build environmental sustainability in the city, through environmental education among the population, and implementation of selective collection, from entering landfill waste pickers in a recyclables workers cooperative. The research aimed to: identify the relationship model that has been established between the emerged group of society and the cooperative in order to contemplate the different social needs and at the same time, legitimated the implementation of selective collection and population environmental education; discussion of the social dimensions of work in the cities and the challenges of its precariousness; discussion of the dimension between labor and the environment and social development of waste in demand for the construction of environmental sustainability in Presidente Prudente; presentation of the institutionalization of the supporters group and the challenges to ownership in Cooperlix; the process of formation and consolidation of the supporters group; and record of the supporters group and Cooperlix trajectories over 15 years of the both creation, until of the contract conclusion between the cooperative and the municipal government. The adopted hypothesis is that was necessary to engender a relationship model that would allow the supporters group to support the Cooperlix day-to-day in order to avoid its paralysis or collapse, as it could not sustain itself. For the results, it was identified that the developed relationship model, of the supporters group and the cooperative management model, was inclusive and democratic along the different society institutions, based on Cooperative Model, Self-Management, and Solidarity Economy, besides engendering an organization of work that welcomed any public or private institution who wished to participate and contribute to the cooperative should offer a territory that housed the landfill scavengers, solid waste selective disposal, and the environmental education by recycling practice. The model identified derives from the mutual interdependence between group of supporters and Cooperlix. Representation is innovative because it shows how ordinary people can collectively become protagonists of social change on a large scale.

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Höglund, Stina, and Camilla Vallström. "E-hälsotjänster i praktiken : En studie av Mina vårdkontakter och Min hälsoplan." Thesis, Umeå universitet, Institutionen för informatik, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-73215.

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As an effect of increased living standards and improved health care, life expectancy has risen in many parts of the world. At the same time, welfare diseases such as diabetes and obesity increases. As the number of elderly and long-term sick rises, so will the medical care needs. E-health applications are often presented as a way to meet future medical and doing so within the scope of existing resources. By facilitating health communication and widen access to health services by offering them online, e-health applications encourages people to become more engaged in their own health, thus working proactively towards a healthier population. However, e-health applications often fail to reach their full potential. The purpose of this study is to explore how health care providers and health care recipients perceives e-health applications and their usefulness and thus being able to identify factors significant for successful introduction and use of e-health services. Two e-health applications have been analysed and six important aspects have been identified and discussed. In order to be successful, an e-health application must facilitate behaviour change and be integrated in the everyday life of the user. Substantial and adequate evaluation is essential to make sure that the application meet the requirements from both health care providers and health care recipients. An understanding of the possibilities technology has to offer is needed in order to fully exploit the potential of e-health applications in health care. Instructions for health care providers on how to use the applications are essential not only to ensure their proper usage but also to make sure that applications are being presented to recipients in a satisfactory way and that care providers can offer the support and help recipients may need. Finally, when discussing e-health applications it is important to remember that there are people who does not want to get involved and that there is still a demand for face-to-face interaction in health care. Therefore, e-health services must be complemented with alternatives providing different types of interaction opportunities.

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Boström, Eva. "Proximity and distance : challenges in person-centred care for diabetes specialist nurses in primary health care." Doctoral thesis, Umeå universitet, Institutionen för omvårdnad, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-80908.

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Background Type 2 diabetes demands self-management over time, to maintain health and reduce the risk for diabetes complications. However, despite efforts, many persons with type 2 diabetes are not reaching the treatment targets. In diabetes, person-centred care and group education are recommended. Diabetes specialist nurses (DSNs) working in primary healthcare have an important role in supporting patients with type 2 diabetes in their self-management to adapt to the demands of the disease in everyday life. Therefore, it is important to explore the DSNs’ professional role and their experiences of practising person-centred care. The overall aim of the thesis was to explore the professional role of DSNs in primary healthcare, and to describe their experiences of person-centred diabetes care. Methods The thesis includes three studies with qualitative, and one with a quantitative, approach. Data collection consisted of focus group interviews, individual interviews, observations, and questionnaires. Qualitative content analysis and statistics were used in the analysis. In studies I and II, 29 and 31 DSNs participated, respectively. In study III, 10 DSNs and 44 persons with type 2 diabetes participated. Lastly, in study IV, 10 DSNs participated. Results The results in the thesis showed that DSNs have a complex and multifaceted professional role that entails striving to be an expert, a fosterer, a leader, an executive, and a role model, which they found challenging. The DSNs perceived high job demands, such as decision-making and learning. The thesis also showed that the interaction between DSNs and persons with type 2 diabetes shifted from empowerment to authority struggles during group support sessions based on person-centred care. The experience of person-centred care was described as enriching, but DSNs also expressed ambivalence, related to an altered professional role. Conclusion There is a desire by DSNs to be close to persons with type 2 diabetes, although they have several challenges to fulfil, which makes it difficult to uphold a relation with proximity; thus, distance is also present. Even though person-centred care is recommended in healthcare, and despite DSNs’ efforts to practise PCC, the result of this thesis shows that it also implies an altered professional role for DSNs that has to be addressed.
Diabetes intervention in Västerbotten, DIVA 2

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Ahnfelt, Camilla, and Malena Wolmestam. "Distriktsköterskans strategier för att stärka egenvård hos personer med hjärtsvikt i hemmet : En integrativ litteraturstudie." Thesis, Högskolan i Halmstad, Akademin för hälsa och välfärd, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-36293.

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Den äldre befolkningen i Sverige ökar dramatiskt medans resurser minskar. Hjärtsvikt är en av Sveriges främsta folksjukdomar och en vanlig orsak till vårdkontakt och sjukhusvistelse för äldre personer. Symtom vid hjärtsvikt kan vara påfrestande och påverkar livskvalitén negativt för både patienter och närstående. Många äldre personer med hjärtsvikt bor kvar hemma och är i behov av stöd för att kunna hantera sin sjukdom och minska återinläggningar. Syftet med litteraturstudien är att beskriva distriktssköterskans strategier för att stärka egenvård hos patienter med hjärtsvikt i hemsjukvård. Metoden är en integrativ litteraturstudie där 19 artiklar av både kvalitativa och kvantitativa metoder ingår. Resultatet visar på fyra kategorier som tar upp strategier vilka distriktssköterskan kan tillämpa för att stärka egenvården hos patienter med hjärtsvikt; grundläggande förutsättningar för distriktssköterskan, vikten av att utgå från patientens situation och behov, att arbeta med mål och uppföljning samt erbjuda utbildning och kunskap. De grundläggande förutsättningarna handlar främst om distriktsköterskans specialistutbildning och att erfarenhet har stor betydelse i arbetet med egenvård. Andra strategier som framkommer är att se varje individ, arbeta med delaktighet, involvera anhöriga och individanpassa utbildning samt följa upp. Det finns ingen generell strategi att stärka egenvården som fungerar på alla. Distriktssköterskans kompetens är nödvändig i arbetet med att ge individuellt stöd som stärker egenvård.
The older population in Sweden increases dramatically while resources are decreasing. Heart failure is one of the most common diseases in Sweden which causes hospitalization for elderly people. Symptoms of heart failure can be stressful and affect the quality of life negatively for both patients and close relatives. A lot of old people with heart failure lives at home and need support to cope with their illness and reduce hospitalization. The aim of the literature study is to describe district nurses' strategies to strengthen self-care in patients with heart failure in home care. The method is an integrative literature study where 19 articles of both qualitative and quantitative methods are included. The results show four categories that address strategies district nurses can apply to strengthen self-care in patients with heart failure. These are essential conditions for district nurse, the importance of starting from the patient's situation and needs, to work with goals and follow-up as well as offer education and knowledge. The essential conditions are mainly that higher education and experience are of great importance in the work of self-care. Other strategies emerging is to see each individual person as unique, work with participation, involve relatives and individualized education as well as follow up. There is no general strategy to strengthen self-care that works for all. District Nurse skills are necessary in the work of providing individual support that strengthens selfcare.

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Paterson, Catherine I. E. "Exploring prostate cancer survivors' self-management behaviours and social supportive experiences using questionnaires and electronic behavioural diaries : does social support buffer the relationship between coping and health-related quality of life?" Thesis, University of Dundee, 2013. https://discovery.dundee.ac.uk/en/studentTheses/22089faa-ef63-420f-92df-72ff81ce4a14.

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Background: Prostate cancer is now the most common type of cancer in men in the UK. Physical effects of treatments have been well documented; however, the extent to which psycho-social factors may impact upon health-related quality of life (HRQoL) is limited. Little is known about the self-management behaviours of men affected by prostate cancer or how they cope with prostate cancer. Men living with and beyond prostate cancer have reported a lack of support in their pursuit to cope with the physical and psychological sequelae. Social support may help men with self-management, but may also buffer the relationship between coping and HRQoL. Most healthcare research has been conducted between individuals and is limited to aggregate group level effects, and has overlooked the importance of within-person experience and change over time. Any future theoretically driven intervention study should be supported empirically at the level it is intended: “the individual man”. Aim: To assess the mechanism effect between the relationship that links coping and social support to HRQoL in a sample of men affected by prostate cancer using between individuals and within individual methodological approaches. In addition, this thesis aimed to identify the actual self-management behaviours and social supportive experiences of men over the cancer journey, between and within individuals over time. Methods: A quantitative approach consisted of a prospective, longitudinal survey and single-case electronic diary data. Clinical, demographic and survey data were collected at baseline (before treatment) and at 6 months follow-up. A sub-sample of n=12 participants completed an electronic behavioural diary for 1 month. Men completed the electronic behavioural diary in the month following their treatment. The duration, timing and design of the behavioural diary were guided by methodological considerations, service users and clinicians’ comments. Findings: The prospective longitudinal survey identified that baseline perceived social support was the most important social support construct that predicted HRQoL (ß=0.266, p=0.021) and depression (ß=0.243, p=0.029) at 6 months and explained approximately 30% of the variance of the dependent variables. Moderation and mediation effects were not identified from the prospective longitudinal findings. Testing theoretical models “within-individuals” over time demonstrated different results for main, moderating and mediating pathways that linked coping and social support to emotional outcome. Men performed a number of self-management behaviours for urinary, bowel and sexual dysfunction, but often with little relief. Discussion/Relevance: Real time data collection moves far beyond traditional retrospective evaluations, enabling a much clearer understanding of the individual patient experience over time. The results from the series of single-case studies have demonstrated the one size does not fit all. The findings from the prospective longitudinal study and the 11 single-case studies suggest that men may benefit from a supported self-management intervention study tailored to the “individual’s needs” of prostate cancer survivors.

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Dissertations / Theses on the topic 'Supported self-management'

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