Browsing by Subject "SELF-MANAGEMENT"

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  • Mendes-Santo, Cristina; Weiderpass, Elisabete; Santana, Rui; Andersson, Gerhard (2019)
    Background: Internet-delivered interventions can provide remarkable opportunities in addressing breast cancer survivors' unmet support care needs, as they present an effective strategy to improve care coordination and provide access to efficacious, cost-efficient and convenient survivorship care. Nevertheless, research focusing on improving survivors' psychosocial needs using internet-based tools is scarce and its practical implementation is limited. Objectives: To study the acceptability, feasibility, efficacy and cost-effectiveness of iNNOVBC, a 10 weeks guided internet-delivered individually-tailored Acceptance and Commitment Therapy (ACT)-influenced cognitive behavioural (CBT) intervention developed to improve mild to moderate anxiety and depression in Breast cancer survivors when compared to treatment as usual (TAU) in a waiting list control group (WLC). Methods: A two-arm, parallel, open label, multicentre, waiting list randomized controlled trial will be conducted to investigate the efficacy and cost-effectiveness of INNOVBC. The primary outcomes in this research will be anxiety and depression. Secondary outcomes will include psychological flexibility, fatigue, insomnia, sexual dysfunction and Health Related Quality of Life (HRQoL). Ethical approval: This study has been reviewed and approved by Comisstio Nacional de Protectio de Dados; Instituto Portuguis de Oncologia do Porto Francisco Gentil; Unidade Local de Satide de Matosinhos, EPE; Centro Hospitalar de Sao Joao and Ordem dos Psicologos ethical committees. Expected results: It is anticipated that iNNOVBC will show to be an efficacious and cost-effective program in improving the outcomes of interest in this study, as opposed to a WLC under TAU. The results of this research will be published in accordance with CONSORT-EHEALTH guidelines. Conclusions: This study will inform on the acceptability, feasibility, efficacy and cost-effectiveness of iNNOVBC, in improving psychosocial outcomes in breast cancer survivors when compared to TAU in a WLC. Its conclusions will contribute to understand the idiosyncrasies of designing and implementing internet-delivered interventions in breast cancer survivors.
  • Mikkola, Ilona; Hagnäs, Maria; Hartsenko, Jelena; Kaila, Minna; Winell, Klas (2020)
    Aims To investigate whether the use of a personalized care plan is associated with clinical outcomes of type 2 diabetes (T2D) treatment in real-world. Methods Quality of treatment was assessed using data from a yearly sample of patients with T2D visiting primary care health centres in 2012–2016. Patients were divided into three groups: 1) patient has a copy of their personalized care plan, 2) care plan exists in the patient record only or 3) patient has no care plan. Data on smoking, laboratory tests, systolic blood pressure (sBP) and statin use were collected. We compared the outcomes between the three groups in terms of proportions of patients achieving the clinical targets recommended by international guidelines. Results Evaluable data were available for 10,403 patients. Of these, 1,711 (16%) had a copy of their personalized care plan, and 3,623 (35%) had no care plan. Those who had a copy of their care plan were significantly more likely than those without to achieve the sBP target (odds ratio [OR] 1.39, 95% confidence interval [CI] 1.29–1.51, p
  • Tornivuori, Anna; Tuominen, Outi; Salantera, Sanna; Kosola, Silja (2020)
    Aims To define digital health services that have been studied among chronically ill adolescents and to describe e-health coaching elements that may have an impact on transition outcomes. Design Systematic review without meta-analysis. Data sources MEDLINE (Ovid), Pub Med, Scopus and CINAHL on 28 May 2018. Review methods Peer-reviewed articles published between January 2008-May 2018 were reviewed following the Cochrane Handbook for Systematic Reviews of Interventions and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. Results Twelve randomized controlled trials were included. The interventions varied significantly in duration and content. E-coaching that included human and social support showed positive impact on transition outcomes. Digital health services incorporated into usual care provide efficient and accessible care. Conclusion E-coaching elements enable tailoring and personalization and present a tool for supporting and motivating chronically ill adolescents during transition of care. Future research should evaluate the effectiveness of e-coaching elements. Impact Digital services are considered a means for increasing adolescents' motivation for self-care and for increasing their accessibility to health care. The coaching elements in digital services consist of a theoretical basis, human support, interactive means and social support. Included interventions varied in terms of duration, dose, content and design. Our results may serve the development of digital health services for adolescents in transition. E-coaching can be used to engage and motivate chronically ill adolescents to improve health behaviour and self-management during transition of care.
  • Bousquet, Jean; Anto, Josep M.; Bachert, Claus; Haahtela, Tari; Zuberbier, Torsten; Czarlewski, Wienczyslawa; Bedbrook, Anna; Bosnic-Anticevich, Sinthia; Walter Canonica, G.; Cardona, Victoria; Costa, Elisio; Cruz, Alvaro A.; Erhola, Marina; Fokkens, Wytske J.; Fonseca, Joao A.; Illario, Maddalena; Ivancevich, Juan-Carlos; Jutel, Marek; Klimek, Ludger; Kuna, Piotr; Kvedariene, Violeta; Le, L. T. T.; Larenas-Linnemann, Desiree E.; Laune, Daniel; Lourenco, Olga M.; Melen, Erik; Mullol, Joaquim; Niedoszytko, Marek; Odemyr, Mikaela; Okamoto, Yoshitaka; Papadopoulos, Nikos G.; Patella, Vincenzo; Pfaar, Oliver; Pham-Thi, Nhan; Rolland, Christine; Samolinski, Boleslaw; Sheikh, Aziz; Sofiev, Mikhail; Suppli Ulrik, Charlotte; Todo-Bom, Ana; Tomazic, Peter-Valentin; Toppila-Salmi, Sanna; Tsiligianni, Ioanna; Valiulis, Arunas; Valovirta, Erkka; Ventura, Maria-Teresa; Walker, Samantha; Williams, Sian; Yorgancioglu, Arzu; Agache, Ioana; Akdis, Cezmi A.; Almeida, Rute; Ansotegui, Ignacio J.; Annesi-Maesano, Isabella; Arnavielhe, Sylvie; Basagana, Xavier; D. Bateman, Eric; Bedard, Annabelle; Bedolla-Barajas, Martin; Becker, Sven; Bennoor, Kazi S.; Benveniste, Samuel; Bergmann, Karl C.; Bewick, Michael; Bialek, Slawomir; E. Billo, Nils; Bindslev-Jensen, Carsten; Bjermer, Leif; Blain, Hubert; Bonini, Matteo; Bonniaud, Philippe; Bosse, Isabelle; Bouchard, Jacques; Boulet, Louis-Philippe; Bourret, Rodolphe; Boussery, Koen; Braido, Fluvio; Briedis, Vitalis; Briggs, Andrew; Brightling, Christopher E.; Brozek, Jan; Brusselle, Guy; Brussino, Luisa; Buhl, Roland; Buonaiuto, Roland; Calderon, Moises A.; Camargos, Paulo; Camuzat, Thierry; Caraballo, Luis; Carriazo, Ana-Maria; Carr, Warner; Cartier, Christine; Casale, Thomas; Cecchi, Lorenzo; Cepeda Sarabia, Alfonso M.; H. Chavannes, Niels; Chkhartishvili, Ekaterine; Chu, Derek K.; Cingi, Cemal; Correia de Sousa, Jaime; Costa, David J.; Courbis, Anne-Lise; Custovic, Adnan; Cvetkosvki, Biljana; D'Amato, Gennaro; da Silva, Jane; Dantas, Carina; Dokic, Dejan; Dauvilliers, Yves; De Feo, Giulia; De Vries, Govert; Devillier, Philippe; Di Capua, Stefania; Dray, Gerard; Dubakiene, Ruta; Durham, Stephen R.; Dykewicz, Marc; Ebisawa, Motohiro; Gaga, Mina; El-Gamal, Yehia; Heffler, Enrico; Emuzyte, Regina; Farrell, John; Fauquert, Jean-Luc; Fiocchi, Alessandro; Fink-Wagner, Antje; Fontaine, Jean-Francois; Fuentes Perez, Jose M.; Gemicioglu, Bilun; Gamkrelidze, Amiran; Garcia-Aymerich, Judith; Gevaert, Philippe; Gomez, Rene Maximiliano; Gonzalez Diaz, Sandra; Gotua, Maia; Guldemond, Nick A.; Guzman, Maria-Antonieta; Hajjam, Jawad; Huerta Villalobos, Yunuen R.; Humbert, Marc; Iaccarino, Guido; Ierodiakonou, Despo; Iinuma, Tomohisa; Jassem, Ewa; Joos, Guy; Jung, Ki-Suck; Kaidashev, Igor; Kalayci, Omer; Kardas, Przemyslaw; Keil, Thomas; Khaitov, Musa; Khaltaev, Nikolai; Kleine-Tebbe, Jorg; Kouznetsov, Rostislav; Kowalski, Marek L.; Kritikos, Vicky; Kull, Inger; La Grutta, Stefania; Leonardini, Lisa; Ljungberg, Henrik; Lieberman, Philip; Lipworth, Brian; Lodrup Carlsen, Karin C.; Lopes-Pereira, Catarina; Loureiro, Claudia C.; Louis, Renaud; Mair, Alpana; Mahboub, Bassam; Makris, Michael; Malva, Joao; Manning, Patrick; Marshall, Gailen D.; Masjedi, Mohamed R.; Maspero, Jorge F.; Carreiro-Martins, Pedro; Makela, Mika; Mathieu-Dupas, Eve; Maurer, Marcus; De Manuel Keenoy, Esteban; Melo-Gomes, Elisabete; Meltzer, Eli O.; Menditto, Enrica; Mercier, Jacques; Micheli, Yann; Miculinic, Neven; Mihaltan, Florin; Milenkovic, Branislava; Mitsias, Dimitirios I.; Moda, Giuliana; Mogica-Martinez, Maria-Dolores; Mohammad, Yousser; Montefort, Steve; Monti, Ricardo; Morais-Almeida, Mario; Mosges, Ralph; Munter, Lars; Muraro, Antonella; Murray, Ruth; Naclerio, Robert; Napoli, Luigi; Namazova-Baranova, Leyla; Neffen, Hugo; Nekam, Kristoff; Neou, Angelo; Nordlund, Bjorn; Novellino, Ettore; Nyembue, Dieudonne; O'Hehir, Robyn; Ohta, Ken; Okubo, Kimi; Onorato, Gabrielle L.; Orlando, Valentina; Ouedraogo, Solange; Palamarchuk, Julia; Pali-Scholl, Isabella; Panzner, Peter; Park, Hae-Sim; Passalacqua, Gianni; Pepin, Jean-Louis; Paulino, Ema; Pawankar, Ruby; Phillips, Jim; Picard, Robert; Pinnock, Hilary; Plavec, Davor; Popov, Todor A.; Portejoie, Fabienne; Price, David; Prokopakis, Emmanuel P.; Psarros, Fotis; Pugin, Benoit; Puggioni, Francesca; Quinones-Delgado, Pablo; Raciborski, Filip; Rajabian-Soderlund, Rojin; Regateiro, Frederico S.; Reitsma, Sietze; Rivero-Yeverino, Daniela; Roberts, Graham; Roche, Nicolas; Rodriguez-Zagal, Erendira; Rolland, Christine; Roller-Wirnsberger, Regina E.; Rosario, Nelson; Romano, Antonino; Rottem, Menachem; Ryan, Dermot; Salimaki, Johanna; Sanchez-Borges, Mario M.; Sastre, Joaquin; Scadding, Glenis K.; Scheire, Sophie; Schmid-Grendelmeier, Peter; Schunemann, Holger J.; Sarquis Serpa, Faradiba; Shamji, Mohamed; Sisul, Juan-Carlos; Sofiev, Mikhail; Sole, Dirceu; Somekh, David; Sooronbaev, Talant; Sova, Milan; Spertini, F.; Spranger, Otto; Stellato, Cristiana; Stelmach, Rafael; Thibaudon, Michel; To, Teresa; Toumi, Mondher; Usmani, Omar; Valero, Antonio A.; Valenta, Rudolph; Valentin-Rostan, Marylin; Pereira, Marilyn Urrutia; van der Kleij, Rianne; Van Eerd, Michiel; Vandenplas, Olivier; Vasankari, Tuula; Vaz Carneiro, Antonio; Vezzani, Giorgio; Viart, Frederic; Viegi, Giovanni; Wallace, Dana; Wagenmann, Martin; Wang, De Yun; Waserman, Susan; Wickman, Magnus; Williams, Dennis M.; Wong, Gary; Wroczynski, Piotr; Yiallouros, Panayiotis K.; Yusuf, Osman M.; Zar, Heather J.; Zeng, Stephane; Zernotti, Mario E.; Zhang, Luo; Shan Zhong, Nan; Zidarn, Mihaela (2021)
    Digital anamorphosis is used to define a distorted image of health and care that may be viewed correctly using digital tools and strategies. MASK digital anamorphosis represents the process used by MASK to develop the digital transformation of health and care in rhinitis. It strengthens the ARIA change management strategy in the prevention and management of airway disease. The MASK strategy is based on validated digital tools. Using the MASK digital tool and the CARAT online enhanced clinical framework, solutions for practical steps of digital enhancement of care are proposed.
  • Simonsen, Nina; Koponen, Anne M.; Suominen, Sakari (2021)
    BackgroundRising prevalence of type 2 diabetes (T2D), also among younger adults, constitutes a growing public health challenge. According to the person-centred Chronic Care Model, proactive care and self-management support in combination with community resources enhance quality of healthcare and health outcomes for patients with T2D. However, research is scarce concerning the importance of person-centred care and community resources for such outcomes as empowerment, and the relative impact of various patient support sources for empowerment is not known. Moreover, little is known about the association of age with these variables in this patient-group. This study, carried out among patients with T2D, examined in three age-groups (27-54, 55-64 and 65-75years) whether person-centred care and diabetes-related social support, including community support and possibilities to influence community health issues, are associated with patient empowerment, when considering possible confounding factors, such as other quality of care indicators and psychosocial wellbeing. We also explored age differentials in empowerment and in the proposed correlates of empowerment.MethodIndividuals from a register-based sample with T2D participated in a cross-sectional survey (participation 56%, n=2866). Data were analysed by descriptive statistics and multivariate logistic regression analyses.ResultsRespondents in the youngest age-group were more likely to have low empowerment scores, less continuity of care, and lower wellbeing than the other age-groups, and to perceive less social support, but a higher level of person-centred care than the oldest group. Community support, including possibilities to influence community health issues, was independently and consistently associated with high empowerment in all three age-groups, as was person-centred care in the two older age-groups. Community support was the social support variable with the strongest association with empowerment across age-groups. Moreover, vitality was positively and diabetes-related distress negatively associated with high empowerment in all age-groups, whereas continuity of care, i.e. having a family/regular nurse, was independently associated in the youngest age-group only.ConclusionPerson-centred care and community support, including possibilities to influence community health issues, supports empowerment among adults with T2D. Findings suggest that age is related to most correlates of empowerment, and that younger adults with T2D have specific healthcare needs.
  • ARIA Study Grp; MASK Study Grp; Bousquet, J. Jean; Schunemann, Holger J.; Togias, Alkis; Haahtela, Tari; Toppila-Salmi, Sanna (2019)
    Background In all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system into integrated care with organizational health literacy. Main body As an example for chronic disease care, MASK (Mobile Airways Sentinel NetworK), a new project of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, and POLLAR (Impact of Air POLLution on Asthma and Rhinitis, EIT Health), in collaboration with professional and patient organizations in the field of allergy and airway diseases, are proposing real-life ICPs centred around the patient with rhinitis, and using mHealth to monitor environmental exposure. Three aspects of care pathways are being developed: (i) Patient participation, health literacy and self-care through technology-assisted "patient activation", (ii) Implementation of care pathways by pharmacists and (iii) Next-generation guidelines assessing the recommendations of GRADE guidelines in rhinitis and asthma using real-world evidence (RWE) obtained through mobile technology. The EU and global political agendas are of great importance in supporting the digital transformation of health and care, and MASK has been recognized by DG Sante as a Good Practice in the field of digitally-enabled, integrated, person-centred care. Conclusion In 20 years, ARIA has considerably evolved from the first multimorbidity guideline in respiratory diseases to the digital transformation of health and care with a strong political involvement.
  • Bousquet, Jean; Chavannes, Niels H.; Guldemond, Nick; Haahtela, Tari; Hellings, Peter W.; Sheikh, Aziz (2017)
  • Inkeroinen, Saija; Koskinen, Jenni; Karlsson, Mia; Kilpi, Taina; Leino-Kilpi, Helena; Puukka, Pauli; Taponen, Ros-Marie; Tuominen, Riitta; Virtanen, Heli (2021)
    Purpose: Patient education improves health and treatment adherence of patients with chronic kidney disease. However, evidence about the sufficiency of patients' knowledge processed in patient education is limited. The purpose of this study was to evaluate subjective and objective sufficiency of knowledge processed in patient education in dialysis care and treatment. Patients and Methods: A cross-sectional study design was used. The sample (n=162) comprised patients in predialysis or home dialysis. All eligible patients during the data collection timeframe (2016-2017) in two university hospital districts in Finland were invited to participate. Subjective sufficiency was evaluated with a structured questionnaire having 34 items divided into six dimensions of empowering knowledge (bio-physiological, functional, social, experiential, ethical, and financial) on a Likert scale (1=not sufficient at all, 4=very sufficient). Objective sufficiency was evaluated with a structured knowledge test with 10 items (score range 0-10, correct=1, wrong/no knowledge=0) based on the multidimensional content of patient education emphasizing bio-physiological dimension. Results: In subjective sufficiency of knowledge, the mean was 3.27 (SD 0.54). The bio-physiological dimension of empowering knowledge was the most sufficient (mean 3.52, SD 0.49) and the experiential the least (mean 2.8, SD 0.88). In objective sufficiency, the means ranged 5.15-5.97 (SD 2.37-2.68) among patients in different modalities of dialysis care and treatment. The least sufficient objective scores were bio-physiological and functional knowledge. The subjective and objective sufficiency did not correlate with each other. Conclusion: Patients' knowledge, either subjective or objective, does not seem to be sufficient. Hence, attention should be paid to supporting patients with more personalized knowledge. Furthermore, the relationship between subjective and objective sufficiency needs future consideration, as their non-correspondence was a new discovery.
  • Lappalainen, Raimo; Sairanen, Essi; Jarvela, Elina; Rantala, Sanni; Korpela, Riitta; Puttonen, Sampsa; Kujala, Urho M.; Myllymaki, Tero; Peuhkuri, Katri; Mattila, Elina; Kaipainen, Kirsikka; Ahtinen, Aino; Karhunen, Leila; Pihlajamaki, Jussi; Jarnefelt, Heli; Laitinen, Jaana; Kutinlahti, Eija; Saarelma, Osmo; Ermes, Miikka; Kolehmainen, Marjukka (2014)
  • Haahtela, Tari; Herse, Fredrik; Karjalainen, Jussi; Klaukka, Timo; Linna, Miika; Leskela, Riikka-Leena; Selroos, Olof; Reissell, Eeva (2017)
    The Finnish National Asthma Program 1994-2004 markedly improved asthma care in the 1990s. We evaluated the changes in costs during 26 years from 1987 to 2013. Direct and indirect costs were calculated by using data from national registries. Costs from both the societal and patient perspectives were included. The costs were based on patients with persistent, physician-diagnosed asthma verified by lung function measurements. We constructed minimum and maximum scenarios to assess the effect of improved asthma care on total costs. The number of patients with persistent asthma in the national drug reimbursement register increased from 83,000 to 247,583. Improved asthma control reduced health care use and disability, resulting in major cost savings. Despite a 3-fold increase in patients, the total costs decreased by 14%, from (SIC)222 million to (SIC)191 million. Costs for medication and primary care visits increased, but overall annual costs per patient decreased by 72%, from (SIC)2656 to (SIC)749. The theoretical total cost savings for 2013, comparing actual with predicted costs, were between (SIC)120 and (SIC)475 million, depending on the scenario used. The Finnish Asthma Program resulted in significant cost savings at both the societal and patient levels during a 26-year period.