Browsing by Subject "self-management"

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  • 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.
  • Klockars, Stella (Helsingin yliopisto, 2020)
    To handle the pressure and maintain healthy mental wellbeing, employees would benefit from knowing how to manage their work motivation. Autonomously motivated employees do their job because they enjoy it or because of its personal importance. The self-determination theory states that employees, who are autonomously motivated experience positive outcomes, beneficial for both individuals and organizations. In order to be optimally motivated, the psychological needs of autonomy, competence and relatedness must be satisfied. Previously, the self-determination theory has mostly focused on how social agents (e.g. managers) can create environments that satisfy these needs. However, employees themselves can also use techniques to self-manage their motivation, such as self-kindness or goal setting. The aims of this thesis are to examine how employees from a public sector organization describe how they manage their work motivation. Moreover, problems in which participants describe using 11 self-motivational techniques are examined. This study uses data from a six-week observational study, where 18 participants responded to brief mobile questionnaires five times during workdays. At the end of the study, individual interviews took place, which will be analysed with thematic analysis. The most frequently used techniques among the participants were goal setting, supporting others and obtaining support. Next, by interpreting different situations for which self-motivational techniques were used, I identified eight themes concerning problems: self-doubt, negative mindset, boring tasks, inability to change tasks, managing chaos, feeling stuck, need of social interaction and negative social interruptions. One technique could be used for solving different problems. The results of the research question, on how the participants describe their use of the techniques, show three main themes: self-management choice guided by self-concept, effects of study participation, and interconnectedness, and five sub-themes. The results show that the participants’ ways of managing their motivation were affected by e.g. their self- concept, their work role and the study participation. Moreover, in some cases, the participants did not separate between self-motivational techniques and regular work behaviour and that some aspects of the techniques led to uncertainty, such as how the participants had interpreted having used them and whether it was done consciously or not. In conclusion, the results shed light on how these techniques have been used and understood, which might have implications for how future research can study how employees can manage their own motivation. This study is among the first qualitative studies to investigate how people use self-enactable techniques to improve their quality of work motivation.
  • International Group for Diabetes and Ramadan (IGRD) (2015)
    OBJECTIVE: To determine if individualized education before Ramadan results in a safer fast for people with type 2 diabetes. METHODS: Patients with type 2 diabetes who received care from participating clinics in Egypt, Iran, Jordan and Saudi Arabia and intended to fast during Ramadan 2014 were prospectively studied. Twelve clinics participated. Individualized education addressed meal planning, physical activity, blood glucose monitoring and acute metabolic complications and when deemed necessary, provided an individualized diabetes treatment plan. RESULTS: 774 people met study criteria, 515 received individualized education and 259 received usual care. Those who received individualized education were more likely to modify their diabetes treatment plan during Ramadan (97% vs 88%, p<0.0001), to perform self-monitoring of blood glucose at least twice daily during Ramadan (70% vs 51%, p<0.0001), and to have improved knowledge about hypoglycemic signs and symptoms (p=0.0007). Those who received individualized education also reduced their body mass index (-1.1±2.4 kg/m(2) vs -0.2±1.7 kg/m(2), p<0.0001) and glycated haemoglobin (-0.7±1.1% vs -0.1±1.3%, p<0.0001) during Ramadan compared those who received usual care. There were more mild (77% vs 67%, p=0.0031) and moderate (38% vs 19%, p<0.0001) hypoglycemic events reported by participants who received individualized education than those who received usual care, but fewer reported severe hypoglycemic events during Ramadan (23% vs 34%, p=0.0017). CONCLUSIONS: This individualized education and diabetes treatment program helped patients with type 2 diabetes lose weight, improve glycemic control and achieve a safer fast during Ramadan.
  • Manchaiah, Vinaya; Pyykko, Ilmari; Zou, Jing; Levo, Hilla; Kentala, Erna (2017)
    Objectives: To facilitate self-help, the Finnish Meniere's Federation (FMF) provides various kinds of support to persons with Meniere's disease (MD), which includes patient magazines (PM) and Internet-based peer support (iPS). The current study aimed to evaluate the benefits reported by MD patients in terms of PM and iPS. Method: The study used a cross-sectional survey design with a mixture of structured and open-ended questions administered online. A sample of 185 patients from the FMF membership database provided complete data. Results: Ninety-two percent of the respondents rated PM as useful, or very useful. The main benefits of PM included: information on the disease and complaints, information about elements of peer support program, patient's experience with useful positive case studies, relevant news on MD, and information of activity of the FMF. Of the 185 persons, 68 reported that they did not have a need for peer support as their disease was either in silent phase or did not cause any annoyance. The main reasons for nonuse were: mild disease, personal reasons, and problems in using. Regarding the benefits of iPS, 75% of recent and 64% of chronic MD patients said that they would benefit from such a program. The main benefits of iPS included: reliable information on the disease and its management, peer support useful for coping with the disease, information about managing MD symptoms, information about managing attitude, and information about therapy. Moreover, the study identified different groups of individuals, which included: nonusers of support from patient organizations, those who used the support but did not feel they benefited, and those who used and also benefited from such programs. Conclusion: The current study results provide some information about the preferences of MD patients regarding different forms of support and could certainly prove helpful while developing wider support strategies.
  • Äijö, Nelli (Helsingfors universitet, 2019)
    As the population becomes older and the amount of multimorbid patients increases, also health care spending increases. New care models are needed where patients’ needs are taken into consideration by providing preventive and patient-centred care. In Finland and internationally, new ways to treat elderly, chronically ill patients have been developed. One of the new models is the health and care plan model. This longitudinal, randomised, controlled trial studied the health and care plan model’s impact on healthcare costs, patients’ physical functioning and patients’ quality of life. The aim of the study was to study the cost-effectiveness of the health and care plan model compared to standard care practice. The goal of this study was to study if rational pharmacotherapy and self-management support can prevent the decline in physical functioning, the decline in quality of life and the increase in health service use and costs among elderly population. This study was conducted between 2014-2018 as a multi-disciplinary cooperation between Tornio health station, University of Helsinki Faculty of Pharmacy and Alatornio pharmacy. The patients in this study were over 75-year old, multimorbid, community dwelling, polypharmacy patients. The patients in the intervention group received an interview based clinical medication review and were formed a medication plan. Furthermore, the patients in the intervention group were planned a health and care plan that was combined with the medication plan into a comprehensive self-management plan in a multi-disciplinary meeting. A case manager was appointed for the patients in the intervention group and the case manager could be contacted by the patients in the intervention group at any point of the study if there arose a non-acute concern with the patient’s health. The patients in the control group were conducted a prescription review based on the information available in the electronic health records system and continued receiving the standard care practice. Cost and effectiveness data were gathered from the patients over the period of two years. The effectiveness data were gathered at Tornio health station where the intervention and control group’s quality of life was measured with the SF-36 generic quality of life measure and physical functioning was measured with Short Physical Performance Battery (SPPB). The quality of life data gathered with SF-36 were transformed into one preference based single index score SF-6D to calculate the quality of life and quality adjusted life years (QALY). Data about the use of health services were extracted from the electronic health records system and transformed into costs by using the national reference costs. At the beginning of the study, the intervention and control group were statistically significantly similar. During the two-year follow-up, no statistically or clinically significant differences were observed between the intervention and control group in their quality of life, in their physical functioning or in the costs of used health services. However, in the intervention group, the cost of used health services was on average 2 406 euros smaller than those of the control group’s during the two-year follow-up. The health and care plan model was cost-effective compared to standard care practice. The incremental cost-effectiveness ratio was -64 504 € per one QALY. Based on this study, it is recommended to support the self-management and physical functioning of the elderly with an intervention like health and care plan model to decrease the health care spending. The results of this study can be applied to Finnish healthcare system to decrease the health care spending of multimorbid, community dwelling and polypharmacy elderly patients. The use of real-world evidence increases the reliability of this study.