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Global Health Action Dec 2022Gestational diabetes mellitus (GDM) is a temporary form of diabetes induced by pregnancy and is potentially harmful to both the mother and fetus The impact of GDM... (Review)
Review
BACKGROUND
Gestational diabetes mellitus (GDM) is a temporary form of diabetes induced by pregnancy and is potentially harmful to both the mother and fetus The impact of GDM diagnosis on pregnant women needs to be taken into account. This is related to the capacity for self-management of GDM, for which quality evidence is still lacking.
OBJECTIVE
to identify several aspects of self-management and self- efficacy for women with GDM.
METHOD
Electronic databases were searched for studies related to the self-management, self-efficacy, and glycemic control of women with GDM, from January 2012 to January 2021. The extraction of study features was based on study location, reported research aims, study design, methodology, and the analytical approach, using Endnote Version X7.7.1. The Critical Appraisal Skills Program Qualitative Checklist (CASP) was used to assess quality, as recommended by the Cochrane Qualitative Research Methods Group.
RESULTS
Ten out of 70 studies were identified as meeting the established criteria and including a diverse population. The synthesis revealed seven major themes: preliminary psychological impact, communicating the diagnosis, knowledge of GDM, self-efficacy and self-management of GDM, risk perception, the burden of GDM, and gaining control. The benefits of a diagnosis were behavioral and were mostly crystalized if a particular level of self-management and self-efficacy was reached and women were able to have specific control over their diet and body weight. On the other hand, women reported that the diagnosis increased their responsibility, as they had to take extra precautions regarding their dietary regimen.
CONCLUSION
Self-management and self-efficacy for GDM management are possible, despite the psychological hurdles that most women confront. There is still potential for improvement in terms of developing a healthy lifestyle that not only manages GDM for the best pregnancy result, but also prevents diabetes after pregnancy.
Topics: Diabetes, Gestational; Diet; Female; Humans; Pregnancy; Pregnancy Outcome; Self Efficacy; Self-Management
PubMed: 35867537
DOI: 10.1080/16549716.2022.2087298 -
JBI Database of Systematic Reviews and... Jan 2016Chronic diseases are increasing worldwide and have become a significant burden to those affected by those diseases. Disease-specific education programs have demonstrated... (Review)
Review
BACKGROUND
Chronic diseases are increasing worldwide and have become a significant burden to those affected by those diseases. Disease-specific education programs have demonstrated improved outcomes, although people do forget information quickly or memorize it incorrectly. The teach-back method was introduced in an attempt to reinforce education to patients. To date, the evidence regarding the effectiveness of health education employing the teach-back method in improved care has not yet been reviewed systematically.
OBJECTIVES
This systematic review examined the evidence on using the teach-back method in health education programs for improving adherence and self-management of people with chronic disease.
INCLUSION CRITERIA
Adults aged 18 years and over with one or more than one chronic disease.All types of interventions which included the teach-back method in an education program for people with chronic diseases. The comparator was chronic disease education programs that did not involve the teach-back method.Randomized and non-randomized controlled trials, cohort studies, before-after studies and case-control studies.The outcomes of interest were adherence, self-management, disease-specific knowledge, readmission, knowledge retention, self-efficacy and quality of life.
SEARCH STRATEGY
Searches were conducted in CINAHL, MEDLINE, EMBASE, Cochrane CENTRAL, Web of Science, ProQuest Nursing and Allied Health Source, and Google Scholar databases. Search terms were combined by AND or OR in search strings. Reference lists of included articles were also searched for further potential references.
METHODOLOGICAL QUALITY
Two reviewers conducted quality appraisal of papers using the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument.
DATA EXTRACTION
Data were extracted using the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument data extraction instruments.
DATA SYNTHESIS
There was significant heterogeneity in selected studies, hence a meta-analysis was not possible and the results were presented in narrative form.
RESULTS
Of the 21 articles retrieved in full, 12 on the use of the teach-back method met the inclusion criteria and were selected for analysis. Four studies confirmed improved disease-specific knowledge in intervention participants. One study showed a statistically significant improvement in adherence to medication and diet among type 2 diabetics patients in the intervention group compared to the control group (p < 0.001). Two studies found statistically significant improvements in self-efficacy (p = 0.0026 and p < 0.001) in the intervention groups. One study examined quality of life in heart failure patients but the results did not improve from the intervention (p = 0.59). Five studies found a reduction in readmission rates and hospitalization but these were not always statistically significant. Two studies showed improvement in daily weighing among heart failure participants, and in adherence to diet, exercise and foot care among those with type 2 diabetes.
CONCLUSIONS
Overall, the teach-back method showed positive effects in a wide range of health care outcomes although these were not always statistically significant. Studies in this systematic review revealed improved outcomes in disease-specific knowledge, adherence, self-efficacy and the inhaler technique. There was a positive but inconsistent trend also seen in improved self-care and reduction of hospital readmission rates. There was limited evidence on improvement in quality of life or disease related knowledge retention.Evidence from the systematic review supports the use of the teach-back method in educating people with chronic disease to maximize their disease understanding and promote knowledge, adherence, self-efficacy and self-care skills.Future studies are required to strengthen the evidence on effects of the teach-back method. Larger randomized controlled trials will be needed to determine the effectiveness of the teach-back method in quality of life, reduction of readmission, and hospitalizations.
Topics: Adult; Case-Control Studies; Chronic Disease; Cohort Studies; Cost of Illness; Diabetes Mellitus, Type 2; Health Education; Heart Failure; Hospitalization; Humans; Non-Randomized Controlled Trials as Topic; Outcome Assessment, Health Care; Patient Compliance; Patient Readmission; Quality of Life; Randomized Controlled Trials as Topic; Self Care; Self Efficacy; Self-Management; Teach-Back Communication
PubMed: 26878928
DOI: 10.11124/jbisrir-2016-2296 -
Journal of Human Lactation : Official... Aug 2017Maternal breastfeeding self-efficacy (BSE) is reflective of a mother's confidence in breastfeeding and is a modifiable factor that may improve breastfeeding rates.... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Maternal breastfeeding self-efficacy (BSE) is reflective of a mother's confidence in breastfeeding and is a modifiable factor that may improve breastfeeding rates. Breastfeeding self-efficacy theory purports that women with higher BSE will have better breastfeeding outcomes. Research aim: The aim of this systematic review was to explore the theoretical link between BSE and breastfeeding outcomes by investigating (a) if interventions to improve BSE were successful and (b) if improvements in BSE resulted in improved breastfeeding rates.
METHODS
The authors performed a systematic search of 10 databases for studies that investigated the effect of interventions for mothers of full-term infants on BSE and breastfeeding rates. They used an inverse-variance, random-effects meta-analysis.
RESULTS
Of 1,366 titles and abstracts identified, 58 full-text articles were screened and 11 met the study criteria. Compared with mothers in control groups, mothers in intervention groups had significantly higher BSE, scoring 4.86 points higher, 95% confidence interval [3.11, 6.61], at 2 months postpartum. Mothers in the intervention groups were 1.56 and 1.66 times more likely to be breastfeeding at 1 month and 2 months postpartum, respectively. Interventions that were implemented in the postpartum period, used combined delivery settings, or were informed by BSE theory had the greatest influence on breastfeeding outcomes. Meta-regression indicated that for each 1-point increase in the mean BSE score between the intervention and control groups, the odds of exclusive breastfeeding increased by 10% in the intervention group.
CONCLUSION
Breastfeeding self-efficacy is a modifiable factor that practitioners can target to improve breastfeeding rates in mothers of full-term infants.
Topics: Adult; Breast Feeding; Female; Humans; Mothers; Pregnancy; Self Efficacy
PubMed: 28644764
DOI: 10.1177/0890334417707957 -
Obesity Reviews : An Official Journal... Dec 2014This review investigated three research questions (i) What is the utility of social cognitive theory (SCT) to explain physical activity (PA)?; (ii) Is the effectiveness... (Meta-Analysis)
Meta-Analysis Review
This review investigated three research questions (i) What is the utility of social cognitive theory (SCT) to explain physical activity (PA)?; (ii) Is the effectiveness of SCT moderated by sample or methodological characteristics? and (iii) What is the frequency of significant associations between the core SCT constructs and PA? Ten electronic databases were searched with no date or sample restrictions. Forty-four studies were retrieved containing 55 SCT models of PA. Methodological quality was assessed using a standardized tool. A random-effects meta-analysis revealed that SCT accounted for 31% of the variance in PA. However, methodological quality was mostly poor for these models. Methodological quality and sample age moderated the PA effect size, with increases in both associated with greater variance explained. Although self-efficacy and goals were consistently associated with PA, outcome expectations and socio-structural factors were not. This review determined that SCT is a useful framework to explain PA behaviour. Higher quality models explained more PA variance, but overall methodological quality was poor. As such, high-quality studies examining the utility of SCT to explain PA are warranted.
Topics: Behavior; Cognition; Exercise; Female; Health Behavior; Humans; Male; Middle Aged; Models, Psychological; Motor Activity; Obesity; Self Efficacy; Treatment Outcome
PubMed: 25428600
DOI: 10.1111/obr.12225 -
Family Medicine and Community Health Mar 2022Journaling is a common non-pharmacological tool in the management of mental illness, however, no clear evidence-based guideline exists informing primary care providers... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Journaling is a common non-pharmacological tool in the management of mental illness, however, no clear evidence-based guideline exists informing primary care providers on its use. We seek here to present this synthesis that may begin to inform future research and eventual evidence-based guideline development.
DESIGN
Of the 3797 articles retrieved from MEDLINE, EMBASE, PsycINFO, 20 peer-reviewed randomised control trials (31 outcomes) met inclusion criteria. These studies addressed the impact of a journaling intervention on PTSD, other anxiety disorders, depression or a combination of the aforementioned.
ELIGIBILITY CRITERIA
Peer reviewed, randomised control trials on the impact of journaling on mental illness were included.
INFORMATION SOURCES
MEDLINE, EMBASE and PsycINFO.
RESULTS
The data are highly heterogeneous (control arm=I of 71.2%, intervention arm=I of 83.8%) combined with a B-level Strength of Recommendation Taxonomy recommendation. It was additionally found that there is a significant pre-post psychometric scale difference between control (-0.01, 95% CI -0.03 to 0.00) and intervention arms (-0.06, 95% CI -0.09 to -0.03). This 5% difference between groups indicates that a journaling intervention resulted in a greater reduction in scores on patient health measures. Cohen's d effect size analysis of studies suggests a small to moderate benefit.
CONCLUSION
Further studies are needed to better define the outcomes. Our review suggests that while there is some randomised control data to support the benefit of journaling, high degrees of heterogeneity and methodological flaws limit our ability to definitively draw conclusions about the benefit and effect size of journaling in a wide array of mental illnesses. Given the low risk of adverse effects, low resource requirement and emphasis on self-efficacy, primary care providers should consider this as an adjunct therapy to complement current evidence-based management.
Topics: Bibliotherapy; Humans; Mental Disorders; Self Efficacy
PubMed: 35304431
DOI: 10.1136/fmch-2021-001154 -
European Journal of Vascular and... Aug 2020This review aims to assess the evidence supporting the impact of patient foot care education on self efficacy, self care behaviour, and self care knowledge in... (Review)
Review
OBJECTIVE
This review aims to assess the evidence supporting the impact of patient foot care education on self efficacy, self care behaviour, and self care knowledge in individuals with diabetes.
METHODS
This systematic review was registered prospectively on the PROSPERO database (CRD42019106171). Ovid EMBASE and MEDLINE databases were searched from 1946 to the end of March 2019, using search terms related to the domains diabetic foot, patient education, self efficacy, self care behaviour, and self care knowledge. All included studies were prospective, randomised controlled trials that assessed foot care education interventions in individuals with diabetes and recorded an outcome related to self efficacy, self care behaviour, and/or self care knowledge.
RESULTS
Thirteen randomised controlled trials were included, reporting on a total of 3948 individuals. The risk of bias was high or unclear in 11 of the 13 included studies, and low in two studies. Both the education interventions delivered, and the outcome assessment tools used were heterogenous across included studies: meta-analysis was therefore not performed. Eight of 11 studies identified significantly better foot self care behaviour scores in individuals randomised to education compared with controls. Self efficacy scores were significantly better in education groups in four of five studies reporting this primary outcome. Foot care knowledge was significantly better in intervention vs. control in three of seven studies. In general, studies assessing secondary endpoints including quality of life and ulcer/amputation incidence tended not to identify significant clinical improvements.
CONCLUSION
The available evidence is of inadequate quality to reliably conclude that foot care education has a positive impact on foot self care behaviour and self efficacy in individuals with diabetes. Quality data supporting accompanying benefits on quality of life or ulcer/amputation incidence are also lacking and should be considered as an important outcome measure in future studies.
Topics: Aged; Diabetic Foot; Female; Health Behavior; Health Knowledge, Attitudes, Practice; Humans; Male; Middle Aged; Patient Education as Topic; Quality of Life; Randomized Controlled Trials as Topic; Self Care; Self Efficacy; Treatment Outcome; Wound Healing
PubMed: 32660807
DOI: 10.1016/j.ejvs.2020.03.053 -
International Journal of Nursing Studies Aug 2022Insufficient self-care behaviors, low self-efficacy, depression, and poor illness perceptions are obstacles to the management of people with heart failure, leading to... (Meta-Analysis)
Meta-Analysis Review
Effectiveness of nurse-led self-care interventions on self-care behaviors, self-efficacy, depression and illness perceptions in people with heart failure: A systematic review and meta-analysis.
BACKGROUND
Insufficient self-care behaviors, low self-efficacy, depression, and poor illness perceptions are obstacles to the management of people with heart failure, leading to adverse patient outcomes. Self-care interventions are strategies used to support individuals in self-care. Currently, evidence on the effects of nurse-led self-care interventions on self-care behaviors and the correlates (self-efficacy, depression, and illness perceptions) in people with heart failure is scarce.
OBJECTIVES
This review aims to systematically synthesize current evidence to determine the effectiveness of nurse-led self-care interventions on self-care behaviors, self-efficacy, depression, and illness perceptions among people with heart failure and identify the optimal characteristics of effective nurse-led heart failure self-care programs.
METHODS
MEDLINE, Embase, Web of Science, CENTRAL, CINAHL, and PsycINFO were electrically searched for relevant articles from the inception to December 2021. Randomized controlled trials examining the effects of nurse-led self-care interventions on self-care behaviors, self-efficacy, depression, and illness perceptions among people with heart failure published in the English language were included. The quality appraisal of included studies was performed using the revised Cochrane tool for assessment of the risk of bias in randomized controlled trials (RoB 2.0). The meta-analysis was conducted using statistical software R. The certainty of the evidence was rated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.
RESULTS
Twenty-four trials with 2488 participants were identified in this review. The results of our study revealed that nurse-led self-care interventions improved self-care maintenance (mean difference [MD]: 9.58, 95% confidence interval [CI]: 5.96 to 13.20, moderate certainty of evidence), self-care management (MD: 12.08, 95% CI: 8.05 to 16.11, high certainty of evidence), self-efficacy (standardized mean difference [SMD]: 0.98, 95% CI: 0.42 to 1.54, moderate certainty of evidence), and depression (SMD: 0.55, 95% CI: 0.34 to 0.77, high certainty of evidence) among people with heart failure. Moreover, subgroup analyses indicated that the ideal intervention duration to enhance self-care behaviors and self-efficacy was 1 to 3 months and to reduce depression was within 1 month.
CONCLUSIONS
This review revealed the beneficial effects of the nurse-led self-care interventions on self-care behaviors, self-efficacy, and depression among people with heart failure. The duration of the intervention is one of the factors that may affect the intervention effects. Further well-designed randomized controlled trials are recommended to strengthen the current evidence.
REGISTRATION NUMBER
(PROSPERO): CRD42022299754.
Topics: Depression; Heart Failure; Humans; Nurse's Role; Quality of Life; Self Care; Self Efficacy
PubMed: 35623153
DOI: 10.1016/j.ijnurstu.2022.104255 -
Sports Medicine (Auckland, N.Z.) Dec 2022To improve the understanding of the psychological impacts of anterior cruciate ligament (ACL) injury, a systematic review synthesizing the evidence on knee... (Meta-Analysis)
Meta-Analysis
BACKGROUND
To improve the understanding of the psychological impacts of anterior cruciate ligament (ACL) injury, a systematic review synthesizing the evidence on knee self-efficacy, fear avoidance beliefs and kinesiophobia following ACL injury is needed.
OBJECTIVE
The aim of this systematic review was to investigate knee self-efficacy, fear avoidance beliefs and kinesiophobia following ACL injury, and compare these outcomes following management with rehabilitation alone, early and delayed ACL reconstruction (ACLR).
METHODS
Seven databases were searched from inception to April 14, 2022. Articles were included if they assessed Tampa Scale of Kinesiophobia (TSK), Knee Self-Efficacy Scale (KSES), or Fear Avoidance Beliefs Questionnaire (FABQ). Risk of bias (RoB) was assessed using domain-based RoB tools (ROBINS-1, RoB 2, RoBANS), and GRADE-assessed certainty of evidence. Random-effects meta-analyses pooled outcomes, stratified by time post-injury (pre-operative, 3-6 months, 7-12 months, > 1-2 years, > 2-5 years, > 5 years).
RESULTS
Seventy-three studies (70% high RoB) were included (study outcomes: TSK: 55; KSES: 22; FABQ: 5). Meta-analysis demonstrated worse kinesiophobia and self-efficacy pre-operatively (pooled mean [95% CI], TSK-11: 23.8 [22.2-25.3]; KSES: 5.0 [4.4-5.5]) compared with 3-6 months following ACLR (TSK-11: 19.6 [18.7-20.6]; KSES: 19.6 [18.6-20.6]). Meta-analysis suggests similar kinesiophobia > 3-6 months following early ACLR (19.8 [4.9]) versus delayed ACLR (17.2 [5.0]). Only one study assessed outcomes comparing ACLR with rehabilitation only.
CONCLUSIONS
Knee self-efficacy and kinesiophobia improved from pre-ACLR to 3-6 months following ACLR, with similar outcomes after 6 months. Since the overall evidence was weak, there is a need for high-quality observational and intervention studies focusing on psychological outcomes following ACL injury.
Topics: Humans; Anterior Cruciate Ligament Injuries; Self Efficacy; Knee Joint; Fear; Anterior Cruciate Ligament Reconstruction
PubMed: 35963980
DOI: 10.1007/s40279-022-01739-3 -
PloS One 2017Current health policies emphasize the need for an equitable doctor-patient relationship, and this requires a certain level of patient empowerment. However, a systematic... (Review)
Review
BACKGROUND
Current health policies emphasize the need for an equitable doctor-patient relationship, and this requires a certain level of patient empowerment. However, a systematic review of the empirical evidence on how empowerment affects medication adherence-the extent to which patients follow the physician's prescription of medication intake-is still missing. The goal of this systematic review is to sum up current state-of-the-art knowledge concerning the relationship between patient empowerment and medication adherence across medical conditions. As our conceptualization defines health locus of control and self-efficacy as being crucial components of empowerment, we explored the relationship between these two constructs and medication adherence.
METHODS
Relevant studies were retrieved through a comprehensive search of Medline and PsychINFO databases (1967 to 2017). In total, 4903 publications were identified. After applying inclusion and exclusion criteria and quality assessment, 154 articles were deemed relevant. Peer-reviewed articles, written in English, addressing the relationship between empowerment (predictor) and medication adherence (outcome) were included.
FINDINGS
High levels of self-efficacy and Internal Health Locus of Control are consistently found to promote medication adherence. External control dimensions were found to have mainly negative (Chance and God attributed control beliefs) or ambiguous (Powerful others attributed control beliefs) links to adherence, except for Doctor Health Locus of Control which had a positive association with medication adherence. To fully capture how health locus of control dimensions influence medication adherence, the interaction between the sub-dimensions and the attitudinal symmetry between the doctor and patient, regarding the patient's control over the disease management, can provide promising new alternatives.
DISCUSSION
The beneficial effect of patients' high internal and concurrent physician-attributed control beliefs suggests that a so-called "joint empowerment" approach can be suitable in order to foster medication adherence, enabling us to address the question of control as a versatile component in the doctor-patient relationship.
Topics: Health Knowledge, Attitudes, Practice; Humans; Internal-External Control; Medication Adherence; Patient Participation; Physician-Patient Relations; Power, Psychological; Self Efficacy
PubMed: 29040335
DOI: 10.1371/journal.pone.0186458 -
The American Journal of Occupational... 2017We reviewed the efficacy of occupational therapy-related interventions for adults with rheumatoid arthritis. (Review)
Review
OBJECTIVE
We reviewed the efficacy of occupational therapy-related interventions for adults with rheumatoid arthritis.
METHOD
We examined 51 Level I studies (19 physical activity, 32 psychoeducational) published 2000-2014 and identified from five databases. Interventions that focused solely on the upper or lower extremities were not included.
RESULTS
Findings related to key outcomes (activities of daily living, ability, pain, fatigue, depression, self-efficacy, disease symptoms) are presented. Strong evidence supports the use of aerobic exercise, resistive exercise, and aquatic therapy. Mixed to limited evidence supports dynamic exercise, Tai Chi, and yoga. Among the psychoeducation interventions, strong evidence supports the use of patient education, self-management, cognitive-behavioral approaches, multidisciplinary approaches, and joint protection, and limited or mixed evidence supports the use of assistive technology and emotional disclosure.
CONCLUSION
The evidence supports interventions within the scope of occupational therapy practice for rheumatoid arthritis, but few interventions were occupation based.
Topics: Activities of Daily Living; Adult; Arthritis, Rheumatoid; Cognitive Behavioral Therapy; Depression; Exercise Therapy; Fatigue; Humans; Occupational Therapy; Patient Education as Topic; Self Care; Self Efficacy; Self-Help Devices; Treatment Outcome
PubMed: 28027042
DOI: 10.5014/ajot.2017.023176