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PloS One 2019Primary health professionals are well positioned to support the delivery of patient self-management in an evidence-based, structured capacity. A need exists to better...
BACKGROUND
Primary health professionals are well positioned to support the delivery of patient self-management in an evidence-based, structured capacity. A need exists to better understand the active components required for effective self-management support, how these might be delivered within primary care, and the training and system changes that would subsequently be needed.
OBJECTIVES
(1) To examine self-management support interventions in primary care on health outcomes for a wide range of diseases compared to usual standard of care; and (2) To identify the effective strategies that facilitate positive clinical and humanistic outcomes in this setting.
METHOD
A systematic review of randomized controlled trials evaluating self-management support interventions was conducted following the Cochrane handbook & PRISMA guidelines. Published literature was systematically searched from inception to June 2019 in PubMed, Scopus and Web of Science. Eligible studies assessed the effectiveness of individualized interventions with follow-up, delivered face-to-face to adult patients with any condition in primary care, compared with usual standard of care. Matrices were developed that mapped the evidence and components for each intervention. The methodological quality of included studies were appraised.
RESULTS
6,510 records were retrieved. 58 studies were included in the final qualitative synthesis. Findings reveal a structured patient-provider exchange is required in primary care (including a one-on-one patient-provider consultation, ongoing follow up and provision of self-help materials). Interventions should be tailored to patient needs and may include combinations of strategies to improve a patient's disease or treatment knowledge; independent monitoring of symptoms, encouraging self-treatment through a personalized action plan in response worsening symptoms or exacerbations, psychological coping and stress management strategies, and enhancing responsibility in medication adherence and lifestyle choices. Follow-up may include tailored feedback, monitoring of progress with respect to patient set healthcare goals, or honing problem-solving and decision-making skills. Theoretical models provided a strong base for effective SMS interventions. Positive outcomes for effective SMS included improvements in clinical indicators, health-related quality of life, self-efficacy (confidence to self-manage), disease knowledge or control. An SMS model has been developed which sets the foundation for the design and evaluation of practical strategies for the construct of self-management support interventions in primary healthcare practice.
CONCLUSIONS
These findings provide primary care professionals with evidence-based strategies and structure to deliver SMS in practice. For this collaborative partnership approach to be more widely applied, future research should build on these findings for optimal SMS service design and upskilling healthcare providers to effectively support patients in this collaborative process.
Topics: Adaptation, Psychological; Depression; Diabetes Mellitus, Type 2; Health Behavior; Humans; Medication Adherence; Practice Guidelines as Topic; Primary Health Care; Pulmonary Disease, Chronic Obstructive; Quality of Life; Self-Management
PubMed: 31369582
DOI: 10.1371/journal.pone.0220116 -
International Journal of Environmental... Sep 2020Poor self-care behaviors can lead to an increase in the risk of adverse health outcomes among patients with heart failure. Although a number of studies have investigated... (Meta-Analysis)
Meta-Analysis
Poor self-care behaviors can lead to an increase in the risk of adverse health outcomes among patients with heart failure. Although a number of studies have investigated the effectiveness of nurse-led self-care education, the evidence regarding the effects of nurse-led intervention in heart failure remains uncertain. This study aimed to evaluate evidence on the effectiveness of nurse-led heart failure self-care education on health outcomes in patients with heart failure. To identify studies testing nurse-led education designed to improve self-care among heart failure patients, comprehensive search methods were used between January 2000 and October 2019 to systematically search six electronic databases: PubMed, CINAHL, Embase, Cochrane library, Web of Science, and SCOPUS. All the eligible study data elements were independently assessed and analyzed using random-effects meta-analysis methods. Of 612 studies, eight articles were eligible for this study. Nurse-led heart failure self-care education significantly reduced the risk of all-cause readmission (risk ratio (RR) = 0.75, 95% confidence interval (CI) = 0.66-0.85), heart failure specific readmission (RR = 0.60, 95% CI = 0.42-0.85), and all-cause mortality or readmission (RR = 0.71, 95% CI = 0.61-0.82). However, nurse-led heart failure self-care education was not associated with improvements in the quality of life and heart failure knowledge. Studies on the effectiveness of nurse-led heart failure self-care education mostly report only the positive effects on patients' health outcomes, whereas evidence of the effectiveness of the nurse-led approach is still limited. Therefore, high quality randomized controlled trials with detailed and explicit descriptions on the components of the interventions are needed.
Topics: Chronic Disease; Heart Failure; Humans; Outcome Assessment, Health Care; Quality of Life; Self Care
PubMed: 32916907
DOI: 10.3390/ijerph17186559 -
Journal of Affective Disorders Aug 2023Bipolar disorder is a severe and chronic mental illness characterized by recurrent major depressive episodes and mania or hypomania. In addition to the burden of the... (Review)
Review
BACKGROUND
Bipolar disorder is a severe and chronic mental illness characterized by recurrent major depressive episodes and mania or hypomania. In addition to the burden of the disease and its consequences, self-stigma can impact people with bipolar disorder. This review investigates the current state of research in self-stigma in bipolar disorder.
METHODS
An electronic search was carried out until February 2022. Three academic databases were systematically searched, and best-evidence synthesis was made.
RESULTS
Sixty-six articles were related to self-stigma in bipolar disorder. Seven key themes were extracted from these studies: 1/ Comparison of self-stigma in bipolar disorder and other mental illnesses, 2/ Sociocultural context and self-stigma, 3/ Correlates and predictors of self-stigma, 4/ Consequences of self-stigma, 5/ Treatments and self-stigma, 6/ Management of self-stigma, and 7/ Self-stigma and recovery in bipolar disorder.
LIMITATIONS
Firstly, a meta-analysis could not be performed due to the heterogeneity of the studies. Secondly, limiting the search to self-stigma has excluded other forms of stigma that also have an impact. Thirdly, the under-reporting of negative or nonsignificant results due to publication bias and unpublished studies might have limited the accuracy of this reviews' synthesis.
CONCLUSION
Research on self-stigma in persons with bipolar disorder has been the focused on different aspects, and interventions to reduce self-stigmatization have been developed, but evidence of their effectiveness is still sparse. Clinicians need to be attentive to self-stigma, its assessment, and its empowerment in their daily clinical practice. Future work is required to establish valid strategies to fight self-stigma.
Topics: Humans; Bipolar Disorder; Depressive Disorder, Major; Social Stigma; Mania
PubMed: 37207946
DOI: 10.1016/j.jad.2023.05.041 -
Frontiers in Psychiatry 2021Nonsuicidal self-injury (NSSI) and perfectionism mean a huge concern related to mental health and psychopathology. Recently, there has been a growing interest in...
Nonsuicidal self-injury (NSSI) and perfectionism mean a huge concern related to mental health and psychopathology. Recently, there has been a growing interest in research on the exploration of the association of perfectionism and NSSI, but till today there is no systematic review has been prepared in this topic. Therefore, we performed a systematic literature review of published studies that investigated the association between NSSI and perfectionism. The systematic search was made on PubMed, OVID Medline, PsychInfo, Scopus, and Web of Science. The search terms were ("nonsuicidal self-injury" OR "nonsuicidal self-injury" OR NSSI OR "self-injury" OR "self-injurious behavior" OR SIB OR "self-harm" OR "deliberate self-harm" OR DSH) AND (perfectionism). The inclusion criteria were as follows: written in English; reported empirical data; used validated self-report measures; investigated the association of nonsuicidal self-injury and perfectionism. There were no restrictions on participants regarding age, gender, race or ethnicity. Exclusion criteria: not written in English; was a review/meta-analysis; measured suicide behavior; measured self-injury irrespective of motivation or suicidal intent; was not about the association between nonsuicidal self-injury and perfectionism. After the screening process, 15 studies were included in our systematic review. The majority of studies (12) were published in the last 10 years. Nine (60%) recruited participants from community samples, four (26.7%) from clinical populations, and two (13.3%) both from community and clinical participants. Fourteen (93.3%) of the studies were cross-sectional studies, and one study contained a longitudinal investigation. The majority of studies included only or mainly female participants (62.3-87.2%) and two studies contained a balanced male-female ratio population. Fourteen (93.3%) studies from the 15 studies found a significant positive association between NSSI and perfectionism. The heterogeneity of used instruments makes it difficult to compare the results of involved studies. Only two studies investigated populations with balanced gender ratios. Only two studies examined both clinical and community populations. Clinical investigations enrolled mainly eating-disordered (ED) patients. The results of the current systematic review highlight the role of perfectionism in NSSI engagement. This systematic review may help the development of effective prevention initiatives and treatment strategies.
PubMed: 34305684
DOI: 10.3389/fpsyt.2021.691147 -
Nutrients Apr 2022Disgust and self-disgust are aversive emotions which are often encountered in people with eating disorders. We conducted a systematic review and meta-analysis of disgust... (Meta-Analysis)
Meta-Analysis Review
Disgust and self-disgust are aversive emotions which are often encountered in people with eating disorders. We conducted a systematic review and meta-analysis of disgust and self-disgust in people with eating disorders using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The systematic review of the literature revealed 52 original research papers. There was substantial heterogeneity regarding the research question and outcomes. However, we found 5 articles on disgust elicited by food images, 10 studies on generic disgust sensitivity, and 4 studies on self-disgust, and we proceeded to a meta-analytic approach on these studies. We found that women with eating disorders have significantly higher momentary disgust feelings in response to food images (1.32; 95% CI 1.05, 1.59), higher generic disgust sensitivity (0.49; 95% CI 0.24, 0.71), and higher self-disgust (1.90; 95% CI 1.51, 2.29) compared with healthy controls. These findings indicate the potential clinical relevance of disgust and self-disgust in the treatment of eating disorders.
Topics: Affect; Disgust; Emotions; Feeding and Eating Disorders; Female; Food; Humans
PubMed: 35565699
DOI: 10.3390/nu14091728 -
Sexual and Reproductive Health Matters 2021Contraceptive self-care interventions are a promising approach to improving reproductive health. Reproductive empowerment, the capacity of individuals to achieve their... (Review)
Review
Contraceptive self-care interventions are a promising approach to improving reproductive health. Reproductive empowerment, the capacity of individuals to achieve their reproductive goals, is recognised as a component of self-care. An improved understanding of the relationship between self-care and empowerment is needed to advance the design, implementation and scale-up of self-care interventions. We conducted a systematic review of the peer-reviewed and grey literature published from 2010 through 2020 to assess the relationship between reproductive empowerment and access, acceptability, use or intention to use contraceptive self-care. Our review adheres to PRISMA guidelines and is registered in PROSPERO (ID CRD42020205235). A total of 3036 unique records were screened and 37 studies met our inclusion criteria. Most studies were conducted in high-income countries, were cross-sectional and had high risk of bias. Almost half included only women. Over 80% investigated male condoms. All but one study focused on use of self-care. We found positive relationships between condom use self-efficacy and use of/intention to use condoms. We found similar evidence for other self-care contraceptive methods, but the low number of studies and quality of the evidence precludes drawing strong conclusions. Few studies assessed causal relationships between empowerment and self-care, indicating that further research is warranted. Other underexplored areas include research on power with influential groups besides sexual partners, methods other than condoms, and access and acceptability of contraceptive self-care. Research using validated empowerment measures should be conducted in diverse geographies and populations including adolescents and men.
PubMed: 35892261
DOI: 10.1080/26410397.2022.2090057 -
BMJ Open Feb 2022Urine pregnancy tests are often inaccessible in low-income settings. Expanded provision of home pregnancy testing could support self-care options for sexual and... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
Urine pregnancy tests are often inaccessible in low-income settings. Expanded provision of home pregnancy testing could support self-care options for sexual and reproductive health and rights. We conducted a systematic review of pregnancy self-testing effectiveness, values and preferences and cost.
DESIGN
Systematic review and meta-analysis using the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) approach.
DATA SOURCES
PubMed, CINAHL, LILACS and EMBASE and four trial registries were searched through 2 November 2020.
ELIGIBILITY CRITERIA FOR SELECTING STUDIES
We included trials and observational studies that compared urine self-testing for pregnancy to health worker-led pregnancy testing on effectiveness outcomes; quantitative and qualitative studies describing values and preferences of end users and health workers and costs of pregnancy self-testing.
DATA EXTRACTION AND SYNTHESIS
Two independent reviewers used standardised methods to search, screen and code included studies. Risk of bias was assessed using the Cochrane Collaboration and Evidence Project tools. Meta-analysis was conducted using random effects models. Findings were summarised in GRADE evidence profiles and synthesised qualitatively.
RESULTS
For effectiveness, four randomised trials following 5493 individuals after medical abortion showed no difference or improvements in loss to follow-up with home pregnancy self-testing compared with return clinic visits. One additional trial of community health workers offering home pregnancy tests showed a significant increase in pregnancy knowledge and antenatal counselling among 506 clients. Eighteen diverse values and preferences studies found support for pregnancy self-testing because of quick results, convenience, confidentiality/privacy, cost and accuracy. Most individuals receiving pregnancy self-tests for postabortion home management preferred this option. No studies reported cost data.
CONCLUSION
Pregnancy self-testing is acceptable and valued by end users. Effectiveness data come mostly from articles on postabortion care, and cost data are lacking. Greater availability of pregnancy self-tests, including in postabortion care and CHW programs, may lead to improved health outcomes.
PROSPERO REGISTRATION NUMBER
CRD42021231656.
Topics: Abortion, Induced; Female; Health Personnel; Humans; Pregnancy; Qualitative Research; Self-Testing
PubMed: 35228285
DOI: 10.1136/bmjopen-2021-054120 -
Journal of Medical Internet Research Sep 2021Self-tracking technologies are widely used in people's daily lives and health care. Academic research on self-tracking and the quantified self has also accumulated... (Review)
Review
BACKGROUND
Self-tracking technologies are widely used in people's daily lives and health care. Academic research on self-tracking and the quantified self has also accumulated rapidly in recent years. Surprisingly, there is a paucity of research that reviews, classifies, and synthesizes the state of the art with respect to self-tracking and the quantified self.
OBJECTIVE
Our objective was to identify the state of the art of self-tracking and the quantified self in terms of health and well-being.
METHODS
We have undertaken a systematic literature review on self-tracking and the quantified self in promoting health and well-being. After a rigorous literature search, followed by inclusions, exclusions, and the application of article quality assessment protocols, 67 empirical studies qualified for the review.
RESULTS
Our results demonstrate that prior research has focused on 3 stakeholders with respect to self-tracking and the quantified self, namely end users, patients and people with illnesses, and health care professionals and caregivers. We used these stakeholder groups to cluster the research themes of the reviewed studies. We identified 11 research themes. There are 6 themes under the end-user cluster: user motivation and goal setting, usage and effects of self-tracking, continuance intention and long-term usage, management of personal data, rejection and discontinuance, and user characteristics. The patient and people with illnesses cluster contains three themes: usage experience of patients and people with illnesses, management of patient-generated data, and advantages and disadvantages in the clinical context. The health care professional and caregiver cluster contains two themes: collaboration among patients, health care professionals, and caregivers, and changes in the roles of patients and professionals. Moreover, we classified the future research suggestions given in the literature into 5 directions in terms of research designs and research topics. Finally, based on our reflections on the observations from the review, we suggest four future research directions: (1) users' cognitions and emotions related to processing and interpreting the information produced by tracking devices and apps; (2) the dark side of self-tracking (eg, its adverse psychosocial consequences); (3) self-tracking as a societal phenomenon; and (4) systemic impacts of self-tracking on health care and the actors involved.
CONCLUSIONS
This systematic literature review contributes to research and practice by assisting future research activities and providing practitioners with a concise overview of the state of the art of self-tracking and the quantified self.
Topics: Delivery of Health Care; Health Personnel; Health Promotion; Humans; Motivation
PubMed: 34546176
DOI: 10.2196/25171 -
Clinical Child Psychology and Psychiatry Jan 2023To conduct a systematic review to establish what is known about the relationship between depression and self-evaluation in adolescents with a chronic illness. (Review)
Review
OBJECTIVE
To conduct a systematic review to establish what is known about the relationship between depression and self-evaluation in adolescents with a chronic illness.
METHODS
A systematic search was conducted using MEDLINE, EMBASE, PsycINFO, Web of Science, The Cochrane Library, and hand-searching. We sought to identify primary research that examined both the cross-sectional and longitudinal associations between depression and self-evaluation in adolescents with chronic illness. The search resulted in 8941 retrieved articles that were screened against an inclusion criteria. A total of 4 papers were included in the review. The MMAT used to assess study methodological quality.
RESULTS
A narrative synthesis was conducted, and a summary figure was included. These 4 studies included 236 adolescents aged 9-18 years with depression and either Type 1 Diabetes (T1D), chronic pain, headaches, or Inflammatory Bowel Disease (IBD). The limited existing evidence indicated that that depression was associated with negative self-evaluation in adolescents in some but not all chronic illnesses investigated to date. We also found some evidence that psychological intervention can help to improve self-evaluation, specifically in adolescents with T1D.
CONCLUSIONS
More robust studies of the association between self-evaluation and depression in adolescents with a chronic illness is needed, with attention to the nuances of differences between chronic illnesses. The existing evidence indicates that there may be a stronger association in some chronic illnesses. Pilot data suggest that specific psychological therapies may improve self-evaluation, although much more extensive evaluation is needed.
Topics: Adolescent; Humans; Cognitive Behavioral Therapy; Depression; Diagnostic Self Evaluation; Diabetes Mellitus, Type 1; Cross-Sectional Studies; Chronic Disease
PubMed: 35853094
DOI: 10.1177/13591045221115287 -
Sports (Basel, Switzerland) Nov 2023The relationship between self-efficacy and performance exclusively within the sports environment is yet to be quantified. Hence, we meta-analysed this relationship by... (Review)
Review
The relationship between self-efficacy and performance exclusively within the sports environment is yet to be quantified. Hence, we meta-analysed this relationship by following the PRISMA guidelines. Two previous meta-analyses, five relevant databases, and Google Scholar were searched. Forty-four articles published between 1983 and 2021 met the inclusion criteria, with 55 independent samples. Comprehensive meta-analysis software version 4 was used for all meta-analytic calculations using a random-effects model to calculate the mean effect size, and a mixed-effects model was used for moderation analyses. The mean pre-event self-efficacy and performance effect size was = 0.31 (95% CI 0.22, 0.40). For moderation analyses, notable mean differences ( values ≥ 0.08) resulted for concordance [concordant ( = 0.37), nonconcordant ( = 0.22)], sports skill [closed ( = 0.37), open ( = 0.23)], and athlete level [elite ( = 0.40), sub-elite ( = 0.28)]. The true effect prediction interval ranged from negative (i.e., self-efficacy impairing performance) to positive (self-efficacy improving performance) for all moderator variables except self-referenced vs. other-referenced performance. In conclusion, the relationship between pre-event self-efficacy and performance is positive and moderate in magnitude, although with prediction intervals ranging from debilitating to facilitating performance. Researchers and practitioners should note that high athlete-rated self-efficacy might not always improve impending competitive sports performance.
PubMed: 37999439
DOI: 10.3390/sports11110222