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Journal of Diabetes Sep 2023Diabetes imposes an increasing health and economic burden on individuals living with it and their societies worldwide. Glycemic control is necessary to reduce morbidity... (Review)
Review
Diabetes imposes an increasing health and economic burden on individuals living with it and their societies worldwide. Glycemic control is necessary to reduce morbidity and mortality of type 2 diabetes mellitus (T2DM). Self-management is the primary tool for managing diabetes. Health literacy (HL) is the primary driver of self-management activities. The aim of this review is to evaluate the impact of HL interventions on glycemic control and self-management outcomes among T2DM. MEDLINE, CINAHL, PubMed, Cochrane, Scopus, and Web of Science were searched for eligible papers. Fifteen randomized controlled trials published in English between 1997 and 2021, used HL-driven intervention, and measured the level of glycohemoglobin A1c (HbA1c) and self-management of T2DM patients were included in this review. The findings showed that HL-driven intervention had a positive impact on glycemic control and improved self-management behaviors. The level of glycemic control and self-management skills were improved through individual and telephone-based intervention respectively. Community worker-led interventions were effective in improvements in diabetes knowledge and self-care behaviors; however, nurse-led interventions were effective in glycemic control. Better glycemic control is achieved in hospital settings compared to outpatient settings. HL interventions yielded better improvement in self-management among people with longer diabetes duration (more than 7 years). It was possible to achieve a large reduction in HbA1c level after a 3-month intervention in hospital settings. HL-driven interventions are effective in glycemic and diabetes self-management outcomes.
Topics: Humans; Diabetes Mellitus, Type 2; Glycated Hemoglobin; Health Literacy; Glycemic Control; Self-Management; Self Care; Randomized Controlled Trials as Topic
PubMed: 37407516
DOI: 10.1111/1753-0407.13436 -
JAMA Network Open Oct 2021Multiple studies have reported that people with autism spectrum disorder (ASD) are at a higher risk for self-injurious behavior and suicide. However, the magnitude of... (Meta-Analysis)
Meta-Analysis
IMPORTANCE
Multiple studies have reported that people with autism spectrum disorder (ASD) are at a higher risk for self-injurious behavior and suicide. However, the magnitude of this association varies between studies.
OBJECTIVE
To appraise the available epidemiologic studies on the risk of self-injurious behavior and suicidality among children and adults with ASD.
DATA SOURCES
PubMed, Embase, CINAHL, PsycINFO, and Web of Science were systematically searched for epidemiologic studies on the association between ASD and self-injurious behavior and suicidality. Databases were searched from year of inception to April through June 2020. No language, age, or date restrictions were applied.
STUDY SELECTION
This systematic review and meta-analysis included studies with an observational design and compared self-injurious behavior (defined as nonaccidental behavior resulting in self-inflicted physical injury but without intent of suicide or sexual arousal) and/or suicidality (defined as suicidal ideation, suicide attempt, or suicide) in children (aged <20 years) or adults (aged ≥20 years) with ASD.
DATA EXTRACTION AND SYNTHESIS
Information on study design, study population, ASD and self-harm definitions, and outcomes were extracted by independent investigators. Study quality was assessed using the Newcastle-Ottawa Scale. Overall summary odds ratios (ORs) and 95% CIs were estimated using DerSimonian-Laird random-effects models.
MAIN OUTCOMES AND MEASURES
The ORs for the associations of ASD with self-injurious behavior and suicidality were calculated. Analyses were stratified by study setting and age groups as planned a priori.
RESULTS
The search identified 31 eligible studies, which were of moderate to high quality. Of these studies, 16 (52%) were conducted in children, 13 (42%) in adults, and 2 (6%) in both children and adults. Seventeen studies assessed the association between ASD and self-injurious behavior and reported ORs that ranged from 1.21 to 18.76, resulting in a pooled OR of 3.18 (95% CI, 2.45-4.12). Sixteen studies assessed the association between ASD and suicidality and reported ORs that ranged from 0.86 to 11.10, resulting in a pooled OR of 3.32 (95% CI, 2.60-4.24). In stratified analyses, results were consistent between clinical and nonclinical settings and between children and adults.
CONCLUSIONS AND RELEVANCE
This study found that ASD was associated with a substantial increase in odds of self-injurious behavior and suicidality in children and adults. Further research is needed to examine the role of primary care screenings, increased access to preventive mental health services, and lethal means counseling in reducing self-harm in this population.
Topics: Adult; Autism Spectrum Disorder; Child; Humans; Risk Assessment; Self-Injurious Behavior
PubMed: 34665237
DOI: 10.1001/jamanetworkopen.2021.30272 -
PloS One 2022Sport psychology as an academic pursuit is nearly two centuries old. An enduring goal since inception has been to understand how psychological techniques can improve... (Meta-Analysis)
Meta-Analysis
Sport psychology as an academic pursuit is nearly two centuries old. An enduring goal since inception has been to understand how psychological techniques can improve athletic performance. Although much evidence exists in the form of meta-analytic reviews related to sport psychology and performance, a systematic review of these meta-analyses is absent from the literature. We aimed to synthesize the extant literature to gain insights into the overall impact of sport psychology on athletic performance. Guided by the PRISMA statement for systematic reviews, we reviewed relevant articles identified via the EBSCOhost interface. Thirty meta-analyses published between 1983 and 2021 met the inclusion criteria, covering 16 distinct sport psychology constructs. Overall, sport psychology interventions/variables hypothesized to enhance performance (e.g., cohesion, confidence, mindfulness) were shown to have a moderate beneficial effect (d = 0.51), whereas variables hypothesized to be detrimental to performance (e.g., cognitive anxiety, depression, ego climate) had a small negative effect (d = -0.21). The quality rating of meta-analyses did not significantly moderate the magnitude of observed effects, nor did the research design (i.e., intervention vs. correlation) of the primary studies included in the meta-analyses. Our review strengthens the evidence base for sport psychology techniques and may be of great practical value to practitioners. We provide recommendations for future research in the area.
Topics: Anxiety; Athletic Performance; Humans; Mindfulness; Psychology, Sports
PubMed: 35171944
DOI: 10.1371/journal.pone.0263408 -
Frontiers in Psychology 2017Nonsuicidal self-injury (NSSI) refers to the intentional self-inflicted destruction of body tissue without suicidal intention and for purposes not socially sanctioned....
Nonsuicidal self-injury (NSSI) refers to the intentional self-inflicted destruction of body tissue without suicidal intention and for purposes not socially sanctioned. Our paper presents an up-to-date overview on nonsuicidal, self-injurious behaviors. In accordance with PRISMA guidelines, a systematic literature search was conducted across two databases, PubMed and PsycARTICLES, regarding the main features of NSSI with a focus on epidemiological and etiologic data, diagnostic criteria, and functions. All English articles, published between 1998 and 2016, were considered, and screened against a priori inclusion/exclusion criteria. The search terms include: self-harm, self-injury, NSSI, epidemiology, comorbidity, gender, functions and DSM. We also examined the references of the retrieved articles. NSSI is most common among adolescents and young adults, and the age of onset is reported to occur between 12 and 14 years. Comorbidity with borderline personality disorder (BPD) and eating disorders is often reported. DSM-5 includes NSSI as a condition requiring further study. This review gives an overview of the prevalence rates (7.5-46.5% adolescents, 38.9% university students, 4-23% adults) and main causes that appear to stem from childhood trauma, comorbidity with many other disorders and several functions of NSSI, and the potential independence of a NSSI disorder. Over the years, interest in NSSI grew to such an extent that an ongoing debate was instigated on whether NSSI should be considered as a diagnosis in its own right and given its own category. This paper provides an up-to-date overview on self-injury, what is known about it and what remains to be done. Clearly, our understanding of the main issues of NSSI has increased in last two decades. However, future researches is needed to examine the developmental trajectories, cultural backgrounds and shed light on the risk factors and functions as well as clarify its role as an independent diagnostic entity.
PubMed: 29167651
DOI: 10.3389/fpsyg.2017.01946 -
Journal of Medical Internet Research May 2017Self-management support is one mechanism by which telehealth interventions have been proposed to facilitate management of long-term conditions. (Review)
Review
Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer.
BACKGROUND
Self-management support is one mechanism by which telehealth interventions have been proposed to facilitate management of long-term conditions.
OBJECTIVE
The objectives of this metareview were to (1) assess the impact of telehealth interventions to support self-management on disease control and health care utilization, and (2) identify components of telehealth support and their impact on disease control and the process of self-management. Our goal was to synthesise evidence for telehealth-supported self-management of diabetes (types 1 and 2), heart failure, asthma, chronic obstructive pulmonary disease (COPD) and cancer to identify components of effective self-management support.
METHODS
We performed a metareview (a systematic review of systematic reviews) of randomized controlled trials (RCTs) of telehealth interventions to support self-management in 6 exemplar long-term conditions. We searched 7 databases for reviews published from January 2000 to May 2016 and screened identified studies against eligibility criteria. We weighted reviews by quality (revised A Measurement Tool to Assess Systematic Reviews), size, and relevance. We then combined our results in a narrative synthesis and using harvest plots.
RESULTS
We included 53 systematic reviews, comprising 232 unique RCTs. Reviews concerned diabetes (type 1: n=6; type 2, n=11; mixed, n=19), heart failure (n=9), asthma (n=8), COPD (n=8), and cancer (n=3). Findings varied between and within disease areas. The highest-weighted reviews showed that blood glucose telemonitoring with feedback and some educational and lifestyle interventions improved glycemic control in type 2, but not type 1, diabetes, and that telemonitoring and telephone interventions reduced mortality and hospital admissions in heart failure, but these findings were not consistent in all reviews. Results for the other conditions were mixed, although no reviews showed evidence of harm. Analysis of the mediating role of self-management, and of components of successful interventions, was limited and inconclusive. More intensive and multifaceted interventions were associated with greater improvements in diabetes, heart failure, and asthma.
CONCLUSIONS
While telehealth-mediated self-management was not consistently superior to usual care, none of the reviews reported any negative effects, suggesting that telehealth is a safe option for delivery of self-management support, particularly in conditions such as heart failure and type 2 diabetes, where the evidence base is more developed. Larger-scale trials of telehealth-supported self-management, based on explicit self-management theory, are needed before the extent to which telehealth technologies may be harnessed to support self-management can be established.
Topics: Asthma; Chronic Disease; Delivery of Health Care; Diabetes Mellitus, Type 2; Heart Failure; Humans; Neoplasms; Pulmonary Disease, Chronic Obstructive; Self-Management; Telemedicine
PubMed: 28526671
DOI: 10.2196/jmir.6688 -
British Journal of Health Psychology May 2010Increasing self-efficacy is an effective method to increase physical activity. Despite this, the evidence concerning the most effective techniques to increase... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
Increasing self-efficacy is an effective method to increase physical activity. Despite this, the evidence concerning the most effective techniques to increase self-efficacy in physical activity interventions has not been systematically reviewed. The aim of the present research is to systematically gather, and meta-analyse, intervention studies which aimed to increase self-efficacy for physical activity; to estimate the association between intervention techniques used, and change in self-efficacy achieved.
METHODS
A systematic database search was conducted for papers reporting lifestyle or recreational physical activity interventions. Published intervention studies explicitly targeting self-efficacy in order to change physical activity behaviour in 'healthy' adults were eligible for inclusion.
RESULTS
The search strategy identified 27 unique physical activity intervention studies, with a total of 5,501 participants. A significant, yet small, relationship between the interventions and changes in self-efficacy was found (mean d=0.16, p<.001). Owing to significant heterogeneity, moderator analyses were conducted, examining the association of changes in self-efficacy with whether or not specific intervention techniques were used. Interventions that included feedback on past or others' performance produced the highest levels of self-efficacy found in this review. Vicarious experience was also associated with higher levels of self-efficacy. Persuasion, graded mastery, and barrier identification were associated with lower levels of self-efficacy.
CONCLUSIONS
This meta-analysis forms an evidence base for which psychological techniques are most effective in increasing self-efficacy for physical activity. The results are presented in terms of recommendations for those developing interventions and directions for future research.
Topics: Health Knowledge, Attitudes, Practice; Health Promotion; Humans; Life Style; Motivation; Motor Activity; Recreation; Self Efficacy
PubMed: 19586583
DOI: 10.1348/135910709X461752 -
Frontiers in Public Health 2022Patient-centered care in diabetes self-management might be a significant factor in improving health outcomes of adults with type 2 diabetes, yet the supporting evidence... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Patient-centered care in diabetes self-management might be a significant factor in improving health outcomes of adults with type 2 diabetes, yet the supporting evidence is inadequate. This review aimed at assessing the effectiveness of patient-centered self-management care interventions on glycemic control (HbA1c) and self-care behaviors compared with usual care.
METHODS
CINAHL, PubMed, Cochrane Library, Google Scholar, and the HEC Digital Library were searched for studies in English language that assessed patient-centered self-management educational and/or behavioral interventions in adults aged 18 years or older with type 2 diabetes from 2005 to 2020. Interventional studies with at least 3 months of follow-up and reporting on self-care outcomes such as glycemic control (HbA1c) and self-care behaviors including diet control, physical activity, foot care, and medication adherence were included.
RESULTS
Of 168 identified records, 24 were found eligible comprising 20 RCTs and four QESs with total 4,083 participants. The meta-analysis involved 19 RCTs that provided enough information for a pooled estimate of HbA1c. Compared with the control group, patient-centered self-management interventions significantly lowered HbA1c, -0.56 (95% CI -0.79, -0.32). Stratified analysis for HbA1c with respect to various aspects of intervention showed larger effects in interventions employing both educational and behavioral components, -0.66 (95% CI -0.97, -0.34); spanned over shorter (<03 months) duration, -0.85 (95% CI -1.28, -0.43); administered by nurses, -0.80 (95% CI -1.44, -0.16); and delivered in community settings -0.70 (95% CI -1.14, -0.26).
CONCLUSION
This systematic review provided evidence supporting the effectiveness of patient-centered self-management care interventions in improving glycemic control and self-care behaviors in adults with type 2 diabetes and identified key features of intervention contributing toward success.
Topics: Adult; Humans; Diabetes Mellitus, Type 2; Glycated Hemoglobin; Patient-Centered Care; Behavior Therapy; Exercise
PubMed: 36388341
DOI: 10.3389/fpubh.2022.994766 -
PloS One 2015To perform a systematic review and meta-analysis for the effects of physical activity intervention on self-esteem and self-concept in children and adolescents, and to... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To perform a systematic review and meta-analysis for the effects of physical activity intervention on self-esteem and self-concept in children and adolescents, and to identify moderator variables by meta-regression.
DESIGN
A meta-analysis and meta-regression.
METHOD
Relevant studies were identified through a comprehensive search of electronic databases. Study inclusion criteria were: (1) intervention should be supervised physical activity, (2) reported sufficient data to estimate pooled effect sizes of physical activity intervention on self-esteem or self-concept, (3) participants' ages ranged from 3 to 20 years, and (4) a control or comparison group was included. For each study, study design, intervention design and participant characteristics were extracted. R software (version 3.1.3) and Stata (version 12.0) were used to synthesize effect sizes and perform moderation analyses for determining moderators.
RESULTS
Twenty-five randomized controlled trial (RCT) studies and 13 non-randomized controlled trial (non-RCT) studies including a total of 2991 cases were identified. Significant positive effects were found in RCTs for intervention of physical activity alone on general self outcomes (Hedges' g = 0.29, 95% confidence interval [CI]: 0.14 to 0.45; p = 0.001), self-concept (Hedges' g = 0.49, 95%CI: 0.10 to 0.88, p = 0.014) and self-worth (Hedges' g = 0.31, 95%CI: 0.13 to 0.49, p = 0.005). There was no significant effect of intervention of physical activity alone on any outcomes in non-RCTs, as well as in studies with intervention of physical activity combined with other strategies. Meta-regression analysis revealed that higher treatment effects were associated with setting of intervention in RCTs (β = 0.31, 95%CI: 0.07 to 0.55, p = 0.013).
CONCLUSION
Intervention of physical activity alone is associated with increased self-concept and self-worth in children and adolescents. And there is a stronger association with school-based and gymnasium-based intervention compared with other settings.
Topics: Adolescent; Athletic Performance; Child; Child, Preschool; Controlled Clinical Trials as Topic; Exercise; Family; Female; Health Facilities; Health Resorts; Humans; Male; Physical Education and Training; Prisons; Prospective Studies; Psychology, Adolescent; Psychology, Child; Public Facilities; Randomized Controlled Trials as Topic; School Health Services; Self Concept; Young Adult
PubMed: 26241879
DOI: 10.1371/journal.pone.0134804 -
Preventive Medicine Jan 2022An increasing body of evidence supports the validity of self-sampling as an alternative to clinician collection for primary Human Papillomavirus (HPV) screening....
An increasing body of evidence supports the validity of self-sampling as an alternative to clinician collection for primary Human Papillomavirus (HPV) screening. Self-sampling effectively reaches underscreened women and can be a powerful strategy in low- and high-resource settings for all target ages. This work aims to summarize the current use of HPV self-sampling worldwide. It is part of a larger project that describes cervical cancer screening programmes and produces standardized coverage estimates worldwide. A systematic review of the literature and official documents supplemented with a formal World Health Organisation country consultation was conducted. Findings show that the global use of HPV self-sampling is still limited. Only 17 (12%) of countries with identified screening programs recommend its use, nine as the primary collection method, and eight to reach underscreened populations. We identified 10 pilots evaluating the switch to self-sampling in well-established screening programs. The global use of self-sampling is likely to increase in the coming years. COVID-19's pandemic has prompted efforts to accelerate HPV self-sampling introduction globally, and it is now considered a key element in scaling up screening coverage. The information generated by the early experiences can be beneficial for decision-making in both new and existing programs.
Topics: COVID-19; Early Detection of Cancer; Female; Humans; Mass Screening; Papillomaviridae; Papillomavirus Infections; SARS-CoV-2; Self Care; Specimen Handling; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 34861338
DOI: 10.1016/j.ypmed.2021.106900 -
Journal of Affective Disorders Apr 2023Over the last 20 years, compassion focused therapy (CFT) has gained popularity as an emerging 'third wave' intervention. Although previous reviews indicated its... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Over the last 20 years, compassion focused therapy (CFT) has gained popularity as an emerging 'third wave' intervention. Although previous reviews indicated its potential benefits, a systematic review and meta-analysis of CFT in those with mental health difficulties has yet to be conducted.
METHODS
A systematic search of five databases was undertaken, focusing on randomised controlled trials and randomised pilot/feasibility studies of CFT only. No language restrictions were implemented. A narrative synthesis was conducted. Random effects meta-analyses were measured on levels of self-compassion, self-criticism/self-reassurance, fears of compassion and clinical symptomology.
RESULTS
Fifteen studies from 2013 to 2022 were included. Findings suggested that CFT was effective in improving compassion-based outcomes and clinical symptomology from baseline to post-intervention and compared to waitlist control. A range of small to large effect sizes were reported for improvements in self-compassion (0.19-0.90), self-criticism (0.15-0.72), self-reassurance (0.43-0.81), fear of self-compassion (0.18), depression (0.24-0.25) and eating disorders (0.18-0.79). Meta-analyses favoured CFT in improving levels of self-compassion and self-reassurance than control groups.
LIMITATIONS
The methodological quality of many of the included studies (7/15) was rated as 'unclear' due to a lack of information. There was a distinct gender gap, with 74.88% identifying as female participants.
CONCLUSIONS
This review was the first to examine the effectiveness of CFT in clinical populations. The results indicate that CFT has promising clinical implications, suggesting that the intervention increases compassion-based outcomes and reduces clinical symptomology in those with mental health difficulties. However, future research is required into the long-term effects of CFT.
Topics: Humans; Female; Empathy; Psychotherapy, Group; Fear; Self-Assessment; Feeding and Eating Disorders
PubMed: 36649790
DOI: 10.1016/j.jad.2023.01.010