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Retrospective comparison of different percutaneous approaches to manage occluded primary uncovered self-expandable metal stents in patients with unresectable malignant hilar biliary obstruction.

Purpose: To compare different percutaneous approaches to manage occluded primary uncovered self-expandable metal stents (SEMS) in patients with unresectable malignant hilar biliary obstruction (MHBO).Materials and Methods: A retrospective study was performed in patients with MHBO who underwent percutaneous management of occluded primary uncovered SEMS between January 2014 and January 2018. Patients were assigned into three groups based on the types of secondary stents, which included SEMS, internal-external drainage (IED), and external drainage (ED). Clinical success, requirement for reinterve

Effect of chronic disease self-management program on the quality of life of HIV-infected men who have sex with men: An empirical study in Shanghai, China.

OBJECTIVES: The HIV/AIDS epidemic rages on in China, particularly among men who have sex with men (MSM). MSM with HIV/AIDS also tend to have … of MSM with HIV/AIDS in Shanghai, as well as determine whether it is influenced by chronic disease self-management (CDSM). METHODS: We conducted a pre-post study to evaluate the effect of CDSM on participants' quality of life. Four hundred twenty participants were assigned to either the CDSM group (n = 210) or the control group (n = 210). We collected data on q …

Using nominal group technique to compare patients' and clinicians' perspectives on symptoms in multiple myeloma to inform the development of a self management tool for patients with relapsed myeloma.

BackgroundThe nominal group technique (NGT) allows stakeholders to directly generate items for needs assessment. The objective was to demonstrate the use of NGT to inform the development of a healthcare app in patients with relapsed myeloma. Healthcare professionals with experience in the care of patients with relapsed/refractory myeloma were invited to participate.MethodsOne NGT group was conducted. In the group, health care professionals working in haematology were asked to vote anonymously in order of highest priority, on symptoms previously highlighted by relapsed/refractory myeloma patien

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… Evidence suggests that by helping patients to self-manage, the risk of adverse events and hospital admissions are reduced and patients’ quality of life is improved 8 . … Despite this ongoing symptom burden, treatment remains episodic and self-management programmes have been limited for those on lifelong treatment 20 . …

The Perceived Benefits of an Artificial Intelligence-Embedded Mobile App Implementing Evidence-Based Guidelines for the Self-Management of Chronic Neck and Back Pain: Observational Study.

BACKGROUND: Chronic musculoskeletal neck and back pain are disabling conditions among adults. Use of technology has been suggested as an alternative way to increase adherence to exercise therapy, which may improve clinical outcomes. OBJECTIVE: The aim was to investigate the self-perceived benefits of an artificial intelligence (AI)-embedded mobile app to self-manage chronic neck and back pain. METHODS: A total of 161 participants responded to the invitation. The evaluation questionnaire included 14 questions that were intended to explore if using the AI rehabilitation system may (1) increase

GET.HAPPY - Acceptance of an internet-based self-management positive psychology intervention for adult primary care patients with mild and moderate depression or dysthymia: A pilot study.

INTRODUCTION: A growing number of internet interventions have been shown to help in alleviating symptoms of depression. So far, only little research has focused on other methods than CBT. The present study aimed to investigate the level of satisfaction with a positive psychology online training among patients with mild and moderate depression or dysthymia. Secondary outcome measures included changes in symptom severity, health related quality of life, and negative effects. METHODS: A total of 81 participants were allocated to the intervention. They were asked to complete online questionnaires

Rationale and methods of the iFightDepression study: A double-blind, randomized controlled trial evaluating the efficacy of an internet-based self-management tool for moderate to mild depression.

BACKGROUND: During the last decade online interventions have emerged as a promising approach for patients with mild/moderate depressive symptoms, reaching at large populations and representing cost-effective alternatives. The main objective of this double-blind, randomized controlled trial is to examine the efficacy of an internet-based self-management tool (iFightDepression) for mild to moderate depression as an add-on to treatment as usual (TAU) versus internet-based psychoeducation plus TAU. METHODS: A total of 310 participants with major depression disorder (MDD) will be recruited at four…

Randomised controlled trial of the clinical and cost-effectiveness of a peer-delivered self-management intervention to prevent relapse in crisis resolution team users: study protocol.

INTRODUCTION: Crisis resolution teams (CRTs) provide assessment and intensive home treatment in a crisis, aiming to offer an alternative for people who would otherwise require a psychiatric inpatient admission. They are available in most areas in England. Despite some evidence for their clinical and cost-effectiveness, recurrent concerns are expressed regarding discontinuity with other services and lack of focus on preventing future relapse and readmission to acute care. Currently evidence on how to prevent readmissions to acute care is limited. Self-management interventions, involving support…

Using the theoretical domains framework to guide the development of a self-management program for individuals with spinal cord injury: Results from a national stakeholder advisory group.

OBJECTIVE: To determine the implementation considerations for a targeted self-management program for individuals with spinal cord injury (SCI) from the perspective of a national stakeholder advisory group using the Theoretical Domains Framework (TDF) as a guide. DESIGN: Qualitative descriptive approach. SETTING: Two focus groups held at the 6th National Spinal Cord Injury Conference (October 2-4th, 2014) in Toronto, Ontario, Canada. PARTICIPANTS: A total of 25 stakeholders from across Canada participated in focus groups or "brainstorming sessions". The stakeholders included 5 clinicians, 14…

Effects of the AI-HEALS intervention based on the Fogg behavior model on self-management in postoperative breast cancer patients: a randomized controlled trial study protocol.

BACKGROUND: Breast cancer is the most common malignancy among women, and postoperative self-management is critically associated with long-term quality of life. Traditional clinical nursing and mobile health interventions frequently lack behavioral theory support, thereby failing to meet individualized rehabilitation needs. The Fogg Behavior Model (FBM) provides a theoretical framework for precise intervention through the dimensions of motivation, ability, and prompts. Accordingly, this study developed an FBM-based AI-HEALS intervention and will validate its effectiveness via a Randomized Contr…

Effectiveness of a self-management intervention on clinical outcomes among patients with type 2 diabetes at high risk for Diabetic Kidney Disease: A Randomised Controlled Trial.

BACKGROUND: Diabetic kidney disease (DKD) is a common complication of type 2 diabetes mellitus (T2DM) and a leading cause of end-stage renal disease, posing substantial health and economic burdens. Early self-management interventions targeting modifiable risk factors are crucial to prevent or slow DKD progression. However, most studies focus on later stages of DKD, leaving a gap in early prevention for high risk of DKD individuals. OBJECTIVE: To evaluate the effectiveness of a structured self-management intervention on clinical outcomes among T2DM patients at high risk of DKD. DESIGN: A pros…

Barriers and facilitators to self-management among patients with breast cancer receiving neoadjuvant chemotherapy: A qualitative study informed by the integrated theory of health behavior change.

OBJECTIVE: To explore barriers to and facilitators of self-management and related support needs across the pathway from neoadjuvant chemotherapy (NAC) to surgery by integrating the perspectives of patients and health care professionals in an analysis informed by the Integrated Theory of Health Behavior Change (ITHBC). METHODS: We used a qualitative descriptive design and maximum variation purposive sampling to recruit 16 individuals who were receiving NAC or awaiting surgery, together with 11 health care professionals involved in NAC care or self-management support. Data were collected throug…

The Work of Faith Care: An Interpretive Phenomenological Analysis on the Role of Spirituality and Religion in Diabetes Self-Management Among Black Older Adults in the Greater Toronto Area.

PURPOSE: The purpose of the study was to explore how faith and spirituality influence diabetes self-management among older Black adults with type 2 diabetes. METHODS: The researchers conducted in-depth interviews with 21 older Black adults (ages 55+) living with type 2 diabetes or prediabetes in the Greater Toronto Area. Guided by Van Manen's interpretive phenomenology and analyzed thematically using NVivo, the researchers examined lived experiences through 4 lifeworld themes: corporeality, spatiality, relationality, and temporality. RESULTS: Four themes emerged: faith as inner strength (spi…

Effectiveness of family and peer support intervention on glycemic control, self-management, and quality of life in type 2 diabetes in rural Indonesia: A randomized controlled trial.

BACKGROUND: Type 2 diabetes mellitus (T2DM) is a major global health burden, with many patients failing to achieve optimal glycemic targets. Family and peer support are recognized as important determinants of effective diabetes self-management. However, there is little evidence of the combined impact. Therefore, this study aimed to evaluate the effectiveness of a structured family and peer support intervention, delivered alongside standard diabetes care, to improve glycemic control. MATERIALS AND METHODS: A randomized controlled trial was conducted on 120 patients with T2DM, allocated into tw…

Preparation for healthy ageing: An integrated educational intervention for enhancing knowledge and self-efficacy in intrinsic capacity preservation, midlife condition management, and caregiving in midlife women.

OBJECTIVES: Midlife women often experience concurrent declines in intrinsic capacity (IC) and increasing caregiving responsibilities. This study evaluated the effectiveness of an educational intervention designed to enhance knowledge of IC preservation, self-care efficacy, and caregiving competencies among midlife women. METHODS: The Pursuit of Wellness Program was developed and evaluated through a multicentre mixed methods study. This program comprised nine modules addressing IC domains (cognitive, vitality, psychological) and six modules focused on priority midlife conditions (e.g., urinary

Messages and Notifications for the "OA Coach" Knee Osteoarthritis Self-Management Mobile App: Codevelopment and Evaluation Using a Participatory Research Design With Focus Groups and Surveys.

BACKGROUND: The OA Coach mobile app is a digital self-management tool designed to support people with knee osteoarthritis (OA). OBJECTIVE: We aimed to enhance the digital user experience of the OA Coach app by working with consumers, health professionals, and researchers to (1) improve existing OA Coach app call-to-action and encouragement notifications by applying behavior change theory, refining, reviewing, and adapting them, and (2) co-design new educational messages based on international OA guidelines. METHODS: This mixed methods study used a 3-phase process for improving existing notif…

Effects of a family-doctor-led community intervention model on self-management and medication taking in patients with type 2 diabetes mellitus: a randomized controlled trial.

BACKGROUND: The purpose of this study is to address the serious challenges China faces in diabetes prevention and treatment. Amidst the rapi … 526, P < 0.001), and medication taking (β = 0.205, P < 0.001) all contributed to the enhancement of self-management capabilities in patients with type 2 diabetes mellitus, jointly accounting for 99.9% of the improvement in overall self-management (adjusted R² = 0.999). CONCLUSIONS: Implementing a comprehensive intervention led by family doctors for patients with …

The effect of mindfulness combined with exercise compared with a self-management guide on measures of nervous system sensitivity in individuals with chronic pain: a pilot randomised control trial.

BACKGROUND: This study described a sensory profile of participants with chronic pain (CP) in a previously reported feasibility RCT, in terms of quantitative sensory testing (QST) measures and the Central Sensitisation Inventory (CSI). AIMS: The study aimed to explore the changes in QST measures and the CSI in this sample following participation in a mindfulness and physical activity intervention compared to an online self-management guide. METHODS: Participants were randomised into (i) a combined mindfulness and exercise online interactive group or (ii) an online self-management group. Press…

Personalisation at the Core of Success: Process Evaluation of the LISTEN Randomised Controlled Trial Evaluating a Personalised Self-Management Support Intervention for People Living With Long Covid.

BACKGROUND: The development and evaluation of rehabilitation interventions designed to support people with Long Covid (LC) remains an important ongoing priority. Many people with LC experience episodic, debilitating symptoms that can reduce their ability to engage in all areas of activity. The Long CovId personalised Self-managemenT support co-design and EvaluatioN (LISTEN) trial co-designed and evaluated a personalised self-management support intervention to build confidence and support people to live better with LC. This paper describes the context, implementation, mechanisms of impact and i…