The purpose of this integrative review is to evaluate research pertaining to self-management programs for older adults with chronic diseases using Albert Bandura’s Social Cognitive Theory (SCT) for behavior change. T...The purpose of this integrative review is to evaluate research pertaining to self-management programs for older adults with chronic diseases using Albert Bandura’s Social Cognitive Theory (SCT) for behavior change. The focus is application of the SCT domains to self-management programs. The exploration of the current chronic disease self-management research provides an understanding of the Social Cognitive Theory concepts studied in interventional self-management research. The integrative review explicated two areas related to the theory in need of further research. First, social support has not been thoroughly explored as a mechanism for enhancing self-management interventions. Second, moral disengagement was not identified as a focus within chronic disease research raising the question about the impact of moral disengagement on long-term adherence and behavior change.展开更多
This study compared ankle range of motion (AROM) including dorsiflexion, plantar flexion, inversion and eversion, and venous refill time (VRT) in leg skin inflamed by venous disorders, before and after a new cryothera...This study compared ankle range of motion (AROM) including dorsiflexion, plantar flexion, inversion and eversion, and venous refill time (VRT) in leg skin inflamed by venous disorders, before and after a new cryotherapy ulcer prevention treatment. Fifty-seven individuals participated in the randomized clinical trial;28 in the experimental group and 29 received usual care only. Results revealed no statistically significant differences between the experimental and usual care groups although AROM measures in the experimental group showed a consistent, non-clinically relevant decrease compared to the usual care group except for dorsiflexion. Within treatment group comparisons of VRT results showed a statistically significant increase in both dorsiflexion and plantar flexion for patients with severe VRT in the experimental group (6.9 ± 6.8;p = 0.002 and 5.8 ± 12.6;p = 0.02, respectively). Cryotherapy did not further restrict already compromised AROM, and in some cases, there were minor improvements.展开更多
Background: Established CRCS guidelines for providers and the public exist, but due to several versions of CRCS guidelines and the variety of test options, confusion often arises among patients and providers, adversel...Background: Established CRCS guidelines for providers and the public exist, but due to several versions of CRCS guidelines and the variety of test options, confusion often arises among patients and providers, adversely affecting CRCS rates. Improving providers’ opportunities to recommend CRCS through provider-directed office-system interventions is critical to increase CRCS rates. Objective: The purpose of this study was to demonstrate the feasibility of adapting provider-directed office-system interventions developed by the Practice Partner Research Network (PPRNet) Translation of Research into Practice (TRIP) Quality Improvement (QI) Model for implementation in an independent, rural West Virginia primary care practice, and to obtain estimates of variability for relevant outcome measures of the interventions to increase CRCS recommendation and rates. Methods: Retrospective and prospective patient data from medical records and electronic medical records were extracted to compare pre-with post-intervention CRCS rates and analyze any significant demographic data. Also, office staff participated in a focus group interview. Results: The pre-intervention CRCS status/completion rate was 4.3% and increased to 36.2%. CRCS recommendation rate rose from 4.3% to 42.1%. Patients in the post group were almost 7 times more likely to get CRCS recommendation compared to patients in the pre group, adjusting for demographic information. Similar to findings for CRCS recommendations, patients in the post group were more than 12 times more likely to have CRCS completion compared to their counterparts in the pre-group (OR 12.61, p < 0.000, CI: 8.30, 19.15). Conclusion: This study demonstrated the feasibility as well as statistically significant preliminary indications that CRCS rates will increase after implementation of this model.展开更多
With the older adult population projected to increase substantially in the next 10 years, the incidence of chronic disease will become a significant factor in the burden of disease both globally and within the United ...With the older adult population projected to increase substantially in the next 10 years, the incidence of chronic disease will become a significant factor in the burden of disease both globally and within the United States. The chronic disease state has been shown to decrease quality of life and the life expectancy of those individuals. In Tennessee the incidence of chronic disease, lower incomes, and education levels increases the risk of decreased quality of life and increased mortality in the older adult population. A review of literature by the researcher reveals that scant research has focused upon the older adult’s perspective toward chronic illness and making changes to their health routine. As part of a mixed-method correlational study, focus groups used a descriptive qualitative approach to increase understanding of the phenomenon of chronic illness. The purpose of this qualitative study was to determine the attitudes and perceptions of older adults in East Tennessee towards behavior change and health maintenance in chronic disease.展开更多
文摘The purpose of this integrative review is to evaluate research pertaining to self-management programs for older adults with chronic diseases using Albert Bandura’s Social Cognitive Theory (SCT) for behavior change. The focus is application of the SCT domains to self-management programs. The exploration of the current chronic disease self-management research provides an understanding of the Social Cognitive Theory concepts studied in interventional self-management research. The integrative review explicated two areas related to the theory in need of further research. First, social support has not been thoroughly explored as a mechanism for enhancing self-management interventions. Second, moral disengagement was not identified as a focus within chronic disease research raising the question about the impact of moral disengagement on long-term adherence and behavior change.
文摘This study compared ankle range of motion (AROM) including dorsiflexion, plantar flexion, inversion and eversion, and venous refill time (VRT) in leg skin inflamed by venous disorders, before and after a new cryotherapy ulcer prevention treatment. Fifty-seven individuals participated in the randomized clinical trial;28 in the experimental group and 29 received usual care only. Results revealed no statistically significant differences between the experimental and usual care groups although AROM measures in the experimental group showed a consistent, non-clinically relevant decrease compared to the usual care group except for dorsiflexion. Within treatment group comparisons of VRT results showed a statistically significant increase in both dorsiflexion and plantar flexion for patients with severe VRT in the experimental group (6.9 ± 6.8;p = 0.002 and 5.8 ± 12.6;p = 0.02, respectively). Cryotherapy did not further restrict already compromised AROM, and in some cases, there were minor improvements.
文摘Background: Established CRCS guidelines for providers and the public exist, but due to several versions of CRCS guidelines and the variety of test options, confusion often arises among patients and providers, adversely affecting CRCS rates. Improving providers’ opportunities to recommend CRCS through provider-directed office-system interventions is critical to increase CRCS rates. Objective: The purpose of this study was to demonstrate the feasibility of adapting provider-directed office-system interventions developed by the Practice Partner Research Network (PPRNet) Translation of Research into Practice (TRIP) Quality Improvement (QI) Model for implementation in an independent, rural West Virginia primary care practice, and to obtain estimates of variability for relevant outcome measures of the interventions to increase CRCS recommendation and rates. Methods: Retrospective and prospective patient data from medical records and electronic medical records were extracted to compare pre-with post-intervention CRCS rates and analyze any significant demographic data. Also, office staff participated in a focus group interview. Results: The pre-intervention CRCS status/completion rate was 4.3% and increased to 36.2%. CRCS recommendation rate rose from 4.3% to 42.1%. Patients in the post group were almost 7 times more likely to get CRCS recommendation compared to patients in the pre group, adjusting for demographic information. Similar to findings for CRCS recommendations, patients in the post group were more than 12 times more likely to have CRCS completion compared to their counterparts in the pre-group (OR 12.61, p < 0.000, CI: 8.30, 19.15). Conclusion: This study demonstrated the feasibility as well as statistically significant preliminary indications that CRCS rates will increase after implementation of this model.
文摘With the older adult population projected to increase substantially in the next 10 years, the incidence of chronic disease will become a significant factor in the burden of disease both globally and within the United States. The chronic disease state has been shown to decrease quality of life and the life expectancy of those individuals. In Tennessee the incidence of chronic disease, lower incomes, and education levels increases the risk of decreased quality of life and increased mortality in the older adult population. A review of literature by the researcher reveals that scant research has focused upon the older adult’s perspective toward chronic illness and making changes to their health routine. As part of a mixed-method correlational study, focus groups used a descriptive qualitative approach to increase understanding of the phenomenon of chronic illness. The purpose of this qualitative study was to determine the attitudes and perceptions of older adults in East Tennessee towards behavior change and health maintenance in chronic disease.
