Objective To systematically assess the effectiveness of self-management during adjuvant treatment for breast cancer. Methods Through formulating the inclusion and exclusion criteria and the search strategy, such databases as The Cochrane Library, PubMed (1966 to 2010), OVID, ELSEVIER, CINAHL, EMbase, CNKI (1980 to 2010), WanFang Data, VIP (1989 to 2010) and CBM (1978 to 2010) were searched to collect the randomized controlled trials (RCTs) about postoperative self-management in breast cancer. Two reviewers evaluated the quality of the included studies, extracted and crosschecked the data; the Review Manager 5.0 software was used to perform the test for heterogeneity, and the cumulative effect was calculated with either fixed or random effects models. Results Among the included ten studies in English, three revealed that the program of self-management had no impact on the overall life quality of patients, three revealed that it could enhance the self-care ability of patients (P=0.004), three revealed that it could not reduce the anxiety level of patients, and two revealed that it had certain influence on the depression level of patients. Conclusion The program of self-management can enhance the patients’ self-care ability, but its influence on patients’ overall life quality as well as the level of anxiety and depression is still undefined.
ObjectiveTo understand the self management status of patients with ankylosing spondylitis (AS). MethodsSixty inpatients and outpatients with AS in the Department of Rheumatology between December 2011 and December 2012 were selected as the study subjects by judgment sampling method. A self-made questionnaire was used for investigation. ResultsThe self-management skills of 10.0% of the patients were poor, 78.3% were moderate and 11.7% were fine. The self-management skills of functional training and keeping healthy lifestyle were relatively poor. The factors with a score from the highest to the lowest were:the mental self-management, symptom management, keeping healthy lifestyle, and the self-management of functional training. ConclusionsThe self-management skills of patients with ankylosing spondylitis range from moderate to relatively poor. Our results suggest that cultural factors and the course of disease may be the main influence factors for self-management skills of patients. Clinical medical personnel should know the situation of patients sufficiently, improve the processes of health education and take corresponding intervention measures to the lack of self management ability. By the above ways, we can improve the compliance obedience and the self-management skills of patients, then the patients' condition and living quality will be greatly improved.
ObjectiveTo investigate the efficacy of follow-up continuous nursing intervention on the self-management ability and medication compliance of patients undergoing maintenance hemodialysis. MethodsBetween June and December 2013, 157 maintenance hemodialysis patients were randomly divided into control group (n=76) and study group (n=81). The control group was given conventional nursing, while the study group received continuous nursing intervention program as well as conventional nursing. Six months later, the self-management ability and medication compliance of the patients were assessed by using self-made Patient Self-management Scale and Morisky Medication Compliance Scale. ResultsSix months later, self-management ability in patients of the study group was significantly better than that in the control group (P<0.05). Medication compliance rate in the study group reached a highest of 45.7%, while it was only 18.4% in the control group, and the difference between the two groups was significant (χ2=13.283, P<0.001). ConclusionFollow-up continuous nursing intervention can obviously improve maintenance hemodialysis patients' ability of self management and compliance behavior, so as to improve the quality of life of these patients.
Objective To discuss the application value in increasing the frequency of monitoring and ensuring the safety of anticoagulation therapy in patient self-monitoring (PST) and self-management (PSM) of portable coagulometer. Method This non-randomized prospective controlled study was conducted in 100 patients receiving oral warfarin anticoagulation therapy after heart valve replacement and met the inclusion criteria in our hospital between March 2013 and April 2014 year. All the patients were divided into three groups including an outpatient follow-up group(outpatient group), a self-monitoring group and a self-management group. Meanwhile, the patients in the outpatient group visited professional institutions, performed international normalized ratio (INR) testing with central lab and adjusted the dosage of orally administered warfarin by the doctors. And the other two groups performed INR testing with CoaguChek XS portable coagulometer by themselves, and the patients in the self-management group performed management by themselves. The follow-up time was 6 months. The dates of time in therapeutic range (TTR), fraction of time in therapeutic range (FTTR) and anticoagulation complications in the three groups were analyzed and compared. Results There was no significant difference in the INR results obtained from the follow-up time among the three groups (P=0.845) . TTR value of INR of the outpatient group, the self-monitoring group, and the self-management group was 45.9% (4368.0 days/9517.0 days), 61.2% (6057.0 days/9897.0 days), and 65.4% (2833.8 days/4333.0 days), respectively with a statistical difference among the three groups (P<0.001) . FTTR value of INR obtained from the outpatient group, the self-monitoring group, and the self-management group was 48.3% (99 times/205 times), 60.7% (164 times/270 times), and 64.9% (100 times/154 times) respectively. There was a statistical difference in the FTTR between the outpatient group and the self-monitoring group (P=0.007) , and also between the outpatient group and the self-monitoring group (P=0.002) . But there was no statistical difference between the self-monitoring group and the self-management group (P=0.392) . There were not any major bleeding and thrombosis complications in all study. And there was no statistical difference in the total complications, thrombosis, and bleeding complications rates between the outpatient group and the self-monitoring group, and also between the outpatient group and the self-management group (P>0.05) . Conclusions The patients receiving oral anticoagulation after heart valve replacement or their care providers were able to perform PST and PSM. The use of portable coagulometer for self-monitoring and self-management can increase the frequency of anticoagulation monitoring and achieve better INR target value control. PST and PSM could achieve higher quality of anticoagulation management and life and without increasing the risk of oral anticoagulation than the traditional monitoring method. The monitoring frequency of once a month is reasonable for the patients receiving oral anticoagulation more than half a year after heart valve replacement.
Objective To systematically review the effect of mobile phone management applications (APP) on biological and biochemical parameters in adults with type 2 diabetes mellitus (T2DM). Methods We electronically searched databases including PubMed, EMbase, The Cochrane Library, Web of Science, CINAHL, PsycINFO, WanFang Data, CBM, CNKI for randomized controlled trials compared mobile phone APP as interventions for managing T2DM with traditional methods from inception to September 30th 2016. Two researchers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was conducted using Stata 12.0 software. Results A total of 10 studies including 1 030 participants (563 in the App group and 467 in the traditional group) were included. The results of meta-analysis showed that the mobile phone app-based interventions group were superior to the control group in HbA1c (MD=–0.43, 95% CI –0.65 to –0.22, P<0.001), systolic blood pressure (MD=–2.53, 95% CI –4.89 to –0.17,P<0.05), triglyceride (SMD=–0.24, 95% CI –0.42 to –0.06,P<0.05) and waist circumference (MD=–1.57, 95% CI –2.65 to –0.48,P<0.05). No significant different were found on any other related results between two groups. Conclusion Mobile phone apps aimed at diabetes management can improve HbA1c, systolic blood pressure, triglyceride, and waist circumference for patients with T2DM. Due to the limited quality and quantity of the included studies, the above conclusions are needed more high quality studies to verify.
Objective To investigate the general situation of self-management behavior of patients with cirrhosis, and analyze its influencing factors. Method From January to June 2015, the in-patients with liver cirrhosis were recruited from Gastroenterology Ward of a comprehensive hospital in Chengdu city by convenience sampling method, and a series of questionnaires were used in the research, including self-management behavior scale, social support scale (SSRS), quality of life questionnaire (WHOQOL-BREF) and sociodemographic characteristics. Results One hundred and sixty-eight patients were enrolled. The self-management behavior of patients with cirrhosis scored an average of 50.4±11.3, which was in the medium level. Self management behavior was positively and significantly correlated with social support (r=0.488, P<0.001) and the overall quality of life (r=0.554, P<0.001). Multiple linear regression indicated that the gender and course of the disease were two influencing factors. Moreover, female experienced better self-management behavior than men (t=27.090, P<0.001); and the longer the course of the disease was, the better the self-management behavior could be found (t=34.057, P<0.001). Conclusion We should strengthen the health education of self-management in patients with cirrhosis, and make full use of the patients’ social support system, so as to improve the patients’ self-management behavior as well as the treatment of diseases and their quality of life.
Objective To explore the correlation between blood glucose and self-management behaviors in patients with type 2 diabetic mellitus before initial basal insulin therapy. Methods A convenient sample of 200 patients with type 2 diabetic mellitus who were hospitalized in a tertiary hospital from February to August 2016 were enrolled in the study on a voluntary basis. Patients’ demographic information, fast blood glucose, glycosylated hemoglobin, and scores of diabetes self-care activities were gathered through questionnaires. Results A total of 193 valid questionnaires were recovered. Before starting basal insulin therapy, the mean blood glucose and the mean glycosylated hemoglobin of the 193 patients were (12.22±3.95) mmol/L and (10.01±2.38)%, respectively, with 12 patients (6.22%) meeting the goal of fasting blood glucose ≤7 mmol/L and 18 patients (9.33%) meeting the goal of glycosylated hemoglobin <7%, respectively. The total score of self-care activities was 26.76±14.77, in which 3 patients (1.55%) performed well. Spearman analysis demonstrated that the total score of self-care activities was negatively correlated with fast blood glucose ( r=–0.401, P<0.001) and glycosylated hemoglobin (r=–0.227, P=0.028). Conclusions The blood glucose levels and self-management behaviors in diabetic patients at the beginning of initial basal insulin therapy are not optimistic. Enhanced management of type 2 diabetic patients with initial basal insulin therapy is the prerequisite to promote diabetes self-care activities.
Objective To investigate the current status of self-management knowledge, attitude and behavior and influencing factors in patients with chronic obstructive pulmonary disease (COPD) in Qianbei area, and to analyze the influencing factors. Methods A total of 329 COPD patients were recruited and investigated with self-compiled questionnaire for self-management knowledge, attitude and behavior of chronic obstructive pulmonary disease, and SPSS 17.0 software was used to analyze the data. Results The mean score of self-management knowledge, attitude and behavior in COPD patients was 132.6±17.0, in which the scores of each dimension from high to low were as follows: smoking, medication treatment, exercise and family oxygen therapy. The analysis of stepwise regression indicated that the main influencing factors of self-management of COPD patients were age, sex, address, degree of education, course of disease and smoking. Conclusions The self-management level of the disease recognition, attitude and behavior in COPD patients should be improved, in which the knowledge is key factor to promote the health behavior of patients. So the healthy workers should pay close attention to the influence factors and apply the new thinking pattern and methods to improve the self-management ability and the quality of life of patients.
ObjectiveTo compare home blood pressure monitoring (HBPM) versus ambulatory blood pressure monitoring (ABPM) versus office blood pressure monitoring (OBPM) in diagnosis and management of hypertension, and to find the optimal blood pressure measurement and management.MethodsThe following were compared among three BP monitoring, such as cost-effectiveness, prognostic value of target organ damage (TOD), predictive value of the progress in chronic kidney disease (CKD) and blood pressure variety (BPV). ResultsCompared to OBPM, ABPM was the most cost-effective method in the primary diagnosis of hypertension, but HBPM was the optimal method in long-term and self-management in hypertension. In hypertensives, compared to OBPM, HBPM and ABPM, especially HBPM, had a stronger predictive value for cardiovascular events, stroke, end-stage renal dysfunction (ESRD) and all-cause mortality. In hypertensives with renal dysfunction, controlling HBPM and ABPM, especially controlling ABPM, was an effective way to slow the progress in renal dysfunction, to decrease cardiovascular events, and to decrease the need of dialysis. All BPV derived from OBPM, ABPM and HBPM had a predictive significance of cardiovascular events, and HBPM BPV performed the best.ConclusionCompared to OBPM, ABPM is the best method in primary diagnosis of hypertension and BP control in CKD patients, while HBPM is the best method in predicting and in evaluating BPV, as well as in long-term and self-management in hypertension.
ObjectiveTo investigate the level and influencing factors of self-management behaviors among maintenance hemodialysis patients.MethodsPatients undergoing maintenance hemodialysis were recruited from 4 tertiary hospitals in Chengdu from October 2016 to October 2017. Convenient sampling method was used to select patients. The instruments used in the study included General Information Questionnaire, Hemodialysis Self-management Instrument, Hemodialysis-related Knowledge Questionnaire, Herth Hope Index, Multidimensional Health Locus of Control Scale, and Chronic Illness Resources Survey.ResultsA total of 360 patients were investigated, and 343 patients were finally included. The mean score of self-management behavior was 54.87±9.65. The results of multiple linear stepwise regression showed that gender, age, ethnic, monthly family income, chronic illness resources, knowledge and internal health locus of control were the significant influencing factors of self-management behaviors (P<0.05).ConclusionThe self-management behavior among patients undergoing maintenance hemodialysis can be promoted by improving the level of knowledge and internal health locus of control, and making effective use of chronic illness resources.