Aim: Patients living with chronic obstructive pulmonary disease (COPD) are challenged with managing the medical, social, and emotional consequences of the disease. Self-management of the disease plays a major role in actively preventing a deterioration such as an acute exacerbation (AECOPD). The aim of this study was to explore patients' perspectives on self-management, for both participants who received a complex multicomponent behavior-focused intervention (e.g., physical activity) after hospitalization (intervention group) and participants who did not (control group). Design: A qualitative descriptive study design was used. Methods: Semi-structured one-to-one interviews were conducted (n = 10). A newly implemented counselling program conducted by an Advanced Nursing Practice (ANP) care team was introduced as part of the study. Participants in the control group received standard treatment for hospitalized AECOPD, while the intervention group received counselling focused on patient self-management from the ANP care team over a 13-week period. Control and intervention group narratives were compared using framework analysis. Results: The predominant four topics in both groups were deducted from Lorig's conceptualization of self-management. These were: the management of burdensome emotions, the management of life roles, the management of medical regimen and recommendations, and the perception of self-management needs. The participants in the intervention group reported that counselling by the ANP team helped motivate them to sustain physical activity. They also found it reassuring to have a contact person they could easily reach out to in case of any queries or uncertainties, which provided them with a sense of security. Conclusion: There is a need for support in several areas of self-management after hospitalization for AECOPD. The newly introduced nurse-led self-management support was immediately well-received. Indeed, all participants appreciated the contact with their respective health professionals.
- MeSH
- chronická obstrukční plicní nemoc * ošetřování prevence a kontrola psychologie rehabilitace MeSH
- kvalita života MeSH
- lidé středního věku MeSH
- lidé MeSH
- pohybová aktivita MeSH
- progrese nemoci MeSH
- průzkumy a dotazníky MeSH
- rozhovory jako téma MeSH
- self-management * psychologie statistika a číselné údaje MeSH
- senioři MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- práce podpořená grantem MeSH
Participant-level meta-analyses assessed the age-specific relevance of office blood pressure to cardiovascular complications, but this information is lacking for out-of-office blood pressure. At baseline, daytime ambulatory (n=12 624) or home (n=5297) blood pressure were measured in 17 921 participants (51.3% women; mean age, 54.2 years) from 17 population cohorts. Subsequently, mortality and cardiovascular events were recorded. Using multivariable Cox regression, floating absolute risk was computed across 4 age bands (≤60, 61-70, 71-80, and >80 years). Over 236 491 person-years, 3855 people died and 2942 cardiovascular events occurred. From levels as low as 110/65 mm Hg, risk log-linearly increased with higher out-of-office systolic/diastolic blood pressure. From the youngest to the oldest age group, rates expressed per 1000 person-years increased (P<0.001) from 4.4 (95% CI, 4.0-4.7) to 86.3 (76.1-96.5) for all-cause mortality and from 4.1 (3.9-4.6) to 59.8 (51.0-68.7) for cardiovascular events, whereas hazard ratios per 20-mm Hg increment in systolic out-of-office blood pressure decreased (P≤0.0033) from 1.42 (1.19-1.69) to 1.09 (1.05-1.12) and from 1.70 (1.51-1.92) to 1.12 (1.07-1.17), respectively. These age-related trends were similar for out-of-office diastolic pressure and were generally consistent in both sexes and across ethnicities. In conclusion, adverse outcomes were directly associated with out-of-office blood pressure in adults. At young age, the absolute risk associated with out-of-office blood pressure was low, but relative risk high, whereas with advancing age relative risk decreased and absolute risk increased. These observations highlight the need of a lifecourse approach for the management of hypertension.
- MeSH
- ambulantní monitorování krevního tlaku MeSH
- hodnocení rizik MeSH
- hypertenze diagnóza epidemiologie MeSH
- internacionalita MeSH
- kardiovaskulární nemoci diagnóza epidemiologie MeSH
- kohortové studie MeSH
- lidé středního věku MeSH
- lidé MeSH
- měření krevního tlaku metody MeSH
- multivariační analýza MeSH
- návštěvy v ordinaci trendy MeSH
- proporcionální rizikové modely MeSH
- self-management statistika a číselné údaje MeSH
- senioři MeSH
- sexuální faktory MeSH
- věkové faktory MeSH
- zdravotní stav MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- metaanalýza MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
- Research Support, N.I.H., Extramural MeSH
Východiska: Škála partnerů ve zdraví (PIH škála) je nástroj ke zjišťování úrovně self-managementu pacientů. Self-management vede pacienty k tomu, aby zvládali své onemocnění sami, bez přítomnosti zdravotníků. Kvantitativní studie navazuje na validizaci české verze PIH škály a ověřuje její konstruktovou validitu. Cíl: Cílem studie je pomocí faktorové analýzy potvrdit konstruktovou validitu PIH škály. Metody: Ve výzkumu je aplikována PIH škála jako nástroj pro hodnocení self-managementu na souboru 432 pacientů s chronickým kardiovaskulárním onemocněním. Výsledky jsou zpracovány pomocí popisné statistiky, analýzy spolehlivosti, explorační a konfirmační faktorové analýzy. Výsledky: Explorační faktorová analýza ukazuje třífaktorové řešení, které bylo následně potvrzeno konfirmační faktorovou analýzou. Hodnoty Cronbachovy alfy pro celou PIH škálu a pro jednotlivé subškály se pohybují mezi 0,85-0,89 a ukazují na vysokou spolehlivost PIH škály. Závěry: Výsledky studie přinášejí informace o faktorovém řešení a reliabilitě PIH škály a potvrzují její dobré psychometrické vlastnosti.
Background: The Partners In Health (PIH) scale is the tool for assessment patients self-management. Self- management leads patients to coping their disease without medical officers. This quantitative study is to follow up on the validation of the Czech version of the PIH scale and to confirm their construct validity. Aim: The aim of this study is to confirm construct validity of PIH scale using the factor analysis. Methods: In the research, the PIH scale is applied as a tool for assessment self-management on the group of 432 patients with chronic cardiovascular disease. The results are processed using descriptive statistics, reliability analysis, exploratory factor analysis, confirmatory factor analysis. Results: The exploratory factor analysis shows three factor solution which was then confirmed by confirmatory factor analysis. The values of Cronbach’s alpha for the whole PIH scale and for the individual subscales are between 0.85-0.89 and show a high reliability of the PIH scale. Conclusions: The results of this study provide information on the factor solution and the PIH scale reliability and confirm its good psychometric characteristics.
