Self-Management Strategies of Life,Positive Youth Development and Academic Buoyancy: a Causal Model

Academic buoyancy is defined as the capacity to overcome challenges that are a part of everyday academic life. The present study sought to determine the relationship between self-management strategies of life and positive youth development with academic buoyancy. 400 female high school students completed self-management strategies of life, positive youth development, and academic buoyancy scales. Using structural equation analysis, positive youth development and self-management strategies were found to have a significant positive relationship on academic buoyancy. Self-management strategies of life indirectly positively influenced academic buoyancy through positive youth development. Therefore, positive youth development plays a mediatory role between self-management strategies and academic buoyancy. 54 % of the variance of academic buoyancy and 55 % of the variance of positive youth development are explained by the variables of positive youth development and self-management strategies, respectively.     

Deconstruction of Nurse-Delivered Patient Self-Management Interventions for Symptom Management: Factors Related to Delivery Enactment and Response

This research examines the processes by which patient self-management interventions are related to symptom responses among cancer patients. A total of 333 patients from two randomized clinical trials were combined. Each patient received a six-contact 8-week patient self-management intervention delivered by a nurse to address symptoms. Nurses’ decisions to deliver the strategies, patient enactment of strategies, and their success were investigated using patient- and symptom-level characteristics. Generalized estimating equation modeling accounted for clustering of symptoms and strategies delivered for each symptom within patient. Patient self-management intervention strategies were classified into four classes. Strategies were delivered by nurses for symptoms with higher interference and longer duration. Patient and symptom factors were related to enactment strategies. Symptom responses were related to number of strategies tried by patients. Delivery and enactment of strategies were related to both patient and symptom characteristics.     

A qualitative investigation of LGBTQ+ young people’s experiences and perceptions of self-managing their mental health

There is evidence that young people generally self-manage their mental health using self-care strategies, coping methods and other self-management techniques, which may better meet their needs or be preferable to attending specialist mental health services. LGBTQ+ young people are more likely than their peers to experience a mental health difficulty and may be less likely to draw on specialist support due to fears of discrimination. However, little is known about LGBTQ+ young people’s experiences and perceptions of self-managing their mental health. Using a multimodal qualitative design, 20 LGBTQ+ young people participated in a telephone interview or an online focus group. A semi-structured schedule was employed to address the research questions, which focussed on LGBTQ+ young people’s experiences and perceptions of self-managing their mental health, what they perceived to stop or help them to self-manage and any perceived challenges to self-management specifically relating to being LGBTQ+ . Reflexive thematic analysis yielded three key themes: (1) self-management strategies and process, (2) barriers to self-management and (3) facilitators to self-management. Participants’ most frequently mentioned self-management strategy was ‘speaking to or meeting up with friends or a partner’. Both barriers and facilitators to self-management were identified which participants perceived to relate to LGBTQ+ identity. Social support, LGBTQ+ youth groups and community support were identified as key facilitators to participants’ self-management of their mental health, which merits further investigation in future research. These findings also have important implications for policy and intervention development concerning LGBTQ+ young people’s mental health.

     

Managing epilepsy well: self-management needs assessment

Epilepsy self-management interventions have been investigated with respect to health care needs, medical adherence, depression, anxiety, employment, and sleep problems. Studies have been limited in terms of representative samples and inconsistent or restricted findings. The direct needs assessment of patients with epilepsy as a basis for program design has not been well used as an approach to improving program participation and outcomes. This study investigated the perceived medical and psychosocial problems of adults with epilepsy, as well as their preferences for self-management program design and delivery format. Results indicated a more psychosocially challenged subgroup of individuals with significant depressive and cognitive complaints. A self-management program that involves face-to-face individual or group meetings led by an epilepsy professional and trained peer leader for 60 minutes weekly was preferred. Six to eight sessions focused on diverse education sessions (e.g., managing disability and medical care, socializing on a budget, and leading a healthy lifestyle) and emotional coping strategies delivered on weeknights or Saturday afternoons were most highly endorsed. Emotional self-management and cognitive compensatory strategies require special emphasis given the challenges of a large subgroup.     

Disability and Self-Management Practices of People with Bipolar Disorder: A Web-Based Survey

In a web-based survey asking adults diagnosed with bipolar disorder about illness management, we obtain frequency of self-reported usage and perceived helpfulness of 27 self-management strategies. We correlated the strategy use and perceived helpfulness with demographic and clinical characteristics, along with the Illness Intrusiveness Scale total score. Completed surveys were obtained from 1,024 individuals. Perceived helpfulness of 18 of 27 strategies was correlated negatively with illness intrusiveness at the P < 0.001 level. Given limitations of web-based surveys, our study underscores the substantial negative impact of bipolar disorder, along with the potential of the Internet to enhance the use of self-management strategies.     

Affinity for self-management: A comparison between counseling clients and controls

Students in counseling were compared with those not in counseling on a brief inventory designed to measure their affinity for self-management concepts. In the main, the counseled students expressed more reluctance to employ self-management strategies than did the regular students. The counseled students expressed less faith in their ability to change their own behaviors, greater aversion to organizing their time and activities, and less willingness to employ external rewards in changing their behaviors.     

A randomized, controlled proof-of-concept trial of an Internet-based, therapist-assisted self-management treatment for posttraumatic stress disorder

OBJECTIVE: The authors report an 8-week randomized, controlled proof-of-concept trial of a new therapist-assisted, Internet-based, self-management cognitive behavior therapy versus Internet-based supportive counseling for posttraumatic stress disorder (PTSD). METHOD: Service members with PTSD from the attack on the Pentagon on September 11th or the Iraq War were randomly assigned to self-management cognitive behavior therapy (N=24) or supportive counseling (N=21). RESULTS: The dropout rate was similar to regular cognitive behavior therapy (30%) and unrelated to treatment arm. In the intent-to-treat group, self-management cognitive behavior therapy led to sharper declines in daily log-on ratings of PTSD symptoms and global depression. In the completer group, self-management cognitive behavior therapy led to greater reductions in PTSD, depression, and anxiety scores at 6 months. One-third of those who completed self-management cognitive behavior therapy achieved high-end state functioning at 6 months. CONCLUSIONS: Self-management cognitive behavior therapy may be a way of delivering effective treatment to large numbers with unmet needs and barriers to care.     

Sibling self-management: Programming for generalization to improve interactions between typically developing siblings and children with autism spectrum disorders

The present study taught typically developing (TD) siblings of children with autism spectrum disorders (ASD) social-communicative and self-management skills. The authors’ hypothesized that the acquisition of self-management skills would support generalization of targeted social-communicative responses. A multiple baseline probe design across sibling dyads was used to decrease exposure to unnecessary sessions in the absence of intervention. Four TD siblings were taught self-management of a social skills curriculum using behavioral skills training, which consisted of instructions, modeling, practice, and subsequent feedback. Results indicated that TD siblings learned to self-manage the social skills curriculum with some generalization across novel settings and over time. Comparisons of social-communicative responses to their typical peers provided some support for the social validity of the intervention outcomes. These results support the use of self-management, when explicitly programming for generalization, which continues to be a key consideration when including TD siblings in interventions with their siblings with ASD.     

Social support for self-management behaviors among people with epilepsy: a content analysis of the WebEase program

Social support is an important component in managing epilepsy; however little is known about support provided to people with epilepsy. This study examined whom people with epilepsy identify as supportive, and how those individuals support people with epilepsy's self-management efforts. Data come from the WebEase project, an effective online epilepsy self-management program. People with epilepsy who participated in the pilot (n=35) and efficacy trials (n=118) were included. A content analysis was conducted on responses to open-ended questions related to support. The majority of participants provided information about their supporters. The number of support providers ranged from 0 to 6, with about 12% indicating no support. Parents and significant others were most commonly listed as supporters. Support providers mainly offer emotional and instrumental support, reminders and aid for taking medication, and support for self-management strategies. These results could be useful for interventions aimed at bolstering support in order to improve self-management.     

Socioeconomic status and self-management in epilepsy: comparison of diverse clinical populations in Houston, Texas

We compared the scores on self-management and associated psychosocial scales of patients with epilepsy at two clinics in Houston, TX, USA, to determine if there were systematic differences associated with socioeconomic status (SES). Patients of low SES reported higher scores on overall, information, and safety management (P<0.03) and no differences on medication, seizure, and lifestyle management. The two groups were similar with respect to the pattern of high and low scores. Reported levels of self-efficacy, depression, social support, stigma, desire for control, and outcome expectations were higher for those of high SES (P<0.01). Knowledge of epilepsy and satisfaction with care were lower (P<0.01). Again, the patterns of high and low scores were similar. Tests of association between psychosocial factors and self-management revealed that people with higher levels of self-efficacy and social support also reported higher self-management (P<0.01) regardless of demographics, seizure frequency, and SES (P<0.05). These findings provide little support for SES-related disparities in self-management and suggest that the focus of strategies to improve self-management may be similar across diverse populations.     

Design and feasibility of a memory intervention with focus on self-management for cognitive impairment in epilepsy

The aim of this study was to assess the feasibility of a self-management intervention targeting cognitive dysfunction to improve quality of life and reduce memory-related disability in adults with epilepsy. The intervention incorporates (1) education on cognitive function in epilepsy, (2) self-awareness training, (3) compensatory strategies, and (4) application of these strategies in day-to-day life using problem-solving therapy. In addition to the behavioral modification, formal working memory training was conducted by utilizing a commercially available program in a subgroup of patients. Our findings suggest that a self-management intervention targeting cognitive dysfunction was feasible for delivery to a rural population with epilepsy, with 13 of 16 enrolled participants completing the 8-session program. Qualitative data indicate high satisfaction and subjective improvement in cognitive functioning in day-to-day life. These findings provide support for further evaluation of the efficacy of this intervention through a randomized controlled trial.     

Patient Self-Management in the Primary Care Treatment of Depression

Efforts to improve primary care treatment of depression incorporate elements of the chronic illness care model, including patient self-management strategies. Case studies, focus groups and the literature suggest six key components of depression self-management programs: (1) implement behavioral change interventions, (2) plan for crisis and relapse prevention, (3) re-establish personal meaning, (4) attend to patients’ experience, context and community, (5) build a patient–clinician partnership and (6) create an integrated, self-management support structure. Successful implementation of these components is facilitated by (1) the care system’s collective and empathic understanding of the disease itself; (2) sufficient time; (3) adequate funding and (4) robust clinical information systems.     

Effects of an educational program on self-management in patients with epilepsy

PurposeSelf-management majorly determines the health status of patients with epilepsy because the most important strategies for controlling seizures include receiving and adhering to prescribed therapies, and making appropriate lifestyle adjustments. Patients with epilepsy have various educational needs and must adopt many self-management behaviors to control their condition. This study was a clinical trial that evaluated the effects of an educational program on self-management in patients with epilepsy.MethodsParticipants (n = 60) were recruited from the Neurology Clinic in Zanjan, Iran. Patients were randomly assigned to the intervention and control groups (n = 30 in each). The intervention group received four educational sessions on epilepsy, including a self-management plan. All participants completed the Epilepsy Self-Management Scale before the intervention and 1 month post-intervention. The chi-square test, Fisher's exact test, independent t-test, and paired samples t-test were used to compare the groups.ResultsAt baseline, demographic characteristics and self-management scores did not differ significantly. One month after the intervention, self-management scores differed significantly (p < 0.001) between the two groups.ConclusionThe educational program had beneficial effects on self-management behaviors in patients with epilepsy.     

An expanded view of self-management: patients' perceptions of education and support in an intervention for chronic musculoskeletal pain

Objectives. Chronic pain is prevalent, costly, and is associated with profound psychological effects. Although pain is prevalent in returning veterans of the recent military conflicts in Afghanistan and Iraq (Operation Iraqi Freedom/Operation Enduring Freedom/Operation New Dawn [OEF/OIF/OND] Veterans), little is known about chronic pain in these patients. This study's objective was to ascertain perceptions of a multicomponent intervention tested in a randomized controlled trial for OEF/OIF/OND veterans with chronic musculoskeletal pain (Evaluation of Stepped Care for Chronic Pain [ESCAPE]). Design. Qualitative interviews were conducted with 26 patients in the intervention arm of ESCAPE (21% of total intervention patients) to determine patients' experiences with and perceptions of the intervention. Patients were purposefully sampled to include treatment responders (defined as ≥30% reduction in pain-related disability or pain severity), nonresponders, and noncompleters (completed <50% of trial). Qualitative analysis was guided by grounded theory. Results. Both responders and nonresponders discussed the importance of the self-management education they received. Of particular significance, patients identified the nurse care manager who administered the intervention as being integral to patients' ability to self-manage their chronic pain. Patients described important ways in which the nurse facilitated their self-management, reported under three themes: 1) helping patients find what works for their pain; 2) holding patients accountable for their pain management; 3) motivating and providing emotional support to patients. Conclusions. Results corroborate previous work and suggest that current conceptualizations of self-management are incomplete. A model is proposed that not only depicts self-management as involving more than activities and strategies, but also acknowledges the central role of relationships and support in pain self-management.     

Self-management of instruction cues for occupation: review of studies with people with severe and profound developmental disabilities

Helping people with severe and profound developmental disabilities acquire and maintain constructive occupation is an objective of great practical importance. During the last 15-20 years, studies directed at this goal have largely relied on five strategies of self-management of instruction cues. Those strategies consist of the use of (1) picture cues presented on sets of cards, (2) picture cues stored in computer-aided systems, (3) object cues attached to cards, (4) verbal cues stored in audio recording devices, and (5) self-verbalizations. This paper reviews the aforementioned strategies and discusses their overall effectiveness and their suitability (practicality). The paper also points out some relevant issues for future research.     

Further Evaluation of the Motivational Model of Pain Self-Management: Coping with Chronic Pain in Multiple Sclerosis

Background  

Growing evidence suggests that motivation to engage in pain-coping strategies is a key predictor of how well a person adjusts to pain. According to the Motivational Model of Pain Self-Management, readiness to engage in pain self-management behaviors is influenced by beliefs about the importance of the behavior (importance) and the ability to carry out the behavior (self-efficacy).     

Behavioral and psychological approaches to the assessment and treatment of chronic pain

This article briefly reviews behavioral and psychologic methods currently used to assess chronic pain patients. Assessment techniques designed to measure pain report, overt behavior patterns, and psychologic functioning are described. A variety of behavioral treatment procedures for chronic pain are also discussed. Treatment techniques can be grouped into two major categories: operant conditioning methods, and self-management strategies. Critical needs for future research are briefly identified.     

Longitudinal feasibility of MINDSET: A clinic decision aid for epilepsy self-management

The purpose of this paper is to report on the development and feasibility of the longitudinal version of MINDSET, a clinical tool to assist patients and health-care providers in epilepsy self-management. A previous study described the feasibility of using MINDSET to identify and prioritize self-management issues during a clinic visit. This paper describes the development of the longitudinal version of MINDSET and feasibility test over multiple visits with a printed action plan for goal setting and the capacity for monitoring changes in self-management. Feasibility was assessed based on 1) postvisit patient and provider interviews addressing ease of use and usefulness, patient/provider communication, and shared decision-making and 2) the capacity of the tool to monitor epilepsy characteristics and self-management over time. Results indicate MINDSET feasibility for 1) identifying and facilitating discussion of self-management issues during clinic visits, 2) providing a printable list of prioritized issues and tailored self-management goals, and 3) tracking changes in epilepsy characteristics and self-management over time.     

Hybrid concept analysis of self-management in adults newly diagnosed with epilepsy

The objective of this study was to analyze and define the concept of self-management for adults diagnosed with epilepsy in the previous 12 months. Using the hybrid concept analysis method, we analyzed the concept of self-management as used in literature and as described by patients. The three phases of a hybrid concept analysis are theory, fieldwork, and analysis. Patient perceptions of the concept were elicited in the fieldwork phase via semistructured interviews. Qualitative content analysis was used to analyze both theoretical and fieldwork phase data. The analysis yielded 12 themes regarding the participants' self-management experiences that were organized under three main, interactive themes: emotional and physical comfort, functional ability, and self-management actions and behaviors. A conceptual framework and definition of self-management also emerged. We conclude that the patients in this population have unique self-management experiences, and an understanding of those needs allows health care providers to devise and utilize interventions to assist those patients in self-managing their epilepsy. Additional research is needed to investigate self-management further in this population.