ABSTRACT
Self-management programmes have previously been found to decrease health problems, enhance quality of life and increase independence. However, there is no literature that examines the influence of the participants' intrinsic motivation on the outcomes of such programmes. This study examined the role of intrinsic motivation in a pilot low vision self-management programme to enhance self-efficacy and quality of life of the programme participants. A positive association was observed between the female participants' perceived choice and perceived competence, two underlying dimensions of the Intrinsic Motivation Inventory. In addition, a positive correlation was observed between the younger participants' perceived competence and the change in their quality of life. The findings provide some support for consideration of participants' intrinsic motivation in the development of effective self-management programmes.
Subject(s)
Motivation , Quality of Life , Self Care , Self Efficacy , Vision, Low/physiopathology , Humans , SingaporeABSTRACT
BACKGROUND: Effective management of diabetes not only relies on lifestyle modification and adherence to a treatment regime, but also the ability to cope with the impact of the disease on daily activities. Stress associated with the multi-caregiver role of women may affect the ability to manage the disease effectively. OBJECTIVES: To explore the experience of women living and coping with type 2 diabetes. INCLUSION CRITERIA: Adult women aged 18 years and above diagnosed with type 2 diabetes.The meaning of living and coping with type 2 diabetes.Qualitative studies, including designs such as phenomenology, grounded theory, ethnography, action research and feminist research. SEARCH STRATEGY: The search strategy used sought only to identify published English research papers from the year 1990 to 2010. A three-step search strategy was undertaken. METHODOLOGICAL QUALITY: The retrieved papers were assessed for methodological quality by two independent reviewers using the Joanna Briggs Institute Qualitative Assessment and Review Instrument. DATA COLLECTION: Data was extracted using the Joanna Briggs Institute Qualitative Assessment and Review data extraction tool. DATA SYNTHESIS: The data were synthesised using the Joanna Briggs Institute approach of meta-synthesis by meta-aggregation. RESULTS: Nine studies were included in the review. Forty-one findings were obtained and then grouped into 11 categories which were then aggregated into four synthesised findings: "Living with type 2 diabetes is emotionally and mentally challenging", "Support (of self, by others, spiritual) provides the ability to cope with diabetes", "Women see their personal responsibility in the management of diabetes and try to maintain their autonomy. Despite this, women place the needs of the family over their own needs thereby resulting in ineffective management" and "Effective management of diabetes is hindered by role duties of women as well as their attitudes and the attitudes of the healthcare providers". CONCLUSIONS: Women are challenged by their multi-caregiving roles and the complexities of managing their diabetes simultaneously. Holistic, individual psycho-education programs for female patients with diabetes and carer programs educating families and friends will facilitate more effective and successful management. IMPLICATIONS FOR PRACTICE: As supported by the evidence obtained in this review, diabetic education programs should include strategies that facilitate emotional coping. Family members should be encouraged to attend diabetes management programs or workshops designed for caregivers or family members to enable them to support female family members with diabetes effectively. Education programs for doctors should focus on the therapeutic helping relationship and the role this relationship plays in facilitating improved health outcomes for patients. IMPLICATION FOR RESEARCH: Implementation of action research with interventions that address the key issues identified in this systematic review would be useful. Additionally, further longitudinal studies that link the incidence and severity of complications and quality of life issues associated with diabetes management to such intervention programs will clarify the benefits, modifying factors and barriers. Despite a plethora of literature examining the coping styles and experiences of Caucasian people with diabetes there is a paucity of literature investigating similar issues among Asian populations. Thus further research studies that examine the experience of living and coping with type 2 diabetes in Asian populations are needed to enhance understanding for these patients.
ABSTRACT
BACKGROUND: Music therapy is a popular form of complementary therapy used in the hospice in Western countries, as people who are terminally ill have several needs arising directly from the disease process. In the area of palliative care, no systematic review has been conducted on the experience of patients using music therapy from the qualitative perspective. Hence, a synthesized summary of the experience of music therapy is presented. OBJECTIVES: The aim of this review was to critically analyse and synthesize existing evidence related to terminally ill patients' experiences of using music therapy in the palliative setting. INCLUSION CRITERIA: This review considered quantitative descriptive studies, and qualitative research with adult participants who were terminally ill receiving palliative care in a hospital, an in-patient hospice, a nursing home, or their own homes, regardless of their diagnosis who had undergone at least one music therapy session with a trained music therapist and were not cognitively impaired. Healthcare workers who have witnessed patients participating in music therapy were also included in the review. SEARCH STRATEGY: Only published primary research studies were included in the review. This review was limited to papers in English. A three-step search strategy was undertaken. First, an initial limited search of CINAHL and MEDLINE was done. Second, an extensive search using all identified keywords and index terms across all included databases was done. Finally, a hand search of the reference lists and bibliographies of included articles was conducted METHODOLOGICAL QUALITY: Papers selected for retrieval were assessed by two independent reviewers for methodological validity prior to inclusion in the review using the standardised critical appraisal instruments from the Joanna Briggs Institute Qualitative Assessment and Review Instrument (QARI) for qualitative papers, and Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) for quantitative descriptive papers. Any disagreement that arose between the reviewers was resolved through discussion with a third reviewer. DATA COLLECTION: Information was extracted by two reviewers from each paper using the Joanna Briggs Institute Qualitative Assessment and Review data extraction tool (QARI) for qualitative papers, and the Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) for quantitative descriptive papers. Any disagreement that arose between the reviewers was resolved through discussion with a third reviewer. DATA SYNTHESIS: Qualitative findings were pooled using the JBI-QARI while quantitative data were presented in narrative format. RESULTS: A total of 10 studies were identified, and of these, 3 were included in the review. Only qualitative papers were included in the studies as the quantitative descriptive papers did not meet the inclusion criteria. Two synthesized findings were developed - "Music therapy should be used in palliative settings to promote social interaction and communication with family, friends, other patients, and healthcare workers", and "Music therapy should be promoted in palliative care setting to provide support for holistic needs of patients". CONCLUSION: From the meta-syntheses of review, it was shown that patients experienced improved social interaction and communication with the people around them, and a more holistic care for as their physical, psychological and spiritual needs were met. No papers relating to the patients' expectations of music therapy was found. IMPLICATIONS FOR RESEARCH: Further research should be conducted to explore the expectations of terminally ill patients with music therapy as no such paper was found from the systematic review. Quantitative studies to find out the effectiveness of music therapy in promoting social interaction and communication and in providing holistic care for patients can be done to quantify the findings. It can also be investigated if the quality of life of terminally ill patients improve after receiving music therapy, since music therapy has been found to have positive benefits for the patients. Also, qualitative studies that aim to find out the experiences of terminally ill patients through the interviewing of the patients should also be done, as the papers found either reported on the perception of healthcare providers, or through the analysis of patients' song lyrics. IMPLICATIONS FOR PRACTICE: The use of music therapy should be encouraged in the palliative setting as the review has shown that music therapy is able to promote social interaction and communication with family members, healthcare workers and the people in their lives, and provides holistic care for patients by relieving physical symptoms, facilitating "moving on" to the next phrase of their life, improving their personal well-being, and providing an outlet for spirituality.
ABSTRACT
Numerous previous studies have suggested that cancer care in rural and regional Australia is fragmented and that rural and regional patients have less access to services. However, knowledge concerning inequality of health and cancer care in regional and rural settings is still inconclusive. The social and economic disadvantages in regional locations are often linked to insufficient resources and infrastructures to support cancer care and treatment. The aim of this study was to explore cancer patients' experiences from the perspective of patients and healthcare providers in a regional area of Western Australia. It was found that patients who had the involvement of a cancer nurse coordinator and cancer support workers had better experiences and more streamlined care than did those who had to navigate the journey alone. This study endorses the function of cancer nurse coordinators and cancer support workers in providing better coordination of care in rural and regional cancer patients.
