Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 19 de 19
Filter
1.
Patient Educ Couns ; 123: 108207, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38447477

ABSTRACT

OBJECTIVE: This study aimed to evaluate the effect of a new health communication intervention focusing on knowledge management skills on health literacy and medication adherence during the first year following kidney transplantation. METHODS: We randomized 195 patients during 2020-2021, to either intervention- or control group. Questionnaires were completed at baseline and at 12 months post-transplantation with a 12-month response rate of 84%. Health literacy was measured by the multidimensional Health Literacy Questionnaire (HLQ) instrument. Medication adherence was measured by the self-reported questionnaire (BAASIS©). RESULTS: Results showed that the intervention group had a significant increase in 2 HLQ domains compared to the control group capturing the "ability to appraise health information" Domain 5, (p-value = 0.002) and the "ability to navigate the healthcare system" Domain 7, (p-value <0.04). The effect sizes of SRM were 0.49 (Domain 5) and 0.33 (Domain 7). Medication adherence was comparable in the groups at any measure points. CONCLUSIONS: This study contributes to important knowledge about how a health communication intervention focusing on knowledge translation using motivational interviewing techniques positively strengthens health literacy in kidney transplant recipients. PRACTICAL IMPLICATIONS: Current patient education practice may benefit from focusing on knowledge translation in combination with motivational interview technique.


Subject(s)
Health Communication , Health Literacy , Kidney Transplantation , Humans , Research Design , Surveys and Questionnaires , Medication Adherence
2.
Patient Educ Couns ; 123: 108220, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38458089

ABSTRACT

OBJECTIVE: To compare the effect of motivational interviewing (MI) and tailored health literacy (HL) follow-up with usual care on hospitalization, costs, HL, self-management, Quality of life (QOL), and psychological stress in people with chronic obstructive pulmonary disease (COPD). METHODS: A RCT was undertaken in Norway between March 2018-December 2020 (n = 127). The control group (CG, n = 63) received usual care. The intervention group (IG, n = 64) received tailored HL follow-up from MI-trained COPD nurses with home visits for eight weeks and phone calls for four months after hospitalization. Primary outcomes were hospitalization at eight weeks, six months, and one year from baseline. The trial was registered with ClinicalTrials.gov (NCT03216603) and analysed per protocol. RESULTS: Compared with the IG, the CG had 2.8 higher odds (95% CI [1.3 to 5.8]) of hospitalization and higher hospital health costs (MD=€ -6230, 95% CI [-6510 to -5951]) and lower QALYs (MD=0.1, 95% CI [0.10 to 0.11]) that gives an ICER = - 62,300. The IG reported higher QOL, self-management, and HL (p = 0.02- to <0.01). CONCLUSION: MI-trained COPD nurses using tailored HL follow-up is cost-effective, reduces hospitalization, and increases QOL, HL, and self-care in COPD. PRACTICE IMPLICATION: Tailored HL follow-up is beneficial for individuals with COPD and the healthcare system.


Subject(s)
Health Literacy , Pulmonary Disease, Chronic Obstructive , Self-Management , Humans , Quality of Life , Hospitalization , Health Care Costs , Pulmonary Disease, Chronic Obstructive/therapy , Pulmonary Disease, Chronic Obstructive/psychology
3.
Article in English | MEDLINE | ID: mdl-38409800

ABSTRACT

INTRODUCTION: Shoulder dystocia is a rare obstetric complication, and the risk of recurrence is important for planning future deliveries. MATERIAL AND METHODS: The objectives of our study were to estimate the incidence and risk factors for recurrence of shoulder dystocia and to identify women at high risk of recurrence in a subsequent vaginal delivery. The study design was a nationwide register-based study including data from the Danish Medical Birth Registry and National Patient Register in the period 2007-2017. Nulliparous women with a singleton fetus in cephalic presentation were included for analysis of risk factors in index and subsequent delivery. RESULTS: During the study period, 6002 cases of shoulder dystocia were reported with an overall incidence among women with vaginal delivery of 1.2%. Among 222 225 nulliparous women with vaginal births, shoulder dystocia complicated 2209 (1.0%) deliveries. A subsequent birth was registered in 1106 (50.1%) of the women with shoulder dystocia in index delivery of which 837 (77.8%) delivered vaginally. Recurrence of shoulder dystocia was reported in 60 (7.2%) with a six-fold increased risk compared with women without a prior history of shoulder dystocia (risk ratio [RR] 5.70, 95% confidence interval [CI]: 4.41 to 7.38; adjusted RR 3.06, 95% CI: 2.03 to 4.68). Low maternal height was a significant risk factor for recurrence of shoulder dystocia. In the subsequent delivery, significant risk factors for recurrence were birthweight >4000 g, positive fetal weight difference exceeding 250 g from index to subsequent delivery, stimulation with oxytocin and operative vaginal delivery. In the subsequent pregnancy following shoulder dystocia, women who underwent a planned cesarean (n = 176) were characterized by more advanced age and a higher prevalence of diabetes in the subsequent pregnancy. Furthermore, they had more often experienced operative vaginal delivery, severe perineal lacerations, and severe neonatal complications at the index delivery. CONCLUSIONS: The incidence of shoulder dystocia among nulliparous women with vaginal delivery was 1.0% with a 7.2% risk of recurrence in a population where about 50% had a subsequent birth and of these 78% had subsequent vaginal delivery. Important risk factors for recurrence were low maternal height, increase of birthweight ≥250 g from index to subsequent delivery and operative vaginal delivery.

4.
Eur J Oncol Nurs ; 68: 102464, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38029601

ABSTRACT

PURPOSE: Explore teachers', school nurses', cancer coordinators' and other local stakeholders' experiences providing education and support for young childhood cancer survivors in the years after treatment. METHODS: We conducted four focus groups and three individual telephone interviews with 15 teachers, nine nurses and three other stakeholders, using inductive thematic analysis inspired by Braun & Clark. Nvivo v12 was used for data-management. RESULTS: Three main themes were developed; "Perceived parent attitudes and facilitation", "The missing link - lack of communication and collaboration", and "Enabling mastery, inclusion and thriving". Parents were perceived to be the sole managers of providing cancer information and school-related follow-up needs. Teachers and other stakeholders experienced the nonexistence of information from specialist healthcare services and poor communication within the municipality. Teachers went to great lengths to meet survivors' pedagogical needs and facilitate peer interactions. Teachers voiced a need for more cancer and late effect knowledge, not being dependent solely on parents' for information. CONCLUSIONS: Teachers and other stakeholders have essential roles in the continuing school experience for survivors. A more regulated teamwork between the stakeholders in the municipalities and the specialist healthcare system could ensure tailored late effect information at school. Implementing formal support could enable a co-creation of a personalized follow up that could relieve the burden on survivors, parents and teachers.


Subject(s)
Cancer Survivors , Leukemia , Neoplasms , Humans , Child , Qualitative Research , Exercise
5.
Epilepsy Behav ; 142: 109222, 2023 05.
Article in English | MEDLINE | ID: mdl-37088063

ABSTRACT

Childhood epilepsy is often complicated by neurobehavioral comorbidities, and parents are expected to actively engage in managing the condition. Insufficient parental health literacy (HL) has been associated with reduced health outcomes for children with epilepsy. Little is known about the parents' experiences of information seeking, social support, navigating the healthcare system, and interactions with healthcare professionals and how these skills may contribute to the development of sufficient HL. This study explored parents' experiences of their caregiver responsibility and the development of their HL in relation to caring for their child with epilepsy. Ten parents of children under 12 years of age with epilepsy were purposedly sampled and interviewed individually, using semi-structured interviews. The interviews were analyzed using qualitative content analysis, in line with Graneheim & Lundman. The analyses resulted in three themes, each comprising two sub-themes. The themes were: (1) Alone with the responsibility, (2) The combat for information and support, and (3) Developing vigilance and distrust in system competence. Lack of flexibility in healthcare services, insufficient multidisciplinary collaboration, and unclear treatment provider responsibility made the parents feel alone in the caregiver's responsibility. Poor local provider competence related to childhood epilepsy was a barrier to developing sufficient HL. A trusting relationship with professionals and timely access to competent health services were facilitators for developing HL. Higher HL made the parents more critical for the healthcare services, which triggered vigilance and reduced their trust in the professionals' information. For the parents, developing and maintaining HL was a continuous emotional, cognitive, and social process. Health information and care support need to be adjusted to the severity of the child's condition, the resources are available, and the parent's HL. The results of this study may contribute to the development of future interventions for strengthening parental HL in the childhood epilepsy context.


Subject(s)
Epilepsy , Health Literacy , Child , Humans , Parents/psychology , Emotions , Qualitative Research , Cognition
6.
Scand J Public Health ; : 14034948221123436, 2022 Oct 10.
Article in English | MEDLINE | ID: mdl-36214166

ABSTRACT

AIMS: The aim of this study was to adapt the Health Literacy Questionnaire (HLQ) in English and Norwegian for use with parents. METHODS: The research group evaluated all HLQ items and, where relevant, modified them to refocus the attribution of care to that of a child by a parent. Five cognitive interviews with parents were undertaken to gain a detailed depiction of the meanings and processes they used to respond to the HLQ items. Assessment of the psychometric properties of the revised HLQ was undertaken using data from a cross-sectional survey of 254 parents of children with epilepsy. Analysis included internal consistency (Cronbach's alpha) and confirmatory factor analysis (CFA). RESULTS: Some 22 out of 44 items and the names of three domains were modified (e.g. attribution changed from 'me' to 'my child'). Cognitive interviews indicated that parents interpreted the HLQ-Parent items in the way intended. All but three factor loadings were high to acceptable. All nine HLQ scales showed satisfactory to good internal consistency (Cronbach's alpha 0.70 to 0.87). When fitting one-factor CFA models, correlated residuals were required for four scales to generate an acceptable fit. One scale, '8. Ability to find good health information', required inclusion of two correlated residuals to generate an acceptable CFA model fit, indicating that further work on this scale is warranted. CONCLUSIONS: The results from both the adaptation process and the CFA analysis supported the relevance, understanding and theoretical structure of the instrument in a parental context.

7.
Patient Educ Couns ; 105(10): 2999-3016, 2022 10.
Article in English | MEDLINE | ID: mdl-35641366

ABSTRACT

OBJECTIVE: To systematically evaluate health literacy (HL) interventions in chronic conditions by exploring theoretical perspectives, intervention content and effectiveness. METHOD: We searched MEDLINE, Cochrane, CINAHL, EMBASE, ERIC, Web of Science and PsycINFO. Standardised systematic review methods were used, and sequences informing our research question were extracted and analysed. The study includes a descriptive summary of the included papers. RESULTS: We included 39 unique interventions, with diabetes and heart disease as the most targeted chronic conditions. Fifty-four percent of papers included a definition of HL, but the studies showed significant heterogeneity of theoretical underpinnings, modes, measures and content. We identified 23 HL measures, mostly assessing functional HL. The HL interventions were often more complex than the measures indicated. A significant change in HL was found in 28 studies. Study quality was generally poor. CONCLUSIONS: Interventions optimizing HL appear important to improve health outcomes in chronic conditions. To ensure cumulative knowledge development of this field we need theory-based interventions, consistency in methods and more tailored and comprehensive measures to capture the interventions' complexity. PRACTICE IMPLICATIONS: A more valid understanding of HL interventions and measurements is needed to reach an agreed understanding of their components and intentions.


Subject(s)
Health Literacy , Chronic Disease , Health Literacy/methods , Humans
8.
Epilepsy Behav ; 130: 108658, 2022 05.
Article in English | MEDLINE | ID: mdl-35358855

ABSTRACT

Parents of children with epilepsy play a key role in the management of their child's condition. Their level of health literacy (HL), which refers to their ability to seek, understand, assess, remember, and utilize health information, is essential for handling the child optimally. The aim of this study was to investigate characteristics associated with high and low levels of different dimensions of HL in parents. HL was assessed with the multidimensional Health Literacy Questionnaire (parents' version) and the electronic Health Literacy Scale, using data from a cohort of 254 parents of children <12 years. Bivariate correlation and multiple hierarchal linear regression (STATA version 16 SE) were used to investigate variables associated with HL. Self-efficacy (St. ß = 0.14-0.34) was the only variable that predicted higher scores on every HL scale. Being older than 35 years (St. ß = 0.18-0.21), level of education (St. ß = 0.16-0.27), and the child having a coordinator of services (St. ß = 0.16-0.28) were associated with higher scores, while sick leave due to the child's epilepsy (St. ß = -0.13 to -0.16), child comorbidities (St. ß = -0.15 to -0.19), and higher levels of mental distress (St. ß = -0.13 to -0.19) were associated with lower scores in several of the different HL dimensions. A total of 44.8% of the parents scored over the cutoff (≥1.85) predicting a mental disorder on the Hopkins symptom checklist. This is the first study to investigate multidimensional parental HL in a childhood epilepsy context. Our results highlight the need to investigate multiple variables, especially mental distress, to determine characteristics that may predict low parental HL. Further qualitative studies are needed to explore the underlying reasons for the parents' HL scores and to develop inventions tailored to meet different HL needs.


Subject(s)
Epilepsy , Health Literacy , Child , Epilepsy/epidemiology , Family , Humans , Parents/education , Surveys and Questionnaires
9.
J Cancer Surviv ; 16(4): 728-740, 2022 08.
Article in English | MEDLINE | ID: mdl-34097249

ABSTRACT

PURPOSE: Living with late effects can affect young childhood cancer survivors' (CCSs) self-management (SM) abilities. In this study, we explored different approaches to SM of everyday life by young CCS. METHODS: This is a sub-study of a larger study on Physical Activity among Childhood Cancer Survivors (the PACCS study). We conducted individual interviews with 22 CCS aged 9 to 18 years who were at least 1 year off-treatment. An hybrid inductive-decductive thematic analysis was used. RESULTS: Three main themes were identified: (1) managing everyday life with fatigue, (2) building self-management competence, and (3) cancer survivor as part of identity. Late effects, especially fatigue, contributed to a perceived ability gap compared to peers, limiting participation in everyday activities. CCS developed new SM skills to overcome such challenges and pushed themselves physically and mentally to master and balance activities and rest to regain energy. CCS changed activities, adapted their expectations, or legitimized their apparent lack of SM skills to regain a sense of self-efficacy. Managing the impact of cancer on relationships with family and friends also required use of SM strategies. CONCLUSIONS: The findings expand our currently limited knowledge of young CCS and SM skills they develop to manage everyday life after treatment completion. These, combined with ongoing support from family and peers, "make it work". IMPLICATIONS FOR CANCER SURVIVORS: The perspectives of young CCS illustrate their SM skills and support needs beyond transitioning off-treatment. Conceptualizing this within follow-up care may contribute to a feeling of mastery and increased satisfaction among CCS.


Subject(s)
Cancer Survivors , Neoplasms , Self-Management , Aftercare , Child , Disease Progression , Fatigue , Humans , Neoplasms/therapy
10.
J Dermatolog Treat ; 33(1): 380-388, 2022 Feb.
Article in English | MEDLINE | ID: mdl-32286098

ABSTRACT

OBJECTIVE: To explore possible associations between alexithymia and health literacy (HL) in persons with psoriasis. METHODS: We conducted a cross-sectional study, including 825 persons with moderate to severe psoriasis, using the Toronto Alexithymia Scale, and the Health Literacy Questionnaire. Descriptive statistics compare HL means between alexithymic and not alexithymic participants. Associations between alexithymia and HL are analyzed using a linear multiple regression model. RESULTS: Twenty-six percent of the participants were characterized as alexithymic, and 26.8% had borderline alexithymia. Higher alexithymia scores were associated with lower education, biological medicines, and more comorbidities, together with lower self-efficacy. The HL domains with the strongest associations with alexithymia were those focusing on managing and getting support for health, as well as the ability to find health information. CONCLUSION: A more elevated alexithymia score is associated with lower HL. Further studies of these associations may contribute to a more comprehensive perspective of psoriasis. To know a patient's alexithymia level and HL needs may guide health care personnel's understanding of possible associations between health status, clinical presentation, behavior, and response to treatment.


Subject(s)
Health Literacy , Psoriasis , Affective Symptoms/epidemiology , Comorbidity , Cross-Sectional Studies , Humans , Psoriasis/complications , Psoriasis/epidemiology
11.
Chronic Illn ; 18(3): 549-561, 2022 09.
Article in English | MEDLINE | ID: mdl-33705224

ABSTRACT

OBJECTIVE: Persons with chronic obstructive pulmonary disease (COPD) require complex follow-up by healthcare professionals (HCPs) and may experience several health literacy (HL) needs. This study aimed to explore such needs in people with COPD and the HCPs who care for them. METHODS: From October 2016 to August 2017 a qualitative study with four focus groups (FG) were performed in people with COPD (n = 14) and three in multidisciplinary HCPs (n = 21). An inductive thematic analysis was used to investigate HL needs. RESULTS: Four HL needs emerged: 1) strengthening the feeling of security; 2) combating the burden of insufficient knowledge on COPD and lack of informational flow; 3) supporting motivation for endurance and self-management; and 4) strengthening dignity. DISCUSSION: This study highlights a gap between people with COPD who express important HL needs and HCPs' capabilities to care for these needs. For HCPs to increase HL in such cases, HCPs need to improve their own HL. It is essential to find solutions on how to improve HL in HCPs who care for people with COPD and to increase the availability of interventions that increase HL in COPD. Education programs, health organizations, and governments should be aware of HL needs in such situations.


Subject(s)
Health Literacy , Health Personnel , Pulmonary Disease, Chronic Obstructive , Self-Management , Attitude of Health Personnel , Focus Groups , Health Personnel/psychology , Humans , Pulmonary Disease, Chronic Obstructive/therapy , Qualitative Research
12.
J Ren Care ; 48(1): 60-68, 2022 Mar.
Article in English | MEDLINE | ID: mdl-34053202

ABSTRACT

BACKGROUND: Patients awaiting kidney transplantation need to be prepared ahead of the upcoming transplantation by developing targeted pre- and post-transplant knowledge. On this background, we designed a new health literacy intervention, including a film and a counselling session, based on motivational interviewing for dialysis patients provided by dialysis nurses. AIM: To explore patients' and nurses' experiences of the feasibility and acceptability of the intervention, focusing on the patient as a prepared knowledge actor. DESIGN: An explorative qualitative study. PARTICIPANTS AND METHODS: Data included in-depth interviews with nine patients and three nurses who participated in the intervention. The interviews were audiotaped and analysed following Kvale and Brinkmann's method for thematic data analysis. FINDINGS: Three main themes were identified: a different kind of health intervention stimulating new insight; a challenging kind of health conversation and changed relationships and increased security. CONCLUSIONS: Both the patients and the nurses had an overall positive attitude toward the intervention, providing a kind of dialogue to prepare dialysis patients going through kidney transplantation. The nurses found the MI methodology to be challenging. When introducing a comprehensive communication method like MI, potential training and supervision needs for the nurses must be addressed.


Subject(s)
Health Literacy , Kidney Transplantation , Feasibility Studies , Humans , Qualitative Research , Renal Dialysis , Translational Science, Biomedical
13.
Heart Lung ; 50(3): 417-424, 2021.
Article in English | MEDLINE | ID: mdl-33618148

ABSTRACT

BACKGROUND: The World Health Organization (WHO) points to health literacy as an important factor in prevention and control of non-communicable diseases (NCDs), including COPD. OBJECTIVE: To investigate associations between selected demographic and clinical variables, psychological well-being and health literacy. METHODS: Health literacy was measured using the nine domain Health Literacy Questionnaire (HLQ) and one domain from the eHealth Literacy Questionnaire (eHLQ). Using data from a cross-sectional sample of 158 people with COPD, recruited from a hospital-based patient list period (2014-2016), multiple regression analyses were performed. RESULTS: The strongest associated variables with health literacy were psychological well-being, measured by the WHO-5 well-being index and education, indicating that higher psychological well-being and educational level are associated with higher levels of health literacy. CONCLUSION: The present study highlights the importance of specifically looking to psychological factors in determining potentially health literacy needs among people with COPD.


Subject(s)
Health Literacy , Pulmonary Disease, Chronic Obstructive , Cross-Sectional Studies , Demography , Humans , Pulmonary Disease, Chronic Obstructive/epidemiology , Surveys and Questionnaires
14.
J Ren Care ; 44(2): 106-114, 2018 Jun.
Article in English | MEDLINE | ID: mdl-29460501

ABSTRACT

BACKGROUND: Nurses' strategies regarding patient education should be informed by the best available research evidence. Clinical nurses play an essential role in implementing new patient education programmes for renal transplant recipients. AIM: This study investigated transplant nurse job satisfaction, competence, training and perceptions of quality of care in relation to the implementation of a new, evidence-based, patient education programme. This paper reports the results from the first part of an implementation study. METHODS: Data were collected in the form of a survey from 50 clinical transplant nurses at a single national transplant centre in Norway in 2015, six months after the patient education programme was implemented. A descriptive, cross-sectional design was used. RESULTS: Seventy-two percent of the respondents reported that they had sufficient knowledge about the new programme; 54.4 % stated that the new programme resulted in renal transplant recipients being better educated. The new programme was found to be more structured, patient-centered and visible for the nurses across the wards, as compared with their previous practice. Nurses with less nursing experience were significantly more motivated about the new patient education programme, than the more experienced nurses (p = 0.05). CONCLUSIONS: Nurses were generally satisfied with their new patient education practice. Knowledge derived from the research evidence on patient education was found to be valuable and transferable to everyday clinical nursing practice.


Subject(s)
Kidney Transplantation/psychology , Nurses/psychology , Patient Education as Topic/methods , Adult , Clinical Competence/standards , Cross-Sectional Studies , Female , Humans , Job Satisfaction , Kidney Transplantation/methods , Male , Middle Aged , Norway , Patient Education as Topic/standards , Program Development/methods , Quality of Health Care/standards , Surveys and Questionnaires
15.
Acta Derm Venereol ; 97(8): 934-940, 2017 Aug 31.
Article in English | MEDLINE | ID: mdl-28536730

ABSTRACT

Alexithymia, defined as difficulty in describing or recognizing emotions, has been shown to be connected with psoriasis, but its relationship with self-management of psoriasis has not been explored. The aim of this study was to assess the frequency of alexithymia and its relationship with self-management and illness perception in the context of psoriasis. A total of 163 patients participating in 3 weeks of climate heliotherapy (CHT) at Gran Canaria were assessed for alexithymia using the Toronto Alexithymia Scale (TAS-20) at baseline. Self-reported measures for self-management (Health Education Impact Questionnaire; heiQ), and disease severity and illness perception (Brief Illness Perception Questionnaire; BIPQ) were assessed twice. Of all patients, 14.1% were characterized as alexithymic and 22.1% scored in the intermediate range. Alexithymic patients scored significantly worse in all heiQ domains, and reported worse illness perception. However, there were no between-group differences in heiQ or BIPQ change from baseline to after CHT. In conclusion, this study shows that alexithymia indicates inferior self-management and reaffirms the associations with illness perception. Further research is required into these relationships.


Subject(s)
Affective Symptoms/psychology , Affective Symptoms/therapy , Heliotherapy , Motivational Interviewing , Psoriasis/psychology , Psoriasis/therapy , Self Care/methods , Self Concept , Adult , Affective Symptoms/diagnosis , Aged , Cost of Illness , Female , Health Knowledge, Attitudes, Practice , Humans , Male , Middle Aged , Patient Reported Outcome Measures , Psoriasis/diagnosis , Quality of Life , Self Report , Severity of Illness Index , Sweden , Time Factors , Treatment Outcome , Young Adult
16.
Acta Derm Venereol ; 96(5): 664-8, 2016 Jun 15.
Article in English | MEDLINE | ID: mdl-26714522

ABSTRACT

There are few studies evaluating the cost-effectiveness of self-management interventions for patients with psoriasis. Motivational interviewing (MI) as a telephone follow-up after climate-heliotherapy was effective on several clinical parameters, but its cost-effectiveness is unknown. A cost-utility analysis was conducted alongside a randomized controlled trial (RCT) comparing MI with usual care. A total of 169 Norwegian patients were included. A within-trial analysis compared the costs and quality-adjusted life years (QALYs). Utilities were measured with the 15D instrument, supplemented with Dermatological Life Quality Index (DLQI). A time-integrated summary score defined the clinical effects. QALYs were adjusted for baseline differences. MI provided equivalent quality of life and utility (15D: -0.0022 QALYs (95% Cl -0.02, 0.01), p = 0.77, and DLQI: -0.62 QALYs (95%CI -0.65, 0.41), p = 0.24, at lower costs €-1103 (-2293, 87), p = 0.058, compared with treatment-as-usual. The MI intervention was thus cost-effective. This result was more evident when using the DLQI as outcome measure compared with 15D.


Subject(s)
Cost-Benefit Analysis , Heliotherapy/economics , Motivational Interviewing/economics , Psoriasis/therapy , Self Care/economics , Female , Humans , Male , Middle Aged , Norway , Quality of Life , Quality-Adjusted Life Years , Treatment Outcome
17.
Acta Derm Venereol ; 95(3): 317-21, 2015 Mar.
Article in English | MEDLINE | ID: mdl-25110924

ABSTRACT

The aim of this study was to investigate the impact of climate therapy on self-management in people with psoriasis. This was a prospective study of 254 adults with chronic psoriasis who participated in a 3-week climate therapy (CT) programme. The 8-scale Health Education Impact Questionnaire (heiQ) was completed at baseline, after 3 weeks of CT, and 3 months later. Change was assessed using paired sample t-tests mean (95% confidence interval) change scores (range 1-4). All heiQ scales showed statistically significant improvement after 3 weeks of CT. The greatest improvement was in Health-directed activity, followed by Emotional distress, and Skill and technique acquisition. At the 3-month follow-up, only the Emotional distress scale remained improved. In addition, disease severity (self-administered PASI; SAPASI) improved significantly from before CT to 3 weeks and 3 months after CT. This study suggests that CT provides a range of benefits that are important to people with psoriasis, particularly in the short term. A challenge is how to achieve long-term benefits.


Subject(s)
Climatotherapy , Health Behavior , Health Knowledge, Attitudes, Practice , Psoriasis/therapy , Self Care , Adult , Aged , Aged, 80 and over , Chronic Disease , Emotions , Female , Humans , Male , Middle Aged , Prospective Studies , Psoriasis/diagnosis , Psoriasis/psychology , Severity of Illness Index , Surveys and Questionnaires , Time Factors , Treatment Outcome , Young Adult
18.
Acta Derm Venereol ; 94(3): 271-5, 2014 May.
Article in English | MEDLINE | ID: mdl-24002676

ABSTRACT

Knowledge of illness perception may aid the identification of groups of patients with a higher risk of coping poorly with the demands of their illness. This study aims to investigate associations between illness perception, clinical characteristics, patient knowledge, quality of life and subjective health in persons with psoriasis. The present study was based on cross-sectional data from patients awaiting climate therapy in Gran Canaria. We included 254 eligible patients (74%) who completed a questionnaire including the revised Illness Perception Questionnaire, the Psoriasis Knowledge Questionnaire, and the Dermatological Life Quality Index. Disease severity was measured using the Psoriasis Area and Severity Index. Several statistically significant associations between clinical characteristics, knowledge and various illness perception dimensions were found. Illness perception was also significantly related to disease-specific quality of life and subjective health. These findings contradict previous findings, which suggested that objective disease factors are not relevant to illness perception in psoriasis.


Subject(s)
Adaptation, Psychological , Cost of Illness , Health Knowledge, Attitudes, Practice , Patients/psychology , Perception , Psoriasis/psychology , Adult , Aged , Aged, 80 and over , Climatotherapy , Cross-Sectional Studies , Emotions , Health Status , Humans , Male , Mental Health , Middle Aged , Psoriasis/diagnosis , Psoriasis/therapy , Quality of Life , Severity of Illness Index , Surveys and Questionnaires , Young Adult
19.
BMC Psychol ; 1(1): 11, 2013.
Article in English | MEDLINE | ID: mdl-25566363

ABSTRACT

BACKGROUND: There is a need for further investigation of sense of coherence (SOC), the central concept of salutogenesis, and its relationship with long-term illnesses such as psoriasis. The aim of this study is to investigate the development of SOC during patient education in the context of climate therapy and to explore factors that may predict changes in SOC among people with psoriasis. METHODS: A prospective design included a baseline assessment and two follow-ups after a 3-week patient education and climate therapy programme (follow-up 1) and again 3 months later (follow-up 2). A total of 254 adults (aged 20-80) with psoriasis participated. SOC was measured by the SOC Questionnaire, illness perception was measured by the Revised Illness Perception Questionnaire, and positive and active engagement in life was measured by the positive and active engagement subscale of the Health Education Impact Questionnaire. Paired-sample t tests were used to evaluate changes in SOC from the baseline to follow-up. Multiple linear regression was used to analyse the ability of socio-demographic and clinical variables, illness perception and positive and active engagement in life to predict the changes in SOC. RESULTS: The SOC score changed significantly by 2.65 points, (95% CI = 0.621, 3.685) from the baseline to follow-up 1. SOC score was still improved by 1.15 points (95% CI = 0.073, 0.223) at follow-up 2. Baseline and change in positive and active engagement in life were linked to change in SOC with standardized beta 0.170 (95% CI = 0.024, 0.319) and 0.259 (95% CI = 0.092, 0.428), respectively. In addition illness coherence perception at baseline and change in emotional representations were significantly associated with the change in SOC with standardized beta 0.212 (95% CI = 0.073, 0.361) and -0.270 (95% CI = -0.481, -0,077), respectively. CONCLUSIONS: SOC improved significantly from before to after patient education in the context of climate therapy. The results indicate that improving positive and active engagement in life, coping with emotional distress and a coherent understanding of the illness might provide important opportunities to improve SOC among people with psoriasis.

SELECTION OF CITATIONS
SEARCH DETAIL
...