This document summarizes the results of a focus group discussion with 5 participants in a study that tested telemonitoring of blood glucose levels with nurse feedback. The key findings were:
1) Participants reported that telemonitoring increased their awareness of diabetes and understanding of the importance of glucose monitoring. They felt more obligated to check their levels regularly.
2) Participants felt supported having someone check in on their glucose levels and provide feedback, making them feel cared for in managing their condition.
3) While participants felt obligated to the study to report readings, especially high ones, compliance could potentially translate to feeling obligated to their own health over time.
A correlation study to determine the effect of diabetes self management on di...Kurt Naugles M.D., M.P.H.
Self-Management in this presentation refers to those activities people undertake in an effort to promote health, prevent disease, limit illness, and restore well being. Several investigators contend that self-management be made a major component of many patient health-care strategy (Glasgow, et al., 2001; Wagner, et al., 2001). Currently, nearly 125 million Americans suffer from chronic debilitating illnesses (Anderson, 2000). These national figures clearly underscore the need to develop a multidimensional approach in regards to disease management. Accordingly, measures that incorporate the patient’s perspective in managing his or her health should be explored.
Diabetes mellitus is among those conditions suspected to be highly influenced by self-management activities (Sprangers, et. al., 2000). If benefits do indeed exist, they need to be fully evidenced. The investigation presented here sought to examine the role self management plays in the health outcomes of individuals living with diabetes.
Disease screening and screening test validityTampiwaChebani
Full lecture covering screening tests and validity testing. Covers topics such as calculation and interpretation of sensitivity, specificity, positive predictive value and negative predictive value of a screening test.
A correlation study to determine the effect of diabetes self management on di...Kurt Naugles M.D., M.P.H.
Self-Management in this presentation refers to those activities people undertake in an effort to promote health, prevent disease, limit illness, and restore well being. Several investigators contend that self-management be made a major component of many patient health-care strategy (Glasgow, et al., 2001; Wagner, et al., 2001). Currently, nearly 125 million Americans suffer from chronic debilitating illnesses (Anderson, 2000). These national figures clearly underscore the need to develop a multidimensional approach in regards to disease management. Accordingly, measures that incorporate the patient’s perspective in managing his or her health should be explored.
Diabetes mellitus is among those conditions suspected to be highly influenced by self-management activities (Sprangers, et. al., 2000). If benefits do indeed exist, they need to be fully evidenced. The investigation presented here sought to examine the role self management plays in the health outcomes of individuals living with diabetes.
Disease screening and screening test validityTampiwaChebani
Full lecture covering screening tests and validity testing. Covers topics such as calculation and interpretation of sensitivity, specificity, positive predictive value and negative predictive value of a screening test.
CHI's Lunchtime Learning is open to all researchers, decision-makers, clinicians, patients and members of the public who want to learn more about the theory and practice of meaningful, inclusive, and safe patient and public engagement.
Following this session, attendees should be able to:
Describe the theoretical foundations of the Valuing All Voices framework;
Describe methods used in co-development of the framework; and
Apply the framework to development of a patient engagement strategy for health research and services projects and/or programs.
Learning through mistakes is the best way to study. At the sametime, it improves the professional growth and also helps to minimize the gap between theory and the practice.
An integrated model of psychosocial cancer care: a work in progress…Cancer Institute NSW
Cancer patients are faced with a multitude of stressors, from diagnosis, through treatment, at recurrence, in the stages following treatment completion, and in the terminal phase. Psychosocial care has been highlighted as a critical aspect of providing comprehensive patient-focused care. Specifically, one of the goals of The NSW Cancer Plan 2011-2015 is to improve the quality of life of people with cancer and their carers. This project was initiated to improve the current psychosocial model of care at The Kinghorn Cancer Centre (TKCC), to better reflect an integrated, holistic and comprehensive model of patient-centred care.
Making a difference - the benefits and challenges of non-medical prescribingMS Trust
This presentation by Nikki Embrey from the North Midland MS Service looks at the benefits of and barriers to nurse prescribing, and whether it can make a difference to patient outcomes.
It was presented at the MS Trust Annual Conference in November 2014.
Making a difference: the benefits and challenges of non-medical prescribingMS Trust
This presentation by Dr Nicola Carey looks at the context of non-medical prescribing in the UK as well as its benefits and challenges.
It was presented at the MS Trust Annual Conference in November 2014.
New York State Drug Court Program: The
participant will be able to: Demonstrate the efficacy of
patient navigation in order to improve maternal/child
health outcomes and parenting skills for the court
involved population.
CHI's Lunchtime Learning is open to all researchers, decision-makers, clinicians, patients and members of the public who want to learn more about the theory and practice of meaningful, inclusive, and safe patient and public engagement.
Following this session, attendees should be able to:
Describe the theoretical foundations of the Valuing All Voices framework;
Describe methods used in co-development of the framework; and
Apply the framework to development of a patient engagement strategy for health research and services projects and/or programs.
Learning through mistakes is the best way to study. At the sametime, it improves the professional growth and also helps to minimize the gap between theory and the practice.
An integrated model of psychosocial cancer care: a work in progress…Cancer Institute NSW
Cancer patients are faced with a multitude of stressors, from diagnosis, through treatment, at recurrence, in the stages following treatment completion, and in the terminal phase. Psychosocial care has been highlighted as a critical aspect of providing comprehensive patient-focused care. Specifically, one of the goals of The NSW Cancer Plan 2011-2015 is to improve the quality of life of people with cancer and their carers. This project was initiated to improve the current psychosocial model of care at The Kinghorn Cancer Centre (TKCC), to better reflect an integrated, holistic and comprehensive model of patient-centred care.
Making a difference - the benefits and challenges of non-medical prescribingMS Trust
This presentation by Nikki Embrey from the North Midland MS Service looks at the benefits of and barriers to nurse prescribing, and whether it can make a difference to patient outcomes.
It was presented at the MS Trust Annual Conference in November 2014.
Making a difference: the benefits and challenges of non-medical prescribingMS Trust
This presentation by Dr Nicola Carey looks at the context of non-medical prescribing in the UK as well as its benefits and challenges.
It was presented at the MS Trust Annual Conference in November 2014.
New York State Drug Court Program: The
participant will be able to: Demonstrate the efficacy of
patient navigation in order to improve maternal/child
health outcomes and parenting skills for the court
involved population.
Rethinking, rebuilding psychosocial care for cancer patientsJames Coyne
Presented as the 8th Trevor Anderson Psycho-Oncology Lecture, September 8, 2014, Melbourne, Australia.
Discusses how psychosocial care for cancer patients needs to be reorganized so that a broader range of cancer patients are served. Routine screening for distress is unlikely to be an efficient means of countering tendencies of cancer care more generally becoming more organized around time efficiency and billable procedures. Psychosocial care for many cancer patients involves discussions, negotiations, and care coordination they cannot be well fit into the idea of a counseling session. The unsung heroes of providing such care are underappreciated social workers and oncology nurses.
RESEARCH Open AccessTelecoaching plus a portion control pl.docxsyreetamacaulay
RESEARCH Open Access
Telecoaching plus a portion control plate
for weight care management: a
randomized trial
Jill M. Huber1, Joshua S. Shapiro2, Mark L. Wieland1, Ivana T. Croghan1, Kristen S. Vickers Douglas3,
Darrell R. Schroeder4, Julie C. Hathaway5 and Jon O. Ebbert1,6*
Abstract
Background: Obesity is a leading preventable cause of death and disability and is associated with a lower health-
related quality of life. We evaluated the impact of telecoaching conducted by a counselor trained in motivational
interviewing paired with a portion control plate for obese patients in a primary care setting.
Methods: We conducted a randomized, clinical trial among patients in a primary care practice in the midwestern
United States. Patients were randomized to either usual care or an intervention including telecoaching with a
portion control plate. The intervention was provided during a 3-month period with follow-up of all patients
through 6 months after randomization. The primary outcomes were weight, body mass index (BMI),waist
circumference, and waist to hip ratio measured at baseline, 6, 12, 18, and 24 weeks. Secondary outcomes included
measures assessing eating behaviors, self-efficacy, and physical activity at baseline and at 12 and 24 weeks.
Results: A total of 1,101 subjects were pre-screened, and 90 were randomly assigned to telecoaching plus portion
control plate (n = 45) or usual care (n = 45). Using last-value carried forward without adjustment for baseline
demographics, significant reductions in BMI (estimated treatment effect -0.4 kg/m2, P = .038) and waist to hip ratio
(estimated treatment effect -.02, P = .037) at 3 months were observed in the telecoaching plus portion control plate
group compared to usual care. These differences were not statistically significant at 6 months. In females, the
telecoaching plus portion control plate intervention was associated with significant reductions in weight and BMI
at both 3 months (estimated treatment effect -1.6 kg, P = .016 and -0.6 kg/m2, P = .020) and 6 months (estimated
treatment effect -2.3 kg, P = .013 and -0.8 kg/m2, P = .025). In males, the telecoaching plus portion control
intervention was associated with a significant reduction in waist to hip ratio at 3 months (estimated treatment
effect -0.04, P = .017), but failed to show a significant difference in weight and BMI.
Conclusion: Telecoaching with a portion control plate can produce positive change in body habitus among obese
primary care patients; however, changes depend upon sex.
Trial registration: ClinicalTrials.gov NCT02373878, 13 February 2015. https://clinicaltrials.gov/ct2/show/
NCT02373878.
Keywords: Obesity, Telecoaching, Portion control plate, Primary care, Patient-centered medical home
* Correspondence: [email protected]
1Division of Primary Care Internal Medicine, Department of Medicine,
Rochester, MN 55905, USA
6Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA
Full list of author information is ...
Qualitative evaluation of successful homeopathic treatment of individuals wit...home
Homeopathy, an over 200-year-old major
system of care within complementary and alternative
medicine, is used worldwide. While homeopathy has
stimulated much debate over the nature of its medicines
(remedies), relatively little research has focused on its
therapeutic process as experienced by patients in clinical
practice. The goal of this qualitative study was to use
descriptive phenomenology to assess patients’ experiences
of the homeotherapeutic process. We interviewed 36
homeopathic patients with a history of at least one chronic
disease who, in the provider’s global clinical impression,
had exhibited a treatment-related sustained, outstanding or
extremely successful outcome in their condition for at
least 1-year follow-up. Two essential structures describing
the lived experiences of homeopathic treatment emerged
from the data. One of the structures characterizes what it
is like to be ‘‘successfully healed’’ as a transformative
process of coming home to self. The second structure
describes the experience of receiving care by a homeopath
as an intensive process of self-exploration and self-discovery
that was facilitated by a trusted partner in care.
The data are consistent with contemporary concepts
within nonlinear complex systems science. The current
findings offer insights into the homeopathic patient’s
experience of treatment and provide a fuller clinical picture
to guide future qualitative and quantitative research in
homeopathy.
Running Head QUANTITATIVE RESEARCH SUMMARY1QUANTITATIVE RESE.docxtodd581
Running Head: QUANTITATIVE RESEARCH SUMMARY 1
QUANTITATIVE RESEARCH SUMMARY 10
QUANTITATIVE RESEARCH SUMMARY
Student’s Name: Letzy Reyes
Institution: Grand Cayon University
Date: 06/10/2018
Nursing Practice Problem
P-(Problem) – elderly patients aged above 50 years admitted in hospital and having shown blood pressure disease signs. Patients not included in the research were pregnant women.
I-(Intervention) – the patients who are subject in this research will be subjected to therapeutic routine concerning hypertension. The blood pressure of all the patients was tested after administering hypertension medicine to the subjects. The resultant changes were recorded every day to determine the reaction and thus the group will make a conclusion.
C-(Comparison) – institutionalized quality methods will be regulated for hypertension and subjected to the group. The comparison between the groups will be done towards the end of the month in the group.
O-(Outcome) - there will be good relation between the hypertension medication and blood pressure.
T-(Time) – for the next one month the blood pressure will be monitored closely.
The nursing practice portion should be in paragraph form.
PICOT Statement
Elderly patients under hypertension medication together with pharmacological interventions can be maintained in hospitals to improve their blood pressure and with understanding the background and culture of the patients will be of great help in dealing with hypertension. Comment by Doreen Farley: Letzy, I know that this is not the PICOT question that we decided on. What happened to the PICOT?
In patients with hypertension, does the use of meditation along with pharmacological interventions compared to medications alone improve blood pressure? This was the PICOT from out last discussion on 6-1-18
This paper is supposed to be double space only. I am not sure why there is so much space in between concepts.
Introduction
Background of the study
The purpose of the study was to evaluate analyze how patients using hypertension medication along with pharmacological interventions compared to medications alone improve blood pressure. The bottom line of the study was to evaluate how different opinions on hypertension and the treatment of the disease and how such opinions differ from one place to another especially due to the difference in culture or ethnicity of these groups. In addition, the study will be evaluated on what the proposed interventions would do to improve the adherence to these groups. Comment by Doreen Farley: The study evaluated…
The proposed interventions from the research on the two articles will be of importance to the nursing field. There is the need for the nurses to connect, care and convey treatment for various groups of patients in our diverse community. These include taking treatment to patients from different ethnic and racial groups. When it comes to hypertension, nurses have been faced with challenges .
Exploring Clinical Trials: How Research Can Help Us Better Detect, Diagnose, ...Ruchi Vahi
The exploration of clinical trials has become increasingly important in the medical field, with each trial providing insight into how we can better detect, diagnose and treat diseases. In this article, we will be looking at the different aspects of clinical research and trial processes, as well as discussing the importance of these studies in advancing healthcare treatments.
Visit us: https://mprex.in/project/late-phase-clinical-trials-and-research/
Week 5 EBP ProjectAppraisal of EvidenceCLC EBP Research .docxcockekeshia
Week 5 EBP Project/Appraisal of Evidence
CLC: EBP Research Table
Citation
Include the APA reference note.
Abstract/Purpose
Craft a 100-150 word summary of the research.
Research/Study
Describe the design of the relevant research or study in the article.
Methods
Describe the methods used, including tools, systems, etc.
Setting/Subject
Identify the population and
the setting in which the study was conducted.
Findings/Results
Identify the relevant findings, including any specific data points that may be of interest to your EBP project.
Variables
Describe the independent and dependent variables in the research/study.
Implication for Practice
Articulate the value of the research to the EBP project your group has chosen.
Independent Variable
Dependent Variable
King-Shier, K.M., Mather, C., &LeBlanc, P. (2013). Understanding the influence of urban or rural living on cardiac patients’ decisions about diet and physical activity: Descriptive decision modeling. International Journal of Nursing Studies, 50(11), 1513-1523. doi: 10.1016/j.ijnurstu.2013.03.003
This research aims to answer to better understand the decision-making process of eating a heart healthy diet and extent of physical activity. Also, are these decisions influenced by whether the subject lives in a rural or urban setting. The research proposal was the cultural issues effected participants decision making as well as place of residence. This research used a previous qualitative research design in which 42 cardiac patients (21 urban, and 21 rural) were interviewed about their diet and physical activity. The researchers then designed a model for interviewing regarding the decision-making process. The combination model was then given and tested with 647 cardiac patients (327 urban and 320 rural) from Canada. The results were based on 93.5% accuracy for diet and 97.5 % accuracy with physical activity. Results indicated that decision-making was less about place of residence and more about perception of control over health including time, effort, or competing priorities, receipt of appropriate clear information, and appeal of the activity.
A three-staged, multi-methods approach was used to develop and analyze the descriptive decision making model that patients use in making decisions regarding their cardiac lifestyle. A cross-sectional survey was used to interview patients one year post-cardiac catherization. These interviews were performed via telephone. A three stage decision tree model was then used to analyze the information offered. The stages were as follows: 1. Factors that were influential in decision making. 2. If and where failure had occurred for patients. 3. Did patients consistently, sometimes, or not at all engage in physical activity and a heart healthy diet. Results were then analyzed using statistical analysis.
Information was gathered from a previous series of qualitative interviews conducted with 42 cardiac patients (21 rural, 21 urban). Based on the infor.
SHARE Webinar: Why Should I Join a Clinical Trial with Dr. Hershmanbkling
Dr. Dawn L. Hershman of the Herbert Irving Comprehensive Cancer Center at Columbia University presented the basics of clinical trials and emphasized how important it is for more patients to participate in them. She also discussed trials currently available for early stage and metastatic breast cancers. The webinar was presented on June 25, 2014. To hear the webinar, visit www.sharecancersupport.org/hershman
Clinical trial : Types and Design (Pharmacovigilance)
Diabetes tele-monitoring project
1. Tele-monitoring of blood glucose with nurse feedback: What do patients think?
W Brye¹, MA; B Eichold², MD, DrPH, FACP; S Brown², RN; S Hansberry¹, BS; V Bonner¹, MPM;
E. Crook¹, MD; M Arrieta¹, MD, MPH, PhD
(¹University of South Alabama Center for Healthy Communities ²Mobile County Health Department)
DISCUSSION
While this study is limited by its small sample size (five participants), it provides information on
how a tele-monitoring system may be effective in supporting SMBG, through an increased
awareness of the diabetes medical condition, a greater understanding of the importance of
monitoring blood glucose, and a feeling of direct connection to the health care provision team. It
would be interesting to learn if the feelings of obligation to the study which produced compliance
to study requests may be shifted to a sense of obligation to one’s health and produce better
outcomes in terms of the health of the diabetic patient and management of the diabetes
condition.
INTRODUCTION
Research shows that a collaborative relationship between the diabetic patient and a medical care
team assists in the patient’s understanding and proper management of diabetes. Self monitoring
of blood sugar (SMBG) is considered essential in diabetes management and has been found to
promote glycemic control in insulin-treated Type 2 diabetes patients. Advances in information
technology have given rise to innovative interventions that enable the real-time electronic
transmission of self-measured glucose levels from patients to providers (biotelemetry), thus
facilitating the provision of immediate feedback when glucose levels are outside of an acceptable
range.
METHODS
A focus group discussion was used to gather participants’ views on the benefit of using a system
of glucose tele-monitoring with nurse feedback.
Source population: Focus group participants had been part of the tele-monitoring arm of the nine-month
study “Real-time Tele-monitoring of Glucose as Adjunct to the Management of Type 2
Diabetes in Primary Care Clinics”. The study randomized patients from four primary care settings
to either self-monitoring of glucose and patient initiated report of abnormal glucose readings or
tele-monitoring (that is, real-time report of glucose measurement via a phone-based interactive
voice response system) with automated report of abnormal readings. Both groups received nurse
feedback upon receipt of information on unacceptable glucose values.
Study participants: Five of the fifteen eligible patients who had completed the intervention arm of
the trial participated in the focus group. While we had planned for a random sample of eligible
patients to participate, we shifted to a convenience sample due to the fact that several of the
patients originally selected at random could not be reached and/or declined to participate in the
study.
Focus Group discussion and analysis: After obtaining their informed consent, participants were led
in a discussion which included questions regarding their experiences as participants in the trial
“Real-time Tele-monitoring of glucose as Adjunct to the Management of Type 2 Diabetes in
Primary Care Clinics” and questions related to their management of diabetes, including diet,
medication, and exercise. The discussion was taped and the tapes were transcribed verbatim.
Two analysts (W.B. and M.A.) reviewed the focus group transcript and arrived at a consensus
interpretation of emerging themes relative to the acceptability to patients of the glucose tele-monitoring
system.
RESULTS
The participants included four females and one male. Three of them had a long
standing diagnosis of diabetes (26, 22, and 13 years). Two of the participants
had been diagnosed in the past year.
Selected quotes substantiating our major findings are presented below:
Type 2 diabetes bio-telemetry combined with nurse feedback increased
patients’ understanding of the importance of glucose monitoring and
resulted in increased monitoring activity
“ …when during the study you realize hey I felt alright but my sugar it was
really too high. A lot of times it made me realize I can’t really go by how I feel
all the time because it don’t tell me exactly a true. It don’t tell me it’s not true by
what I feel. It’s something that you really need to check and with the study it
made me. It brought me back to what I should have been doing from the
beginning.”
“I wasn’t real faithful [measuring blood glucose] before the study. I’m more
faithful now than I was before.”
Patients reported an increased awareness of their diabetes
“This study in a whole it made you, it made me more aware of my condition
and how and what I need to do in order to control it.”
“It [call from nurse coordinator] made you think more on what you may eat or do
concerning the glucose level, the disease itself and how to take care of it.”
Patients reported that they had assistance in dealing with their disease
and that someone genuinely cared about their well-being
“I thought it was rather interesting. You think about who is interested in you
today anyway.”
“And one thing about diabetes study, when you’re alone and depressed and
disgusted it comes in handy cause you know you got someone to talk to and
someone that cares.”
“That’s right.”
“It does.”
“She’s [nurse coordinator] really there for you.”
ACKNOWLEDGMENTS: The authors would like to thank Dr. Dan Roach , Ms. Barbie Oliver, and staff at the University of South Alabama Center for Strategic Health Innovations for their
support in the telemonitoring process and to Mobile County Health Department personnel for their unwavering support to the project: Dr. Reuben Belen, Ms. Angelia Blackmon, RN, NP,
Dr. Gregory Evans, Dr. Sumbal Khan, Dr. John Roberts, Dr. Thomasina Sharpe, Dr. Kenneth Sherman, Ms. Susan Stiegler , BSN, MPH; Mr. Frank Mitchell, M Ed, MPA; and Ms.
Kathleen Johnson. This work was supported in part by a grant from Robert Wood Johnson Foundation Finding Answers Disparities Research for Change -award number 64247.
OBJECTIVE
To determine Type 2 insulin dependent diabetes patients’ perceptions of the benefits of a system of biotelemetry
and nurse feedback used to monitor blood glucose
RESULTS (CONTINUED)
Patients commented on the non-judgmental, concerned nature of the feedback
“And she’s [nurse coordinator] not gone tell you nothing negative to try to get you disgusted and
depressed.”
“She [nurse coordinator] really makes you feel good about yourself.”
Compliance with the intervention (calling in blood glucose values) was at times motivated
by a sense of obligation or duty to the study
“You feel like you’re obligated to do it. It’s something you really must do. And I wish I had that
kind of attitude because it is something that you need to do every day.”
Patient acknowledged having, on occasion, avoided sending high glucose values and/or
waiting for the glucose value to return to an acceptable level before calling it in
“If mine was too high I would say oh man I better go get it down then I call it…”
“Like I said mine was really high. Man, I would go to drinking water and I mean I would really get
this stuff down and then start just really start looking at it cause these people might throw me in
the hospital. I don’t wanna go to no hospital.”
Patients felt that they benefited from tele-monitoring
“I love to send mine [glucose measurements] over the phone because if it wasn’t right they would
call me back and let me know so and so…”
“It [tele-monitoring] makes you more aware.”