As an effect of increased living standards and improved health care, life expectancy has risen in many parts of the world. At the same time, welfare diseases such as diabetes and obesity increases. As the number of elderly and long-term sick rises, so will the medical care needs. E-health applications are often presented as a way to meet future medical and doing so within the scope of existing resources. By facilitating health communication and widen access to health services by offering them online, e-health applications encourages people to become more engaged in their own health, thus working proactively towards a healthier population. However, e-health applications often fail to reach their full potential. The purpose of this study is to explore how health care providers and health care recipients perceives e-health applications and their usefulness and thus being able to identify factors significant for successful introduction and use of e-health services. Two e-health applications have been analysed and six important aspects have been identified and discussed. In order to be successful, an e-health application must facilitate behaviour change and be integrated in the everyday life of the user. Substantial and adequate evaluation is essential to make sure that the application meet the requirements from both health care providers and health care recipients. An understanding of the possibilities technology has to offer is needed in order to fully exploit the potential of e-health applications in health care. Instructions for health care providers on how to use the applications are essential not only to ensure their proper usage but also to make sure that applications are being presented to recipients in a satisfactory way and that care providers can offer the support and help recipients may need. Finally, when discussing e-health applications it is important to remember that there are people who does not want to get involved and that there is still a demand for face-to-face interaction in health care. Therefore, e-health services must be complemented with alternatives providing different types of interaction opportunities.

Syfte: Syftet med studien var att undersöka hur patienter med diabetes typ 2 utförde sin egenvård och hur de upplevde sin livskvalitet utifrån utförda egenvårdsåtgärder. Metod: Detta arbete var en explorativ studie och utformad efter en kvalitativ metod. Datainsamlingen genomfördes på en vårdcentral där nio patienter med diabetes typ 2 intervjuades. Patienterna fick själva avgöra deltagande genom att kontakta vårdcentralen. Data strukturerades med en innehållsanalys. Resultat: Studien resulterade i fyra kategorier vilka var upplevelse av egenvård, upplevelse av livskvalitet, egenvårdsåtgärder och livskvalitet samt diabetes typ 2 och livskvalitet. De utförda egenvårdsåtgärderna var främst kost och fysisk aktivitet men även fotvård, synundersökningar, stresshantering, blodsockermätning, hålla en konstant vikt och undvika visceralt fett samt vara uppdaterad inom diabetes typ 2. Majoriteten av informanterna upplevde att deras livskvalitet inte påverkades negativt av egenvårdsåtgärderna. En minoritet kände en viss påfrestning av att behöva ha dessa egenvårdsåtgärder i åtanke. Det framgick även att enstaka upplevde bättre livskvalitet relaterat till sjukdomen. Slutsats: Diabetes typ 2 är en folksjukdom vilken kommer att öka nationellt och internationellt. De vanligaste egenvårdsåtgärderna en patient med diabetes utför är fysisk aktivitet och kost. Sammanfattningsvis upplevdes egenvårdsåtgärder inte påverka patienternas livskvalitet. Däremot upplevde enstaka patienter en viss påfrestning gällande utförandet av egenvårdsåtgärder. / Aim: The aim of the study was to investigate how patients with diabetes type 2 performed their self-management and how they experienced their quality of life related to the fulfilled self-management. Method: This study was an explorative study composed after a qualitative method. The data were gathered at a care center with interviews and remained of nine patients who had diabetes type 2. The patients decided participation by contacting the care center. The data were processed with a content analysis. Result: The study was classified in four categories; experience of self-management, experience of quality of life, intervention of self-management with quality of life and diabetes type 2 with quality of life. The most common interventions were diet and physical activity, also care of the feet, vision screening, stress management, measure the blood glucose, not gain any more weight or avoid visceral fat and to be updated within the subject. The majority of the informants perceived that their quality of life not was affected adversely by the interventions. Some felt distress having to think about all the essential interventions. It also appeared that some informants experienced a better quality of life related to the disease. Conclusion: Diabetes type 2 is a widespread disease which will increase all over the world. The most common and most important interventions of self-management is diet and physical activity. In summary the interventions did not influence on the patients quality of life. However, some patients experienced tension to do the interventions of self-management.

According to a recent report that in Taiwan, more than 50% health problems were due to unhealthy and harmful life styles. Most people, especially at workplace, either live under pressure, work sedentarily, exercise their body little or have a unhealthy diet. The subsequent problems of the overweight, sleeplessness and a declined condition of physical fitness all lead to health problems. A Quasi-experimental design of purposive samples was conducted using 51 participants from employees or faculty members from one school and one hospital. The purpose of this study is to investigate the effects of health self-management program with nutritional and exercise intervention to improve the participants¡¦ physical and psychological health status. Research measuring tools include a structural questionnaire, SF-36 scale, laboratory examination (blood test), physical fitness test administrated to the participants, and a 12-week follow-up test. After the intervention of health self-management, there were significant differences in sleep pattern and diet behavior. On health belief congnition, perceived susceptibility, perceived seriousness, and percieived barriers were increased. On the SF-36 scale, higher scores were attained on mental health dimension. Furthermore, Cholesterol, SGOT, SGPT, B.U.N, Crattinine, Uric acid and blood sugar were significantly decreased. As for body composition, fat mass and waist-hip-ratio were significantly reduced, while for physical fitness, muscular strength endurance and cardiorespiratory endurance were much improved among participants. The results suggest well-designed health self-management activities can reduce unhealthy habit and improve mental and physical health status. Furthermore, it can serve as one important component of health promotion stratigies.

Despite the efficacy of pulmonary rehabilitation programs which assist patients in managing chronic obstructive pulmonary disease (COPD), the high costs and lack of availability of such programs pose considerable barriers for underserved COPD patients, such as those living in rural communities. Because of this, patients are encouraged to actively self-manage COPD. Unfortunately, COPD patients have reported dissatisfaction with the self-management education they are provided. This mixed methods study assessed the self-management learning needs of COPD patients treated at a Certified Federal Rural Health Clinic through conducting focus group interviews (n = 2) to inform the development a targeted self-management education DVD. The effectiveness of 3 distinct educational treatments (DVD vs. Pamphlet vs. DVD Pamphlet) was evaluated by comparing outcomes related to informational needs, self-management self-efficacy, and generic/lung-specific HRQoL in a randomly-assigned, multiple-group pretestposttest design with a control group (n = 41). Focus group data was analyzed using three qualitative analysis tools. Findings from the interviews indicated that patients viewed self-management as simply taking prescribed medications and reducing activity. Patients reported a lack of knowledge and skill development related to rehabilitative activities such as controlled breathing and stress reduction. A multivariate analysis of covariance was conducted to determine the effect of 3 educational treatments on multiple outcome measures. Three nontrend orthogonal planned contrasts were tested to determine selected contrast effects. The data analysis revealed that participants receiving a DVD reported statistically significantly higher levels of lung-specific physical functioning as compared to those in the Pamphlet group. Additionally, the DVD group revealed clinically significant improvements on the physical ( 19.01) and emotional ( 10.74) functioning dimensions of lung-specific HRQoL; whereas, no such improvement occurred within the Pamphlet and control groups. Results also suggested that providing patients with a Pamphlet alone was more effective than providing participants with both interventions concurrently to increase self-management self-efficacy. The simultaneous provision of both interventions did, however, enhance generic HRQoL more so than the provision of one of the two treatments alone. Finally, any type of self-management education as compared to usual care did not statistically significantly improve outcome variables among this small sample of rural patients.

Thesis (M.S.)--State University of New York at Binghamton, Department of Psychology, 2009. / Includes bibliographical references.

Thesis (Ph. D.)--University of Texas at Austin, 2000. / Vita. Includes bibliographical references (leaves 120-130). Available also in a digital version from Dissertation Abstracts.

Abstrakt Bakgrund: Typ 2 diabetes är en livsstilssjukdom som ökar både i Sverige och globalt. Egenvården är en viktig del i behandlingen av sjukdomen och är en livslång uppgift. Sjuksköterskan har en viktig roll i att, genom stöd, undervisning och vägledning, motivera och stärka personens egenvårdskapacitet. För att bättre förstå personens behov i egenvården är det betydelsefullt att sjuksköterskan får ta del av personers erfarenheter av egenvård vid typ 2 diabetes. Syfte: Syftet med denna litteraturstudie var att belysa personers erfarenheter av egenvård vid typ 2 diabetes. Metod: Litteraturstudie baserad på tolv kvalitativa artiklar. Artiklarna söktes i databaserna Cinahl och PubMed. Artiklarna kvalitetsgranskades och analyserades och kategorier och underkategorier identifierades.  Resultat: Resultatet kategoriserades i fyra kategorier och elva underkategorier. Dagligt liv med underkategorier kost, fysisk aktivitet, läkemedelsbehandling och blodsockerkontroll. Stöd; socialt stöd, stöd i samband med sociala sammankomster, familjen som stöd och tron som stöd. Psykiska aspekter; motivationens betydelse för egenvård och känslor i samband med egenvård. Kunskap/information; kunskap och förståelse och behov av diabetesutbildning. Konklusion: Erfarenheter av egenvård varierar från person till person. Att kunna stödja och motivera personen till egenvård ställer stora krav på sjuksköterskans omvårdnadskapacitet. Mycket talar för att Orems egenvårdsteori är användbar i sjuksköterskans arbete med detta.  Nyckelord: Typ 2 diabetes, egenvård, Orem, patientperspektiv, omvårdnad.

Osteoarthritis (OA), the most common form of arthritis in older adults, often results in pain, disability and poor psychological well-being. Compared to White adults, Black adults consistently report more pain, more activity limitations, and have different perceptions about OA. Racial disparities also exist in treatments, and prevalence of arthritis. It is imperative to have effective interventions and treatment options for older Blacks. Yet, few arthritis interventions have included Black participants in their samples, and nearly all of those have failed to report separate analyses indicating the effectiveness for Black adults, thus leaving a gap in the literature. The purpose of this study is to begin to identify factors needed to design arthritis interventions that will reduce barriers and increase appeal to Blacks. The present dissertation consists of one study with two related parts. The first part consists of a needs assessment that examined intervention preferences, barriers to healthcare, knowledge about interventions and care, utilization, and health beliefs among Black and White adults with self-reported physician-diagnosed OA. The second part evaluated materials used in an existing arthritis intervention for acceptability. The study was based on the Arthritis Self Management Program (ASMP). Frequencies were examined to determine needs related to arthritis healthcare of Blacks and Whites recruited from the community. Independent samples t-tests and Pearson’s Chi-square analyses were examined to determine group differences between Blacks and Whites. Blacks were more likely to report cost, lack of trust, fear of being the only person of their race, lack of recommendation from their doctor, and lack of recommendation of a family or friends as barriers to participating in arthritis interventions. In addition, Blacks were more likely to prefer the intervention content, structure and delivery, and arthritis resources presented in the needs assessment in comparison to Whites. As for the evaluation of the intervention materials, Blacks and Whites were similar on most sections. Based on our findings we suggest that practical adaptations (e.g., cost) be made to existing arthritis interventions to increase cultural sensitivity. Such adaptations have the potential to minimize barriers and offer a program that would be appealing to Blacks with OA.

Academic researchers and marketing practitioners are exploring methods to improve salesperson training. Recently, self-directed learning projects were proposed as a new paradigm for learning to take place in the sales domain (Artis & Harris, 2007). Current conceptual work provides a strong foundation for understanding salesperson self-directed learning; however, prior to quantitatively testing proposed models, scales must be created and modified to address salesperson specific learning endeavors. The purpose of this dissertation is: 1) to develop scales to measure salesperson willingness to use self-directed learning projects (SDLP's), 2) to develop a conceptual model of salesperson self-directed learning, 3) to modify current scales to specifically examine salesperson self-directed learning, and 4) to test this model empirically. To accomplish this, the relevant theories and literature were analyzed to create a theoretical model that would test the following research questions: 1.What factors contribute to salesperson willingness to use SDLP's? 2.What is the relationship between salesperson willingness to use SDLP's and salesperson use of SDLP's? 3.What is the relationship between salesperson use of SDLP's and salesperson performance? Two conceptual models were created to account for two categories of learning projects, induced and synergistic SDLP's. The following variables reflect the conceptual models: willingness to use induced/synergistic SDLP's, use of induced/ synergistic SDLP's, perceived supervisor/organizational support for induced/synergistic SDLP's, and self-regulation training and performance. Data from 392 salespeople within the financial services industry fit the measurement model and suggest that use of synergistic (non-mandatory) SDLP's positively impacts performance (.396) and use of induced (mandatory) SDLP's does not impact performance. Willingness to use synergistic SDLP's positively impacts use of synergistic SDLP's. Support from the organization and supervisor positively impact willingness to use induced and synergistic SDLP's. Surprisingly, training in self-regulation did not positively impact salesperson willingness to use induced or synergistic SDLP's. The new measures for all constructs exhibit Cronbach's alpha reliability statistics over .7 and acceptable confirmatory factor analysis results. The study provides reliable measurement scales and empirical support for the future study of self-directed learning in a sales context.

This waitlist-controlled study aimed to evaluate the effects of the “Development Of Executive Skills (DOES)” program (Education Bureau, HKSAR, 2010) on the executive functions of children with Attention-Deficit/Hyperactivity Disorder symptoms. Sixteen participants (15 boys, 1 girl), aged 7 to 8 years (M = 7.95, SD = 0.59), were recruited voluntarily from a local service center. Half of them, the DOES group, received the 7 weekly training sessions after the pre-tests; the other half, the Waitlist group, joined the same program after the post-tests. Their demographic characteristics, medical conditions and nonverbal intelligence were comparable. Cognitive measures and parent observations assessing their executive skills and social behavioral functions were taken before the study, after the training for the DOES group and that for the Waitlist group. No statistically significant intervention effect was found. Effect size analyses, however, suggested potential social benefits of the program. Recommendations on improving the program effectiveness were discussed. / published_or_final_version / Educational Psychology / Master / Master of Social Sciences