This study evaluated a model of perceptual accuracy and self-management behavior in pediatric diabetes. Participants were 169 children and adolescents (10-18 years) attending diabetes summer camps. Error grid analysis quantified global perceptual accuracy and specific blood glucose estimation errors. The mean accuracy index was 15%, failure to detect hyperglycemia being the most frequent error. Path analysis evaluated models for failure to detect hypoglycemia, failure to detect hyperglycemia, and overestimation of normal blood glucose. Results reflected relatively good fit of the data with the models; however, results did not support mediational hypotheses and explained minimal variance in perceptual error. In sum, participants made considerable estimation errors that may affect self-management; however, results did not support the theoretical models in this sample.

Attention-deficit/hyperactivity disorder (ADHD) is one of the leading diagnoses for children. Children diagnosed with ADHD often have difficulty in many settings including at school as well as in the home. Medication is often a common treatment for these children, however, it has been often shown ineffective when used alone. A review of behavioral interventions, including various self-regulation interventions has been studied. Self-regulation interventions have been shown to be effective for children diagnosed with ADHD primarily in school or academic settings. The purpose of this study was to evaluate the effects of a self-management intervention on the on-task behavior of children diagnosed with ADHD. Specifically, this study aimed to examine the impact a self-management intervention would have on the on-task behavior of children during various routines, both academic and non-academic, in the child's home setting. Participants were trained to use a self-management intervention. As a result of the accurate use of the self-management intervention all three participant's on-task behavior increased. For one participant, the duration of the targeted routine also substantially decreased.

This qualitative descriptive study examined the day-to-day self-management decision making in Cuban Americans with type 2 diabetes including major decisions, resources and influences to decisions, desired amount of control and advice, and the role of the health care provider. The sample consisted of 20 English speaking, Cuban-American adults between the ages of 45 to 65 years. The mean A1C was 7.49%; mean diabetes duration 4.5 years. Data were collected through discussion of a short self-management decision-making scenario, a semi-structured interview, and demographic questionnaire. Interviews were analyzed using Miles and Huberman’s method of content analysis framed by the concepts of Paolo Freire’s empowerment theory. Self-management tasks of exercise, diet, medication administration, and glucose monitoring were all thought to be important by the participants. Cost, time, structural barriers, social environment, symptoms, and medical information influenced self-management decisions. Challenges included negotiating social occasions, acknowledgement of friends and family, structural barriers, and available resources. Most participants felt they had some personal control and responsibility in decision making. Health care providers, friends, and family were sources of advice. Attempts were made to integrate health care providers’ advice into day-to-day self-management. The aspects of Freire’s theory (dialogue, reflection, and praxis) were reflected in participants’ descriptions of self-management decisions. The findings of this study suggest the challenges of balancing self-management practices with everyday life should be considered when caring for Cuban Americans with diabetes. Culturally sensitive interventions that facilitate the integration of glucose monitoring, exercise, diet, and mediations need to be developed. / text

The aim of the research was to explore the subjective experience of patients admitted to a psychiatric hospital. Sub-aims were to explore how these experiences relate to self management, stress and psychological well-being. This study was motivated by research literature that documents a wide variety of negative experiences by patients. A recent psychiatric patient survey conducted in England and Wales (Mind, 2004) found that more than 50% of respondents indicated that hospital surroundings had not helped their recovery. In fact, close to a third of those thought that it had a detrimental effect on their health. Wood and Pistrang (2004) found that psychiatric patients often represent a lower status, marginalized group in society and thus their views are often not taken into account in mainstream research. These results, however, were overwhelmingly based on research conducted in an American or European context. The South African context is unique in the sense of our political, economic and social issues that influence people's perceptions. In relation to other developing and developed nations little research has been done. The research was conducted at a large Psychiatric hospital in Pretoria South Africa. An availability sample of five adults from the hospital was used. A qualitative case study method design was used. Data were obtained through interviews and analysed using Interpretive Phenomenological Analysis (PA) (Smith, 1996; Smith et al., 1997, 1999) Using the IPA method the data was analysed to extract significant or relevant points related to the research topic. These themes were then collated with themes that occur in other accounts and from there tested against the hypothesised outcomes of the investigation. Positive experiences and negative experiences were identified as the main themes; these were each divided into sub themes. The negative experiences related primarily to interaction with hospital staff and -environment, while positive experiences primarily related to effective treatment. Implications of results are that patient experiences and perceptions may be more influential for long term psychological wellbeing than has been acknowledged by care givers within larger mental healthcare facilities. It was concluded that many if not all of the results of previous studies were confirmed. Additionally this study recognised that singular positive experiences may to a greater degree influence patients recovery and maintenance than a combination of negative experiences. Recommendations following from the findings include further studies to assess enhanced interpersonal skills training for nursing staff, and greater community based care facilities. / Thesis (M.A. (Clinical Psychology))--North-West University, Potchefstroom Campus, 2006.

In the health psychology literature there has been a proliferation of research linking forms of self-attention to psychological distress, especially to depression. The broad conclusion that self-attention is harmful, however, challenges the central premise of self-regulation theory - a theory detailing the role of self-attention as the engine of an adaptive regulating system that enables people to achieve their goals. In an attempt to reconcile these perspectives, I conducted two studies to distinguish the forms and states of self-attention that serve an adaptive self-regulation function from those that create a vulnerability to depression. Both studies included a pretest and a daily diary component. Participants were pretested on trait self-attention, trait negative affectivity (Study 1), depression (Study 2), and a goal inventory. Study 2 included a follow-up session where participants again completed the depression inventory. For the diary component, participants described and rated the most negative event they experienced during the rating period (twice daily for 2 weeks in Study 1; once daily for 4 weeks in Study 2). Diary self-report measures of self-attention included: level of rumination (Study 1), initial self-analysis (Study 2), and multi-day-protracted attention (Study 2). After the diaries were completed, participants' event descriptions were coded for goal-relevance and level of self-focused attention (SFA). Consistent with self-regulation theory, participants' goal-related events elicited stronger self-attentional responses (higher levels of SFA, rumination, initial self-analysis, and protracted attention) than did their goal-unrelated events. These within-person effects were not moderated by the pretest measures, nor did they predict levels of emotional distress. Thus, in daily life it appears to be typical and not harmful for people to respond to goal-setbacks by engaging in elevated levels of introspection, self-analysis, and even negative, symptom-focused rumination. With respect to individual differences, people higher in pretest rumination and in chronic daily rumination, initial self-analysis and protracted attention experienced higher levels of emotional distress. Chronic daily levels of initial self-analysis and rumination predicted emotional distress after controlling for pretest levels of distress. Thus, self-attention appears to create a vulnerability to depression only when people have chronic difficulty containing initial levels of self-analysis and rumination in response to negative events.

Intervening early in the course of psychotic illness (e.g. schizophrenia) may significantly improve prospects for the recovery, both in medical and psychosocial terms, of the individuals who experience these conditions. Engaging such individuals in care, however, remains a challenge. One barrier to engagement is lack of insight, or the low illness awareness that is considered to be a typical characteristic of people who experience psychotic illnesses, particularly in their early phases. The dominant view of this phenomenon is that it is primarily related to the illness itself and thus is biologically based. There is reason to believe, however, that understanding the psychosis experience is also an interpretive process, and that the meaning of this experience for the individual arises out of dialogue between the person, mental health professionals and significant others. There is also reason to believe that the relationship between insight and recovery may not be as straightforward as presumed. While the dominant view sees insight as a crucial condition for recovery, emerging evidence suggests that insight once gained may lead to depression and demoralization. Insight thus may be understood as an interpretive, dialogical process that is fundamentally narrative in nature, the consequences of which may be divergent. Using qualitative methods (constructivist grounded theory complemented by narrative analysis), the present study sought to understand the process by which insight developed in early psychosis, and sought to explore the relationship between insight and the early stages of illness management and recovery, as reflected by the written and oral accounts of twelve individuals who were within the first three years of illness. Overall, the results suggest that insight development in early psychosis can be conceptualized as the process of coming to an acceptable, adaptive explanation. More specifically, the results first of all suggest that insight development involves finding or negotiating an account of illness that fits or can be accommodated with the individual’s own story of the psychosis experience. The process also involves finding an account of illness and its treatment that can be envisioned as a helpful rather than disruptive aspect of the individual’s future biography.

Chronic pain affects approximately 16% to 36% of Canadian adults and is one of the most common reasons for physician visits in Canada. The effects of a self-referral community-based education/exercise program (Y-PEP) on physical function and well-being were initially evaluated in 20 individuals with chronic pain who had attended one of three Y-PEP sessions in 2007. The 10-week program incorporated chronic pain education/self-management and various exercise modalities to allow individuals with chronic pain to try different physical activities in a safe and supported environment. Questionnaires were administered pre-, post-program, and at 10-weeks follow-up and provided data on demographic information, physical activity levels, depression, pain perception, and pain catastrophizing. Maximal activity levels and adjusted activity levels increased 7% and 10% respectively at post-program, but only the adjusted activity levels remained elevated at the 10-week follow-up. No significant changes occurred in any of the other outcome measures, however, the extent to which maximal and daily activity increased was significantly correlated with greater improvements in the extent to which pain interfered with one’s life (r=0.45) and with pain catastrophizing (r=0.45). These latter two improvements were significantly associated with greater decreases in depression score (r=0.50). Overall, these findings suggest that a community-based program for individuals with chronic pain can improve physical function and psycho-social well-being. Further effort is required to establish such programs in communities for individuals with chronic pain. / Thesis (Master, Rehabilitation Science) -- Queen's University, 2009-09-14 13:01:08.784

Introduction: Women possess characteristics and experiences unique and different from men. Menstruation, pregnancy, puberty and menopause may present challenges for self-management, a prerequisite for those living with Type 1 diabetes mellitus (T1DM). The meaning and experiences of self-management have not been adequately explored from a young woman’s perspective within the diabetes literature. Purpose of the Study: Blood glucose and glycosylated hemoglobin (HbA1c) values are keys for determining success in self-management among individuals living with T1DM; however, the values may enable feelings of vulnerability and worthlessness in individuals living with T1DM. Through learning about the experiences of young women, it was hoped that the meaning of self-management would be uncovered. The research question was: What are the experiences of self-management among young women with Type 1 diabetes mellitus? Methods and Methodology: Descriptive phenomenology was used to uncover the experiences of self-management. Unstructured interviews with nine young women aged 22-30 years were conducted to uncover their lived experience. Data collection and analysis followed the methodical structure outlined by van Manen (1997). Findings: Data analysis revealed five themes, and the essence of participants’ self-management experiences. Identified themes included: 1) elusiveness of control; 2) the dualism of technology; 3) forecasting and establishing routines; 4) dealing with the “ups and downs”; and, 5) interface with the health care team. The essence that emerged from the data was “being in balance”. Conclusions: Self-management encompassed the desire and need to be in balance with one’s life and blood glucose levels. Self-management was something that evolved over time, and grew in complexity as phases progressed; it was something participants were still trying to grasp. Individual attitudes, goals, and self-management strategies dominated participants’ discourse in describing their hope of achieving and sustaining balance in their day-to-day lives. / Thesis (Master, Nursing) -- Queen's University, 2012-01-24 18:35:33.911

The aim of the research was to explore the subjective experience of patients admitted to a psychiatric hospital. Sub-aims were to explore how these experiences relate to self management, stress and psychological well-being. This study was motivated by research literature that documents a wide variety of negative experiences by patients. A recent psychiatric patient survey conducted in England and Wales (Mind, 2004) found that more than 50% of respondents indicated that hospital surroundings had not helped their recovery. In fact, close to a third of those thought that it had a detrimental effect on their health. Wood and Pistrang (2004) found that psychiatric patients often represent a lower status, marginalized group in society and thus their views are often not taken into account in mainstream research. These results, however, were overwhelmingly based on research conducted in an American or European context. The South African context is unique in the sense of our political, economic and social issues that influence people's perceptions. In relation to other developing and developed nations little research has been done. The research was conducted at a large Psychiatric hospital in Pretoria South Africa. An availability sample of five adults from the hospital was used. A qualitative case study method design was used. Data were obtained through interviews and analysed using Interpretive Phenomenological Analysis (PA) (Smith, 1996; Smith et al., 1997, 1999) Using the IPA method the data was analysed to extract significant or relevant points related to the research topic. These themes were then collated with themes that occur in other accounts and from there tested against the hypothesised outcomes of the investigation. Positive experiences and negative experiences were identified as the main themes; these were each divided into sub themes. The negative experiences related primarily to interaction with hospital staff and -environment, while positive experiences primarily related to effective treatment. Implications of results are that patient experiences and perceptions may be more influential for long term psychological wellbeing than has been acknowledged by care givers within larger mental healthcare facilities. It was concluded that many if not all of the results of previous studies were confirmed. Additionally this study recognised that singular positive experiences may to a greater degree influence patients recovery and maintenance than a combination of negative experiences. Recommendations following from the findings include further studies to assess enhanced interpersonal skills training for nursing staff, and greater community based care facilities. / Thesis (M.A. (Clinical Psychology))--North-West University, Potchefstroom Campus, 2006.

The purpose of this research was to examine the impact of self-management on daily net calories consumed by women who are overweight. Four white females between the ages of 35 and 41 with a self-reported BMI between 25 and 29.9 completed this study. A multiple baseline across participants design was used to demonstrate a functional relation between the independent variable (i.e., self-management) and the dependent variable (i.e., net calories consumed) for each participant. Three of the four participants decreased their daily net calories consumed after beginning the self-management intervention. This was the first single case research study to examine the effectiveness of self-management on daily net calories consumed (i.e., caloric intake minus caloric expenditure) and extended previous literature on white females who were overweight.