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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
31

Women's Self-Management of Arm Morbidity After Breast Cancer: A Secondary Data Analysis

Samuel, Vicky Rosine January 2017 (has links)
Background: Arm morbidity continues to impact the lives of many breast cancer survivors long after acute treatments are completed. The most debilitating symptoms of arm morbidity are pain, lymphedema and limitation with range of motion (ROM). As a chronic condition, management of arm morbidity symptoms requires survivors to engage in self-management practices that alleviate symptoms. Objective: To explore self-management practices performed by breast cancer survivors, and the treatments women receive from healthcare practitioners in managing symptoms of arm morbidity. Methods: A secondary analysis of quantitative and qualitative data was undertaken. A descriptive correlational design was used to analyze data from breast cancer survivors (N = 740). Logistic regression identified variables related to self-management that were associated with pain, lymphedema and ROM limitations. A descriptive qualitative design was used to analyze data from a subset of participants (n = 40). Inductive content analysis approach was applied to develop codes, categories and themes related to how women self-manage arm morbidity symptoms and the treatments they received from healthcare providers to manage their arm morbidity. Results: Participants reported ongoing symptoms of pain (24%), lymphedema (21%), and range of motion limitation (34%) 30 to 36 months post-surgery. Pain was associated with experiencing swelling, taking pain medications, and discussing treatments for pain. Lymphedema was associated with swelling and receiving treatment for pain. ROM limitations were associated with swelling, receiving treatment for pain and taking pain medication. Two overarching qualitative themes emerged: 1) physical symptoms self-management, and 2) psychosocial self-management of uncertainty. Themes for treatments options included: rehabilitation and taking medications. Conclusion: Findings highlight that women living with symptoms of arm morbidity require ongoing monitoring and support for self-management, and there is a need for multidisciplinary approaches. Self-management practices reported are in line with the current lymphedema guidelines, however, the complexities associated with self-management practices can be burdensome to women. Chronic pain and ROM limitation necessitates further investigation to understand their cause and develop management strategies. Oncology nurses are well positioned to implement survivorship care plans that address survivorship needs with multidisciplinary teams and primary healthcare practitioners when women with breast cancer transition from acute cancer care to home. Future research is needed to provide an in depth understanding of self-management of arm morbidity in breast cancer survivors.
32

Identifying types of Motivation in Type 1 Diabetes Self-Management and Exercise in Adolescents

Kwan, Jason, Nguy, Linda, Yang, Jingxin January 2017 (has links)
Class of 2017 Abstract / Objectives: The purpose of the study was to identify the types of motivation that promote sustained physical activity among adolescents between the ages of 11-17 who are diagnosed with type 1 diabetes (T1D) to prevent diabetes related complications. Methods: Questionnaires were distributed and collected among the Juvenile Diabetes Research Foundation’s (JDRF) listserv, Facebook page, and events in Phoenix and Tucson, Arizona on motivations for managing diabetes and exercise and confidence in diabetes management and performing physical activity. Demographic data was collected on age, gender, and race/ethnicity. Physical activity, levels of activity intensity, weight, height, health- related risk behaviors, chronic health conditions, and use of preventative services were also included in this study. Results: 11 adolescents completed questionnaires, categorized by participants who exercise less than 60 minutes daily (Group below recommended exercise level, GBRE) and participants who exercise more or equal to 60 minutes daily (Group meeting recommended exercise level, GMRE). GBRE’s average mean age was 15.75 and GMRE’s average mean age was 13.92. GMRE was associated with higher intensity physical activity (42.85% versus 0%). GBRE had a relative autonomy index (RAI) of 1.67 on the Treatment Self-regulation Questionnaire (TSRQ) compared to GMRE with a RAI of 3.81 (Mann-Whitney U 19, p-value 0.412). GBRE scored 73.75 on the Diabetes Self-efficacy Scale (DSES) and GMRE scored 78.71 (Mann-Whitney U 7, p-value 0.23). Conclusions: Adolescents who exercised ≥ 60 minutes daily were observed to be self-motivated in managing their diabetes, especially maintaining exercise recommendations to decrease diabetes related complications.
33

Managing HIV: Self-Efficacy, Mindfulness, Optimism, and Meaning

Miller, James M. 08 1900 (has links)
The purpose of the current study is to investigate the extent to which mindfulness (observing and describing), dispositional optimism and personal meaning are associated with self-efficacy for managing a chronic disease (SEMCD) among 57 people living with HIV in the DFW Metroplex. Several statistical analyses, including a hierarchical linear regression analysis, were conducted. Results indicate, after controlling for age and gender, the overall model accounted for a significant proportion of the variance (adjusted R2 = .39) in self-efficacy for managing chronic disease, F (6, 50) = 5.80, p < .01. Both subscales of mindfulness were significantly related to self-efficacy. However, observing was negatively, associated with SEMCD (β = -0.44, p < .05), and describing was positively associated with self-efficacy (β = 0.60, p < .01). As a result, incorporating these mindfulness skills into self-efficacy based self-management programs may greatly improve self-management, thus positively influencing psychological and physiological health outcomes that are essential to the health and wellbeing of people living with HIV/AIDS. Future research should investigate methods of manipulating observing and describing, and determine what proficiency in these skills is most beneficial to improve self-efficacy.
34

Are Adolescents Rational?: Valuing Self-Management Leads to Doing It for Some but Not All.

Johsnon, Kiana, Scal, Peter 01 January 2016 (has links)
Abstract available in the Journal of Adolescent Health.
35

Evaluating the Effectiveness of Registered Nurse-led Chronic Pain Self-Management Program within a Primary Care Facility

Assefa, Metasebia 16 April 2019 (has links)
Self-management support (SMS) is considered an effective approach to chronic pain (CP) management. However, the provision of SMS for chronic pain patients faces challenges within primary care facilities in Ontario. An innovative SMS program led by a Registered Nurse (RN) at the Bruyère Family Health Team in Ottawa has been created for chronic pain patients. The goal of this program is to improve the current chronic pain management using SMS in an outpatient facility by harnessing the skills of primary health care team members. The hope would be that this program could be spread and scaled across other programs in the region. This thesis exists in two parts: 1. Evaluate the RN-led chronic pain self-management program to determine its effectiveness in terms of self-reported pain scales and Morphine Equivalence Quotient (MEQ) 2. Understand the perspectives of health care practitioners, administrators and patients within the RN-led chronic pain self-management program Patients meet with the RN for initial face-to-face visit for an hour, for SMS and then for at least one follow up visit. The primary outcome variables of interest were their self-reported pain evaluated using validated pain scales. Opioid use was also assessed before and after the porgram based on the MEQ. Results were analyzed using SPSSversion20. An online questionnair was distributed to team members. All responses were conceptually arranged into a SWOT analysis, which will be directed toward the ongoing management needs of the clinic. Between January 2016 and August 2018, 125 patients were seen of these 58 patients (12 males and 46 females) had at least one follow up appointment with the RN. In 46.2% of the population there was a decrease in their total opioid dose from their first to their last appointment and of these 4 patients (15.4%) had a daily MEQ of 0 by their last appointment. There was a significant average difference between patient’s daily MEQs at their first and last appointment (t20= 2.245, p<0.05). On average patients came into their first appointment with a daily MEQ of 23.88 higher than at their last visit (95% CI [1.69, 46.07]). Staff and patients who participated in the online survey identified the following strengths: multidisciplinary approach, increased accessibility for patients, cost effectiveness, better patient engagement, and no refills of opioids Canada needs a better strategy to manage the CP epidemic. This chronic pain self-management program led by an RN focuses on a multidisciplinary approach that is readily accessible to patients and integrated within primary care to best meet and prioritize the needs of chronic pain patients.
36

Diabetes Self-Management Education Program

Williams, Lesa Faye 01 January 2015 (has links)
Diabetes is a devastating disease in American. The disease can cause chronic health comorbidities, and untreated diabetes has negative consequences for individuals and on our nation's economy. Newly diagnosed diabetics often have a lack of knowledge about the disease process. The purpose of this project was to design and implement a diabetes educational program to enhance participants' knowledge about diabetes management and self-care using the Health Belief Model. Diabetes Self-Management Education (DSME) is critical in improving patient outcomes and the prevention of diabetes related complications. Participation in a standardized diabetic educational intervention will improve patient knowledge, as measured by a reliable and valid pretest and posttest questionnaire. The objective was to develop a DSME curriculum that will be recognized and approved by the American Diabetes Association. A one group pretest /posttest method was employed with ten participants. A sample of ten participants between the age of 22 years old through 65 years old included eight women and two men all identified as African American. Upon completion of the 5-week DSME program, participants were noted to have started participating in weekly exercise or increased the number of days of exercise from 2 days to 3 days per week. Participants also noted a decrease in their systolic and diastolic blood pressure reading. Participants noted on average a 2-3 pound weight loss. Significant improvements were shown on both the knowledge scale and confidence scale of the modified Diabetes Project Participation Questionnaire. Results from this project indicated that participants applied knowledge from the DSME program to improve their own health status.
37

Culturally-Based Diabetes Self-Management Education and Diabetes Knowledge in the Hispanic Population

Grunden, Leslie Weldon 01 January 2016 (has links)
The Hispanic population has an elevated prevalence of diabetes, resulting in large part from a lack of self-management skills required to obtain glycemic control. The purpose of this project was to determine whether diabetes self-management knowledge was improved through the use of a culturally-based diabetes self-management program for Hispanic adults with diabetes using elements of the Hispanic culture. The research question asked whether a researcher-developed diabetes self-management education program that incorporated elements of the Hispanic culture improved diabetes knowledge in the Hispanic population when compared to a non-culturally based diabetes self-management program. The project was conducted using a quasi-experimental control group pre-test/post-test design using the stages of change transtheroretical model as its theoretical framework. Twenty-three Hispanic adults who had a diagnosis of diabetes and a Hemoglobin A1c level of greater than 7%, were recruited for the project. All project participants were recruited through a referral process from a local community clinic located in Montgomery County Texas. Pre/post-test data for the project were obtained through use of the University of Michigan's Diabetes Knowledge Test. A paired-sample t test was conducted to compare the pre-test and post-test results of the experimental group and the control group The project data results showed a significant difference (p < 0.05) between the pre/post-test scores of the experimental group but showed no difference between the 2 scores for the control group, leading to the recommendation that diabetes self-management education should be culturally based. Positive social change was gained from this project through the empowerment of Hispanics in the self-management of diabetes.
38

Let’s Get Motivated: Identifying what Facilitates Youth’s Motivation for Learning about Health Self-Management

Johnson, Kiana, Scal, Peter 01 March 2015 (has links)
Abstract available in the Journal of Adolescent Health.
39

The Process By Which Persons With Type 2 Diabetes Manage Their Disease

Thoman, Joan Ellen 19 November 2009 (has links)
No description available.
40

The Effects of the MotivAider on Increasing the On-task Behavior of Students who have been Diagnosed with Severe Emotional Disturbances

Jellison, Michael Allen 24 September 2009 (has links)
No description available.

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