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Item Beliefs About Dysmenorrhea and Their Relationship to Self-Management(Wiley, 2016-05-13) Chen, Chen X.; Kwekkeboom, Kristine L.; Ward, Sandra E.; School of NursingDysmenorrhea is highly prevalent and is the leading cause of work and school absences among women of reproductive age. However, self-management of dysmenorrhea is not well understood in the US, and little research has explored factors that influence dysmenorrhea self-management. Guided by the Common Sense Model, we examined women’s representations of dysmenorrhea (beliefs about causes, symptoms, consequences, timeline, controllability, coherence, and emotional responses), described their dysmenorrhea self-management behaviors, and investigated the relationship between representations and self-management behaviors. We conducted a cross-sectional, web-based survey of 762 adult women who had dysmenorrhea symptoms in the last six months. Participants described various causes of their dysmenorrhea symptoms which were perceived as a normal part of life. Dysmenorrhea symptoms were reported as moderately severe, with consequences that moderately affected daily life. Women believed they understood their symptoms moderately well, and perceived them as moderately controllable, but expected their timeline to continue through menopause. Most women did not seek professional care but rather used a variety of pharmacologic and complementary health approaches. Care seeking and use of self-management strategies were associated with common sense beliefs about dysmenorrhea cause, consequences, timeline, and controllability. The findings may inform development and testing of self-management interventions that address dysmenorrhea representations and facilitate evidence-based management.Item Beliefs About Dysmenorrhea and Their Relationship to Self‐Management(Wiley, 2016-08) Chen, Chen X.; Kwekkeboom, Kristine L.; Ward, Sandra E.; School of NursingDysmenorrhea is highly prevalent and is the leading cause of work and school absences among women of reproductive age. However, self‐management of dysmenorrhea is not well understood in the US, and little evidence is available on factors that influence dysmenorrhea self‐management. Guided by the Common Sense Model, we examined women's representations of dysmenorrhea (beliefs about causes, symptoms, consequences, timeline, controllability, coherence, and emotional responses), described their dysmenorrhea self‐management behaviors, and investigated the relationship between representations and self‐management behaviors. We conducted a cross‐sectional, web‐based survey of 762 adult women who had dysmenorrhea symptoms in the last six months. Participants had varied beliefs about the causes of their dysmenorrhea symptoms, which were perceived as a normal part of life. Dysmenorrhea symptoms were reported as moderately severe, with consequences that moderately affected daily life. Women believed they understood their symptoms moderately well and perceived them as moderately controllable but them to continue through menopause. Most women did not seek professional care but rather used a variety of pharmacologic and complementary health approaches. Care‐seeking and use of self‐management strategies were associated with common sense beliefs about dysmenorrhea cause, consequences, timeline, and controllability. The findings may inform development and testing of self‐management interventions that address dysmenorrhea representations and facilitate evidence‐based management.Item Commentary: Pain, Stigma, and the Politics of Self-Management(Oxford, 2020-05) Jain, Andrea R.; Religious Studies, School of Liberal ArtsItem Correction of Habits Through Management Principles(CIALSA, 1987-02) Stanley, Mary J.The author describes how one can change behavioral patterns through the theory of self-management principle set by Fred Luthan. She uses her own habit of procrastination of undesirable tasks as an example.Item Cost-effectiveness of a chronic pain intervention for people living with HIV (PLWH)(Taylor & Francis, 2018) Merlin, Jessica S.; Westfall, Andrew O.; Johnson, Mallory O.; Kerns, Robert D.; Bair, Matthew J.; Kertesz, Stefan; Turan, Janet M.; Clay, Olivio J.; Starrels, Joanna L.; Kilgore, Meredith; Medicine, School of MedicineBackground: Chronic pain is a common, disabling, and costly comorbidity, particularly in people living with HIV (PLWH). This study developed and pilot tested a pain self-management intervention for chronic pain tailored to PLWH called Skills TO Manage Pain (STOMP). Objectives: Given the additional resources needed to deliver STOMP in HIV clinical settings, an important objective of the pilot study was to assess not only STOMP’s preliminary efficacy, but also its cost-effectiveness. Research design and subjects: The present study draws from a 44-participant, 2-arm randomized pilot trial of the STOMP intervention vs usual care among PLWH and at least moderate chronic pain (Clinicaltrials.gov: NCT02824562). Cost-effectiveness is presented as the incremental cost-effectiveness ratio (ICER). Costs were considered from the clinic perspective over a 1-year time horizon using real costs from the pilot trial. It was conservatively assumed there would be no costs savings. The Standard Gamble (SG) method was used to directly measure utilities. Results: Thirty-six participants met inclusion criteria for the present analyses. Mean age was 52 years; 61% were female and 86% were black. The total cost of STOMP was $483.83 per person. Using the SG method, the change in QALYs was 0.15, corresponding to an ICER of $3,225. Conclusions: STOMP’s cost/QALY is substantially lower than the $50,000 to $100,000/QALY benchmark often used to indicate cost-effectiveness. Although based on a pilot trial and, therefore, preliminary, these findings are promising, and suggest the importance of cost analyses in future STOMP trials.Item Evaluation of a peer coach-led intervention to improve pain symptoms (ECLIPSE): Rationale, study design, methods, and sample characteristics(Elsevier, 2019) Matthias, Marianne S.; Daggy, Joanne; Adams, Jasma; Menen, Tetla; McCalley, Stephanie; Kukla, Marina; McGuire, Alan B.; Ofner, Susan; Pierce, Emilee; Kempf, Carol; Heisler, Michele; Bair, Matthew J.; Communication Studies, School of Liberal ArtsChronic pain is prevalent, costly, and a leading cause of disability. Pain self-management (i.e., employing self-management strategies including behavioral modifications) is an effective, evidence-based treatment. However, implementation and delivery of a pain self-management model is challenging because of time and resources. Peer supported pain self-management offers a promising approach to implementing pain self-management programs using fewer clinical resources. Evaluation of a Peer Coach-Led Intervention for the Improvement of Pain Symptoms (ECLIPSE) is a randomized controlled trial testing effectiveness of peer coach-delivered pain self-management intervention versus controls receiving a class on pain and pain self-management. ECLIPSE is a Hybrid Type 1 study testing effectiveness while examining implementation factors. ECLIPSE enrolled 215 veterans randomly assigned to the peer coaching (N = 120) or control (N = 95) arm. The peer coaching intervention lasts 6 months, with patient-peer coach pairs instructed to talk twice per month. Coaches attend initial training, are provided a detailed training manual, and attend monthly booster sessions. Outcomes are assessed at baseline, 6 months, and 9 months. The primary outcome is overall pain (intensity and interference), measured by the Brief Pain Inventory (BPI). Secondary outcomes are self-efficacy, social support, pain catastrophizing, patient activation, health-related quality of life, and health care utilization. To maximize implementation potential of pain self-management, innovative delivery methods are needed that do not require additional resources from healthcare teams. A novel and promising approach is a peer-coaching model, in which patients who are successfully managing their pain offer information, ongoing support, and advice to other patients with pain.Item Facilitators and Barriers to Participation in a Peer Support Intervention for Veterans With Chronic Pain(Ovid Technologies (Wolters Kluwer) - Lippincott Williams & Wilkins, 2016-06) Matthias, Marianne S.; Kukla, Marina; McGuire, Alan B.; Damush, Teresa M.; Gill, Nabiha; Bair, Matthew J.; Department of Communication Studies, School of Liberal ArtsOBJECTIVE: To understand facilitators and barriers to participation in a peer support intervention for self-management of chronic pain. METHODS: After completing a pilot intervention study, peer coaches and their veteran patients took part in a qualitative, semistructured interview to explore their experiences with the intervention. Data were analyzed using an immersion/crystallization approach. RESULTS: Three facilitators and 2 barriers to patient participation in a peer support intervention for veterans with chronic pain emerged. Facilitators were (1) having a shared identity as veterans, (2) being partnered with a person who also has chronic pain, and (3) support from the study staff. Barriers were (1) logistical challenges, and (2) challenges to motivation and engagement in the intervention. DISCUSSION: Awareness of facilitators and barriers to participation in a peer-supported self-management program for chronic pain, as well as strategies to capitalize on facilitators and mitigate barriers, are essential for further study and ultimate clinical implementation of such a program.Item Feasibility of an emotion regulation intervention for patients in cardiac rehabilitation(2021) Wierenga, Kelly L.; Fresco, David M.; Alder, Megan L.; Moore, Shirley M.Cardiac rehabilitation is important to improve physical activity and reduce cardiovascular disease risk factors among people who have experienced a major cardiac event. However, poor emotion regulation can make it difficult to change cardiovascular risk factors. The purpose of this paper was to assess the feasibility of the Regulating Emotions to improve Nutrition Exercise and reduce Stress (RENEwS) intervention, an education program aimed at improving emotion regulation strategies among patients in cardiac rehabilitation. Fourteen cardiac rehabilitation patients (mean age 61 years) enrolled in 5 weekly RENEwS sessions. Qualitative analysis of participants’ comments was used to assess eight elements of feasibility. Fifty-seven percent of participants completed the intervention. Participants thought the intervention was feasible, with strengths in the areas of acceptability, demand, adaptation, integration, and implementation. Other comments regarding practicality, expansion, and perceived efficacy provide guidance for intervention refinement.Item Illness Management and Recovery: A Review of the Literature(2014) McGuire, Alan B.; Kukla, Marina; Green, Amethyst; Gilbride, Daniel; Mueser, Kim T.; Salyers, Michelle P.Item The multidimensional kidney transplant self-management scale : development and psychometric testing(2018-04-03) Chung, Shu-Yu; Hacker, Eileen; Jones, Josette; Ellis, Rebecca Bartlett; Rawl, Susan; Bakas, TamilynPoor long-term kidney transplant outcomes are a significant problem in the U.S. Interventions must focus on preserving allograft function by managing modifiable risk factors. An instrument capable of identifying problems with post-kidney transplant self-management behaviors may enable the design and testing of self-management interventions. This study’s purpose was to test the psychometric properties of the new Kidney Transplant Self-Management Scale (KT–SM). The Zimmerman framework adapted for kidney transplant self-management guided the cross-sectional study. A total of 153 kidney recipients recruited from Facebook® completed the Self-Efficacy for Managing Chronic Disease (SEMCD), Patient Activation Measure (PAM), Kidney Transplant Questionnaire (KTQ), and KT–SM Scale instruments via a REDCap® survey. Most participants were female (65%), White (81.7%), and middle-aged (M = 46.7; SD = 12.4 years) with a history of dialysis (73%) and received a kidney transplant an average of 6.58 years previous (SD = 6.7). Exploratory factor analysis results supported the 16-item KT–SM Scale as a multidimensional scale with five domains with loadings ranging between .39 and .89: medication adherence, protecting kidney, cardiovascular risk reduction, ownership, and skin cancer prevention. Internal consistency reliability for the total scale (Cronbach’s α = .84) and five domains ranged from .71 to .83. The total and domains were positively correlated, ranging from r = .51 to .76, p = .01. Criterion-related validity was evidenced by significant correlations of KT–SM and domains with SEMCD (r =.22 to .53, p = .01), PAM (r = .31 to .52, p = .01), and the overall KTQ (r = .20 to .32, p = .01) except for one KT–SM domain: protecting kidney. Construct validity was evaluated using multivariate regression analysis. The linear combination of age, patient activation, and self-efficacy explained 45% of the variance in KT–SM behaviors; 47% of the variance in KTQ (measuring quality of life) was predicted by age, comorbidity, and self-efficacy. These findings provide beginning evidence of reliability and validity for the newly developed KT–SM scale. Instruments like this may provide a means to capture the self-management behaviors of the kidney transplant population, which is critical for future work on interventions.