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    • "Individuals actively manage medical aspects of their disease and engage in health promoting behaviors (i.e., medical and behavioral management task), maintain life roles (i.e., role management task), and deal with emotional experiences of living with a chronic disease (i.e., emotional management task) (Corbin & Strauss, 1988; Lorig & Holman, 2003; Coleman & Newton, 2005). Examples of strategies used as part of arthritis self-management and/or symptom control that fit within these three broad self-management tasks include activities such as seeking education and information, following a medication, nutrition, or physical activity regime, reducing or modifying activities to maintain independence, and/or relying upon social networks (MacKay et al., 2007; Keysor et al., 2003). "
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    ABSTRACT: Community resources can influence health outcomes, yet little research has examined how older individuals use community resources for osteoarthritis (OA) management. Six focus groups were conducted with 37 community-dwelling older adult African Americans and Caucasians who self-reported OA and resided in Johnston County, North Carolina. Descriptive analyses and qualitative constant comparison methodology revealed individuals use local recreational facilities, senior centers, shopping centers, religious organizations, medical providers, pharmacies and their social network for OA management. Participants also identified environmental characteristics (e.g., sidewalk conditions, curb-cuts, handicapped parking, automatic doors) that both facilitated and hindered use of community resources for OA management. Identified resources and environmental characteristics were organized around Corbin & Strauss framework tasks: medical/behavioral, role, and emotional management. As older Americans live with multiple chronic diseases, better understanding of what community resources are used for disease management may help improve the health of community-dwelling adults, both with and without OA.
    Full-text · Article · Oct 2012 · Journal of Applied Gerontology
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    • "While studies of self-care or self-management of chronic illness among older adults are plentiful, several obstacles prevent generalizing the findings. In a critical review and a metaanalysis of studies of self-management of arthritis, (Keysor et al., 2003) indicate that one of the major problems with research on self-care is that the data are collected using a variety of different categorizations (categorical response lists versus qualitative subjective interviews, for example) or conceptual models (broad versus narrow frameworks), making comparisons of the findings problematic. For example, Albert et al., (2008 in press) question including doctor-prescribed actions with actions that the patient develops in describing self-management for OA. "
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    ABSTRACT: Osteoarthritis (OA) is the most prevalent form of arthritis and is among the most prevalent chronic conditions in the USA. Because there is no known cure for OA, treatment is directed towards the alleviation of pain, improving function, and limiting disability. The major burden of care falls on the individual, who tailors personal systems of care to alleviate troublesome symptoms. To date, little has been known about the temporal variations in self-care that older patients with OA develop, nor has it been known to what extent self-care patterns vary with ethnicity and disease severity. This patient-centered descriptive study was designed to demonstrate the self-care strategies used by older African Americans and whites to alleviate the symptoms of OA on a typical day and during specific segments of a typical day over the past 30 days. A sample of 551 older adults participated in in-depth interviews, and the authors clustered their responses into six categories. Findings showed that the frequency of particular behaviors varied by time of day, disease severity, and race. Overall, patterns of self-care behaviors were similar between African Americans and whites, but African Americans used them in different proportions than whites. This study contributes to our knowledge of the dynamic and changing nature of self-care actions even within a single day. By defining how self-care is used in one illness by two different ethnic groups, we may be able to design appropriate educational programs that are more culturally specific to better meet the needs of patients with OA.
    Full-text · Article · Nov 2008 · Journal of Cross-Cultural Gerontology
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    • "Criterion validity of the NAP SACC self-assessment instrument was evaluated for this project. Face, although its worth has been contested [41], and content validity were reasonably established in a comprehensive literature and resource review that was conducted prior to the development of the self-assessment instrument [34]. In addition, construct validity was assessed in a national expert review that took place in January through April of 2004. "
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    ABSTRACT: Few assessment instruments have examined the nutrition and physical activity environments in child care, and none are self-administered. Given the emerging focus on child care settings as a target for intervention, a valid and reliable measure of the nutrition and physical activity environment is needed. To measure inter-rater reliability, 59 child care center directors and 109 staff completed the self-assessment concurrently, but independently. Three weeks later, a repeat self-assessment was completed by a sub-sample of 38 directors to assess test-retest reliability. To assess criterion validity, a researcher-administered environmental assessment was conducted at 69 centers and was compared to a self-assessment completed by the director. A weighted kappa test statistic and percent agreement were calculated to assess agreement for each question on the self-assessment. For inter-rater reliability, kappa statistics ranged from 0.20 to 1.00 across all questions. Test-retest reliability of the self-assessment yielded kappa statistics that ranged from 0.07 to 1.00. The inter-quartile kappa statistic ranges for inter-rater and test-retest reliability were 0.45 to 0.63 and 0.27 to 0.45, respectively. When percent agreement was calculated, questions ranged from 52.6% to 100% for inter-rater reliability and 34.3% to 100% for test-retest reliability. Kappa statistics for validity ranged from -0.01 to 0.79, with an inter-quartile range of 0.08 to 0.34. Percent agreement for validity ranged from 12.9% to 93.7%. This study provides estimates of criterion validity, inter-rater reliability and test-retest reliability for an environmental nutrition and physical activity self-assessment instrument for child care. Results indicate that the self-assessment is a stable and reasonably accurate instrument for use with child care interventions. We therefore recommend the Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) instrument to researchers and practitioners interested in conducting healthy weight intervention in child care. However, a more robust, less subjective measure would be more appropriate for researchers seeking an outcome measure to assess intervention impact.
    Full-text · Article · Feb 2007 · International Journal of Behavioral Nutrition and Physical Activity
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