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Self Management - Science topic

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I need this questionnaire for my Master's thesis
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It will depend on your focus as there are ones for e.g. obesity, alcohol, diabetes etc. Some very basic ones are PHQ-9 or GAD-7. If you map out your focus it might help to draw you to the right tool. DASS is a emotional health/self-management assessment tool for diabetes. Google Self-Management Support in Behavioral Health: Organizational Assessment Tool | Resources for Integrated Care and see if they suggest something.
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I am trying to figure out how self-efficacy and confidence of patient activation are different. I know that self-efficacy is a more situation specific term and confidence is for general situations. But the concept "patient activation" has an element of "confidence" and the items for confidence of Patient Activation Measure (PAM) sound like self-efficacy to me. Anyone who can give me any ideas or suggestions of books, readings, etc..? 
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Driss Benattabou
Attached are the list of publications and presentations on MTM. Here is 2 minute YouTube that explains it: https://youtu.be/OXPdZX-1O3I
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Thank you very much for your considerations.
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Replacing face-to-face learning with the online one may be the only solution at these days of COVID-19. From my point of view, e-learning alone ( i.e. distance learning) will not succeed without traditional face-to-face learning. e-learning cannot be a substitute for face-to-face learning, it is complementary to classroom teaching.
Because e-learning hasn't achieved the desired aims or results, traditional learning is better. At least, the hybrid learning (i.e. blended learning) of both of them is better than the traditional one. This is especially true for the developing countries.
To diminish cheating, exams must be inside the scientific institutes like universities.
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I am conducting a research on how coaching makes impact on student's self management and inter-persona skills. Your topic seems to be very interesting. I am wondering what does it take for me to read your paper if it has been finished already.
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Noriko, my papers can be found on ResearchGate and my University's website at: https://staff.lincoln.ac.uk/jmendy.
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Newbie researcher with a looming research-induced panic attack - I'm in need of some guidance.
My research project is focusing on how social interaction influence the self-management of chronic disease by baby boomers.
I would like to do a mixed methods study with a case study.
Could anyone suggest any robust ways to flesh out this methodology?
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It sounds like you want to do either qualitative interviews or surveys with three different sets of men. For surveys, the biggest limitation you are likely to face is sample size, since you might need at least 100 participants in each subsample in order to do effective sample comparisons. For qualitative interviews, you might need only 10 or so per subsample, and the trade-off would be aiming for detailed responses on a limited number of topic, rather than coverage of a wider range of variables.
One substantive issue is that might be hard to guarantee that your participants have regular, interacting groups that influence them. Instead, you might expand your interests to "sources of information," with a particular focus on that particular source, when it is available.
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ok so I am trying to run a simple linear regression in which median household income is the independent variable and HRQOL survey scores are the dependent variable. I ran a bivariate correlation for assumption testing and found that income standardized. beta coefficient was not significant, thus cannot be a predictor. How should I transform income data? I tried log, binary and z scores which normalized the distribution plots but still beta is non-sig. Should I created dummy variables or change analyses completely? the sample is quite small n=46
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What is the theoretical frame work which links your independent and dependent variables? In what context this relation ship holds? Check.
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Hello,
I am doing my research about the self-management concept in contemporary organizations. I haven't been able to find any appropriate scales suitable for measurement of either the level of SM in a group/company in general or the level of SM on an individual employee level. If anyone has a suggestion, it is very welcome.
Thank you,
Aleksandra
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Thank you! If there are any research paper (WoS) where these or other tools have been used for the empirical evaluation of self-management, it would be very helpful.
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In self-management training for health education, do peer instructors add value to the outcomes of SM intervention in comparaison to nurse-led interventions ?
Peer instructors= patients teaching fellow patients
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This is a question we asked nearly thirty years ago for arthritis. In short people with professional instructors learned more and people with peer instructors changed behavior more.
One of the key ways to enhance SE is from modeling and trained peers act as excellent models.
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I'm looking for articles about AR and self management tools like ONESELF
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follow Peter J. Schulz, he was the project leader. Also check out the publications with data from the project he co-authored with Luca Camerini, Maria Caiata, Zlatina Kostova, Ahmad Allam.
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I am writing a literature review on therapeutic outcomes in the context of the NHS. some relevant themes are patient-centred care, the shift to prevention and self-management, shifts in "taking responsibility", the idea of the "quantitative self" and human-sensor networks in data, and a focus on mental health.
Any help much appreciated
Ellie
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Dear Ellie, there are a variety of good resources through the NHS website,
Here is a weblink that may give you additional resource materials. James.
URLs:
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Relation between general and task specific self efficacy.
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Two thoughts:
1. The level of generality depends on the way the self-efficacy questions are framed. If a scale is constructed with items like "I believe that I can successfully complete any task I set myself," it is measuring a very general level of self-efficacy. But if the item read "I believe I can successfully train myself to run a mile in under five minutes," it is much more specific (in this case, to athletics). As a rule, relatively general scales allow for weak predictions to be made of a wide range of behaviors, while highly specific ones allow for stronger prediction within their domain, but none at all outside of that narrow range. (By the way, I don't think anyone has ever empirically differentiated "self-efficacy" from "self-confidence.")
2. Referring to self-efficacy as a trait is a misnomer. Bandura was not working within a trait model, but instead a social-cognitive one similar to Julian Rotter's expectancy-value theory (though Bandura was not one to reference earlier iterations of similar ideas). In this sort of personality model, behaviors are construed as learned, and expectancies (of which self-efficacy is one type) refer to a person's subjective estimate of the probability of success or attainment of reinforcing outcomes. Because we accrue a great deal of experience in certain situations, we generalize from that experience. These generalized expectancies can be quite broad in scope and can acquire a trait-like stability, though they are always open to modification.
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I am highly interested in your research. Please kindly let me know how i can contribute and at the same time tap from your wealth of experience. I am currently doing a research on career self management behaviors and graduate unemployment.
Best Regards,
Chimere.
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Dear Chimere Elele,
I have done my doctoral thesis on tourism. We can have some mutual research. Please share your idea in personal message.
Looking forward,
Atif
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Dear researchers and practitioners,
The literature on competences is disperse and characterized by a lot of conceptual overlap with other related theoretical concepts.
In the context of (semi-) self-steering teams and project teams in general: what are applicable and practical relevant theoretical models on competency?
More specific, which competency models are useful within the context of team management, project management and self-management?
_______________________________________________________________
I would like to start this discussion by providing one competency model that could be of use:
--> Stevens & Campion: KSA framework for teamwork
The drawback of this model is the KSA related test, which seems to have psychometric issues in the underlying factor structure of the taxonomy. Although the model and the content in itself seems to have sufficient face validation and practical value in general.
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Dear Jonatan,
theere are plenty of models for competences in Project Management. However, I would suggest that you start pulling the thread by reading the International Project Management Association (IPMA) competence baseline. This is one of the most relevant organisations in Project Management nowadays and their model is based ini competences. Also, the Association of Project Management (APM) has a model based on competences (outside its APMBoK).
Hope it helps.
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Hello,
I am planning a humble research project about an online group of self help (mutual aid). I would like to know about some serious experience (or bibliographical reference) about this kind of online group. I know how these groups work face to face but not much online. I mean groups for support to other members in certain circumstances. For instance people with no common disorders could get in touch with other patients in the other corner of the world because it is not easy for them the contact face to face (for the distance). Thanks for reading!
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In his classic book, The Theory and Practice of Group Psychotherapy, Yalom (2005) discussed internet support groups and their effectiveness. These groups can "take the form of synchronous, real-time groups...or asynchronous groups, in which members post messages and comments, like a bulletin board." (p. 520). These groups can be professionally directed or self-directed.
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Urban men do not feel comfortable for seeking health care in normal condition. They only demand health care in case of severe situations like:
Unbearable pain
Inability to do work  etc.
This study is going to to introduced self-management technique by using Internet to deal with CHD. Social media is main source of information on internet and Patients with CHD can find information and techniques to deal with it.
Can academic researchers and medical professionals please introduce me some possible Mediators or Moderators to influence self-management of Coronary Heart Disease (CHD) through social media?  
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Relationships with other people living with CHD might serve as mediators. I would hypothesize that people who successfully used social media to connect with fellow CHD patients would, over time, learn more about how to manage their own health by following and dialoguing about the experiences of others. The social support introduced by such relationships could serve as a secondary mediator linking the relationships themselves with your outcomes of interest.
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I'm interested in understanding existing self-management interventions for people with chronic disease. However, a systematic review is not appropriate when investigating complex interventions, and so a realist approach seems most appropriate. I'd be interested to hear if anybody has conducted an evidence synthesis / realist synthesis / realist review, and whether you have any suggestions for the approach. Many thanks in advance!
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 I have always believed (note I do not say know) that pulling apart interventions to find the magic is like pulling apart a good cake--impossible or near impossible.  I have also come to believe that interventions that offer a mix of content and methods are best as the participants then self-tailor the intervention to their needs and abilities.  We do have some evidence that this is true. 
I have been compiling all the literature I can find on the Stanford interventions.  There are lots of articles--well over 100 and I also have many reports that have never gotten into the literature.   It would be a terrific service for someone to do a synthesis.  My collection is not complete but am happy to share what we have.  I think that there is lots and lots of collective wisdom there that go well well beyond effect size.
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A lot of studies in the field of self-management  interventions use group settings to demonstrate efficacy. Clinical practice on the other side is often done in one-on-one consultations, and chronically ill persons have their own ways to self-manage their illnesses.
I'm interested in your experiences in tailoring interventions from research, in approaches that work best in your clinical practice with chronically ill patients.
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Hi Robert,
I fully agree with what you write in your question. I work with Professor Fiona Jones here at Kingston University and St George's, University of London, UK, and I think that her work might be of interest to you.
Fiona is a leading academic in the field of self-management support for people with complex and multiple long-term conditions. Based on her work over the past ten years, Fiona has developed Bridges Self-Management, an approach that integrates self-management support into the everyday one-to-one interactions between health professionals and patients, so it is not a stand-alone group programme like many other self-management programmes that are on offer.
This work began in stroke rehabilitation, and has now developed to become more generic and applicable in patients with different and multiple long-term (chronic) conditions. Recent projects included patients with traumatic brain injury, multiple sclerosis, Parkinson's disease, dementia, and other conditions. Fiona also runs a well established training programme for health professionals in how to support patients' self-management skills.
Our website will give you a good overview of Fiona's work, as well as links to recent research projects and publications: www.bridgesselfmanagement.org.uk
To answer your question: Bridges Self-Management provides an evidence-based solution to tailoring self-management interventions to the needs of individual patients, by using a well-developed methodology based on co-production, person-centredness and partnership working between health professional and patient.
I hope this is helpful to you, please feel free to get in touch should you have any queries or wish to discuss further,
Best wishes
Tino
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Would like to focus on an organizational approach
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Steven J. Stein, PhD, is doing work in this area
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I am pursuing research of the problem of accessing to healthy food, the cost to acquire it, how to find "substitutes" for low cost/nutrient-deficient alternatives, delay discounting that maintain aversive long-term healthy consequences, changing eating habits to avoid health related diseases among an underserved community in a large urban area. Couple areas I am pursuing - access to a supermarket or bringing the food closer via placement in corner stores, taxing and labeling of "unhealthy" alternatives and how to shape and maintain healthy eating habits. In addition, interested in how one gets children to eat more fruits and vegetables using the School Lunch program as a vehicle.
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Very interesting story of an inventor who has diligently photo-documented his meals as an attempt to understand the correlation between diet, optimal health and creativity. I think Instagram is a good idea, especially if the photos extend to the mundane, and the routine. Perhaps along a similar philosophy as the quantified self movement.
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I am doing a dissertation about young patients with a chronic condition. The main aim is to explore the phenomenon of self-management. The draw-and-write technique is offered as an adjunct to interviews. I did a lot of literature review about the method but I am a firm believer of pragmatism. So anyone who can share their experience on using it would be much appreciated.
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Hi Harry.  I'm not familiar with draw-and-write as a research technique though I have seen it used in learning.  However, I have a lot of experience with what I presume are similar techniques; variously called elicitation of projective techniques.  One technique I have used a fair bit is  asking people to draw a picture and then talk about it, rather than write.  I find it very effective.
I am on the road at the moment and don't have references to hand but Dawn Mannay published a paper on a very similar technique in Qualitative Research in 2010 (I think).  I wrote on the use of the technique, among others, in an article 'Recreating Experience: improving the validity of data'  in the Evaluation Journal of Australasia, (which can be accessed through RG).  If you are interested in lessons from this sort of technique I suggest you also look at Jenkins et al Qualitative Research (2010) and Breivik and Supphellen. 
If you are interested in some of the theoretical issues I can share some material with you directly, or you could have  a look at the paper I gave to the American Evaluation Association Conference 'Understanding the Subjective: Eliciting Hidden Meaning'  (available through RG)
In summary I suggest starting the interview with the drawing technique and then asking questions afterwards;  try to make the drawing task as close as possible to the experiences of the children, something they see a relevant.  In your scenario, I would probably start by asking them to think about their experience of managing their condition and then asking them to draw a picture that summarizes those experiences.
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There is an increasing number of literature on the patients perspective respectively on patient reported outcomes in Haemophilia. But there are very few publications on patient education in this area. Does anyone know specific patient education tools / self-management education programs for adult patients with haemophilia?
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there is a lot of information as well in the world hemophilia site (www.wfh.org) & www.ehc.eu
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Health-based self-efficacy OR a medical adherence scale would be particularly useful since this is for a sample of chronically ill children aged 10-17. Illness type varies so it has to apply to all conditions. Thank you!
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No, nobody can do this.  This is because self-efficacy is just another word for power, or will, and it motivates achievement.  The only achievement that is rated in young children is grades.  So you have power, curiosity, and assertiveness combined in part at young ages, at least to raters of most scales.   see www.motivatelearning.com
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Patients are reporting issues such as poor access to care, availability of socio-economic resources and time; knowledge; and emotional and physical energy. (Bee et al. 2014)
The work patients must do to care for their health; problem-focused strategies and tools to facilitate the work of self-care; and factors that exacerbate the burden felt (Eton et al 2014)
Capacity, responsibility, and motivation: a critical qualitative evaluation of patient and practitioner views about barriers to self-management in people with multimorbidity. BMC Health Services Research (Impact Factor: 1.77). 11/2014; 14::536. DOI: 10.1186/s12913-014-0536-y
Building a measurement framework of burden of treatment in complex patients with chronic conditions: a qualitative study. Patient Related Outcome Measures 2012:3 39–49 http://dx.doi.org/10.2147/PROM.S34681
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Have you considered the first tool within the Flinders Program - Chronic Condition Care Planning? You'll find details about it at:  http://www.flinders.edu.au/medicine/sites/fhbhru/self-management.cfm
It's called the 'Partners in Health Scale' and it's a 12 item measure that the person self-rates re their knowledge, relationship with health professionals, access, monitoring and responding, physical, social and emotional impacts, lifestyle, etc. The tool has been validated and used in many research trials and in practice as either a standalone to measure change over time, determine client groupings, determine for services which clients would benefit from care planning, etc.
It has been adapted into other languages and used in the US, NZ, Australia, Hong Kong and some other countries.
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I am currently doing research on project teams. In the past I published an article on social and behavioral influences on team process and realized that I need to have a greater understanding sociology, social psychology, and organizational behavioral issues pertaining to team processes, team development, and transitioning them into self managed teams. Any suggestions on references or articles would be useful
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Dear Vittal, you will find some helpful articles in the Handbook of Cultural Intelligence, ed. by Soon Ang & Linn Van Dyne (2008, especially part 3).
A meta-analysis of 108 empirical studies on processes and performance in 10,632 teams is offered here:
Stahl, G. K., Maznevski, M. L., Voigt, A. & Jonsen, K. (2010). Unraveling the effects of cultural diversity in teams: A meta-analysis of research on multicultural work groups. Journal of International Business Studies, 41, 690–709, doi:10.1057/jibs.2009.85.
And here's a paper quite typical for social psychological approaches to the topic and containing valuable bibliographical hints:
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My team provides disease specialist management of patients living in the community with chronic conditions such as respiratory, cardiovascular and diabetes. In the past we measured disease severity and other biomarkers, but with the move towards self management of chronic disease we want to measure other aspects of health and wellness. Any suggestions? 
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Some of what you want to focus on is biomedical control (BP, A1c, cholesterol)  and what are barriers to medication adherence, obviously, but also look at the behavioral risk factors and what you are doing about them. Is the patient a smoker, and if so what cessation support are you providing? Is the patient physically active? What are you doing for him/her or for his or her community to make them more likely to practice physical activity? What is their sugary drink consumption?   Have you provided nutrition support and counseling or other comity supports?  What is their readiness or motivation to engage in change?  If pre diabetic, have you referred to the diabetes prevention program  and were they able to engage in it? 
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In the Netherlands self-management for chronic disease patients has been adopted in routine care in both primary and secondary care. Evidence suggests high variance in succes of self-managment exposure. In our quest to unravel success of this therapeutic stimulus, in a prospective cohort study we aim at assessing both patient- and intervention- specific effect modifiers of success of self-management. To assess patient-profiles and direction and size of effectiveness will not be much of a problem. Otherwise, assessing both content, mode and intensity (dose) of routine care self-management exposure is a larger issue. Do you have any suggestions how we can screen/measure this hybrid type of exposure ? What is your opinion on providers (mostly nurses) self-reporting content/mode/dose of their own consultations in our longitudinal cohort study ?
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I would say it depends on how you are defining self-management so that would be my first consideration. If you are limiting it to adherence to recommended treatment and lifestyle changes, then healthcare professionals could record the patient education and information they have provided using a checklist. In the UK computer templates are used for consultations that allow the user to tick when they have given advice about diet or exercise or stopping smoking for example. But there is obviously much more to facilitating self-management as it depends on lots of factors such as the therapeutic relationship (which is affected by patient-centredness and relational continuity), communication skills, skill in goal setting or negotiating management plans, and addressing health literacy issues, To get at those factors will probably require more qualitative work involving recording of consultations, although there are measures that can be completed by patient and/or healthcare professional or used to apply to recordings. It seems to me that the interaction with the patient is the most important part and that has to be judged by the patient as well as the healthcare professional. The healthcare professional may think she has reached an agreement with the patient about a course of action only to find that the patient does not implement it or did not understand or take in the information. Tricky!
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I need to brainstorm a research problem statement and present a decent research problem statement. Some of your replies will help define my research problem statement. My work focuses on the individual’s ability to adapt to new work changes based on his cognition to adaptability
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Wow... Jean Piaget dates back to some years ago. Thanks for the tip I'll be also investigating these areas of studies you mentioned.
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I've just read two recent papers that have me musing: LAKEMEIER S, Lind M, Schultz W, Fuchs-Winkelmann S, et al. (2013) paper looks at a comparison between steroid injections and radiofrequency denervations for people with low back pain. The conclusion suggests that both procedures "...appear to be a managing option for chronic function-limiting low back pain of facet origin with favorable short- and midterm results..."; and ANDREW MOORE R. (2013) "What Works for Whom" suggesting that statistical significance is less useful than a patient-centric view of effectiveness.
My question is - if chronic back pain is a condition likely to persist, what are the effects in terms of beliefs about pain, quality of life, interference in "living well despite pain" when a person needs to keep attending clinics to have invasive treatments?
I say this after seeing people who have attended self management programmes, with the same pre-treatment pain intensity, distress, disability as those reported in Lakemeier's paper, remain well with reduced distress and disability - and more importantly from a systems perspective - less need to rely on healthcare.
How can this be measured? Has anyone carried out a head-to-head economic study of self management vs ongoing procedures? Or am I simply showing my self-management bias?
The two references:
LAKEMEIER S, Lind M, Schultz W, Fuchs-Winkelmann S, et al.
A Comparison of Intraarticular Lumbar Facet Joint Steroid Injections and Lumbar
Facet Joint Radiofrequency Denervation in the Treatment of Low Back Pain: A
Randomized, Controlled, Double-Blind Trial.
Anesth Analg. 2013.
ANDREW MOORE R.
What works for whom? Determining the efficacy and harm of treatments for pain.
Pain. 2013 Mar 15. pii: S0304-3959(13)00119-X. doi: 10.1016/j.pain.2013.
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This is a difficult question to answer. As I'm sure you know, most economic models for the management of any chronic illness vary considerably in depth and breadth and I have personally struggled quite a bit to incorporate models of direct and indirect cost into my own chronic pain research. I'm aware of a few manuscripts that describe the general cost of chronic pain management programs (see Gatchel & Okifuji, 2006 for an example), but I am unaware of any prospective comparative trials with a strong economic endpoint. Most seem to agree that information about healthcare utilization patterns before and after an intervention can serve as a reasonable surrogate for more refined cost models, but I have yet to see any studies advance this line of research beyond basic measures of disability and absenteeism (missed work time). I personally believe that studies of work presenteeism (present at work, but less productive) are sorely needed. For a few of my manuscripts I have actually counted the # of appointments attended in general and specialty clinics to represent healthcare utilization, but this method is only as reliable as the medical records reviewed for the count. This count revealed a significant decrease in healthcare utilization after self-management intervention (but I did not compare head-to-head with other interventions). It may also be good enough to ask patients to recall the number of visits for care to study utilization, though I don't know how reliable these data would be compared to medical record review. I suspect that more detailed cost estimates would support your suspicion that self-management offers significant long-term cost benefits.
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I am researching wellbeing in the workplace as part of my Professional Doctorate and want to look at presenteeism rather than absenteeism as one of the means of establishing the benefit of introducing a workplace wellness intervention. Can anyone advise on which is the most suitable measure and where I may be able to obtain a copy to assess suitability?
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Well, that's quite difficult to measure presenteeism. First thing is how You define presenteeism - as being at work while ill or as loss of productivity. All the scales I know, are based on self-report and majority of them regard productivity loss (e.g. in %) - see e.g. Mattke S., Balakrishnan A., Bergamo G., Newberry S.J. A Review of Methods to Measure. Health-related Productivity Loss. Am J Manag Care. 2007, 13 (4) or Schultz A. B., Chin-Yu C., Edington D. W.: The cost and impact of health conditions on presenteesim to employers. A review of the literature. Pharmaeconomics. 2009; 27 (5), When considering attendace while ill, researchers usually simply ask one question such as "How many times have you been at work, despite feeling ill?", "Has it happend that you have been at work despite feeling ill?" (or others like that). Usually it regards the period of former 12 months, but sometimes it is 6 months, 3 month or even weeks. There are different problems with such measurment, e.g. people simply do not remeber how many times/how often they were at work while ill... In our department we are working on the project about presenteesim and at first we planned to use Stanford Presenteeism Scale, but eventually we have created a new tool. We have checked its psychometric properties - they are satisfactory and we would like to publish it soon. The concept is that people have a stronger or weaker tendency to go to work despite feeling ill (though moderated by different indivdual, e.g. job satisfaction, and contextual factors, e.g. organisational culture) and that presenteeism might be negative or positive for the individual and for his/her enviroment (co-workers and employer).Contact me (awezyk@imp.lodz.pl), if You would like to know more about our research and the measure.
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There are arguments that staff should come to office on time; utilise the office hours for official work ethically and in a professional manner. Whereas, some argue that it is the completion of work that is more important; and targets must be achieved. Employees must be evaluated based on the results produced. There should be flexibility in the working hours. Please share your country experiences and research evidence, if any, as to the appropriateness of defined working hour and the flexible working hours.
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Thanks Lindsay: In many developing countries, the employees must come at 10 and leave at 4 or 5 with one hour lunch break. It is normally believed that productivity is linked with office hour. Leader emphasized for adherence to office time. But there is little concerned for results. I am also a person believing on flexible working hours, not rigid on office hour; but absolutely must meet the deadlines of our work.
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I'm reflecting on the type of pain management approaches on offer to people who have pain, and noticing that there doesn't appear to be an "independent living" or "disability rights" movement amongst the chronic pain community. This means the predominant voices in chronic pain research are clinicians or researchers, and the voices of people with pain seem remarkably silent.
What would it mean to have people with chronic pain be involved in determining how chronic pain is viewed?
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Thanks Derek, yes probably it is a dialogue between "enlightened" professionals and people who have chronic pain. I guess one thought I had was that chronic pain, unlike many disabling health conditions, can be readily misunderstood by both the lay community ("why can't they just fix me?") and the health community ("why don't they just get better?").
Is there concern from within the self-management/psychological approaches to chronic pain sector that people with chronic pain might not really like what they are being told is good for them? Is there a fear from clinicians and researchers that people with chronic pain want to focus only on cure, not management (ie the self management model is unpalatable, and professionals need to "convince" people that self management is a Good Thing?).
Not that I want to focus on political activism, but it does seem odd, given the number of people living with ongoing painful conditions.
I do have access to a "consumer" group organisation that actively reviews research proposals, and aims to include "consumers" in research relevant to their health condition. I'm really interested in how you've gone about your work with older people - will go and investigate!
My hope is that people with chronic pain can be involved in research and person-centred health management. It just feels a bit like people with chronic pain may be disenfranchised, and it would be fascinating to discover why.
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Hoping to do research for a class, am attending graduate school
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Thank you again - I will look at the Journal of Clinical Child and Adolescent Psych too!