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Biomedical subjects

K Lorig

Publications and source records attributed to K Lorig.

At least 37 records · Page 2Linked to original sources
PubMed1993

The effectiveness of medical self-care interventions: a focus on self-initiated responses to symptoms.

Medical self-care has always been a primary means of caring for health problems. Educational materials and interventions have been used for centuries to improve the quality of medical self-care. However, relatively few studies have been undertaken to examine the effects of these interventions on the health of the individual or on the use of professional services. This review was undertaken to provide (1) a summary of studies describing the practice of medical self-care and (2) a summary of studies evaluating the impact of medical self-care interventions to improve self-initiated responses to symptoms. In addition, we summarize the effectiveness of those self-care interventions.

Health Knowledge, Attitudes, Practice↗
PubMed1992

Theory in health education practice.

Although social and behavioral science theories are claimed to be able to contribute greatly to the effectiveness of health education programs, most practitioners in the profession seem to doubt this, and very few ever deliberately use theories in their work. Some reasons for such diverse views reside in the nature of the theories, in the very different roles they play in the worlds of theory-minded and practice-oriented health educators, respectively, in widespread unrealistic expectations of what theories can and cannot contribute to practice, and in lack of appropriate training in theories and their uses. Suggestions are offered to both practicing and academic health educators on ways to bridge the gap between the two camps, to render theories more useful to practitioners, and to train practitioners and health education students to appreciate the potentials of theories and to acquire skills needed to utilize such potentials.

Behavioral Sciences↗
PubMed1992

The integration of theory with practice: a 12-year case study.

Although the integration of health education theory with practice has always been taught, this linkage has not always occurred as a systematic part of program or theory development. This paper reflects the 12-year experience of one health education program which started from a base not soundly grounded in theory and moved to one tightly linked with theory. Throughout this process, outcome data were collected allowing for evaluations of both practice and theory.

Arthritis↗
PubMed1991

Obstacles to and future goals of ten comprehensive community health promotion projects.

Over 100 project staff, community coalition members, and other representatives from 10 comprehensive community health promotion projects in the western United States were surveyed two years into a three year funding cycle about: (1) the problems or obstacles they judged as preventing successful completion of their current goals and objectives, and (2) future goals and objectives they envisioned for their projects. The key issues confronting respondents were diverse, although issues around the process of implementing community health promotion programs were cited more frequently than issues related to the content of health promotion. When respondents were asked to prioritize Future Goals in the second survey, consensus across communities was obtained despite broad differences in the type of community surveyed and the health problem targeted. This study identifies the common organizational and community development problems faced by newly emerging community health promotion programs and has implications for other communities involved in designing, implementing, and evaluating community-wide health promotion programs.

Community Health Services↗
PubMed1990

Four psychosocial theories and their application to patient education and clinical practice.

Although the development of theoretically based and empirically verified practice guidelines is now possible, some health education practice still remains uninformed by this research-based knowledge. This article describes four psychosocial theories that have been useful in our practices: self-efficacy, stress and coping, learned helplessness, and social support. The theories are introduced and compared; practical suggestions for their use in the development of health education interventions are then discussed. Skills mastery, modeling, reinterpretation of physical signs and symptoms, and persuasion are presented as ways of enhancing self-efficacy. Some similar strategies are presented as examples of coping techniques, including positive reappraisal or reinterpretation. Other coping strategies such as confronting, distancing, self-care, seeking social support, accepting responsibility, escape avoidance or ignoring, problem solving, activity, distraction, self-talk, and prayer are also introduced. Cognitive restructuring is examined most fully as an example of an intervention strategy derived from learned helplessness theory. And finally, five strategies for fostering positive social support are presented: enhancing personal networks, linking volunteers, establishing mutual aid networks, identifying and supporting neighborhood helpers, and community empowerment.

Adaptation, Psychological↗
PubMed1989

Development and evaluation of a scale to measure perceived self-efficacy in people with arthritis.

There is evidence that the psychological attribute of perceived self-efficacy plays a role in mediating health outcomes for persons with chronic arthritis who take the Arthritis Self-Management Course. An instrument to measure perceived self-efficacy was developed through consultation with patients and physicians and through study of 4 groups of patients. Tests of construct and concurrent validity and of reliability showed that the instrument met appropriate standards. Health outcomes and self-efficacy scores improved during the Arthritis Self-Management Course, and the improvements were correlated.

Adult↗
PubMed1989

The beneficial outcomes of the arthritis self-management course are not adequately explained by behavior change.

Evaluation of the Arthritis Self-Management Course revealed significant positive changes in the practice of behaviors that were taught and in health outcomes. However, utilizing a variety of statistical techniques, we were able to demonstrate only weak associations between changes in behavior and changes in health status. This suggests the need to examine the mechanisms by which health education affects health status.

Aged↗
PubMed1989

Impact of juvenile arthritis on families. An educational assessment.

State of the art patient education programs have as their goals changes in behaviors, coping styles, health status, and/or costs. The accomplishment of these goals often involves not only the patient but also his or her whole family. This is especially true if the patient is a child. Based on this premise, we undertook an educational needs assessment of 50 children with juvenile arthritis (JA) and their families. Through utilization of a grounded theory methodology, open-ended questionnaires were completed by JA children, their parents, and their siblings. The resulting analysis suggests (1) the need for family-based education, (2) differing needs of various family members, and (3) several hypotheses for further study.

Adolescent↗
PubMed1989

Long-term outcomes of an arthritis self-management study: effects of reinforcement efforts.

An underlying assumption of self-care interventions is that they are most effective when reinforced. To test this assumption, 8 months after baseline, 589 subjects who had taken a 6-week Arthritis Self-management Course (ASMC) were randomized to (1) receive a bi-monthly arthritis newsletter, (2) attend a new 6-week Arthritis Reinforcement Course (ARC) or (3) receive no reinforcement. Between 8 and 20 months there were no significant differences among the three randomized groups. The results were unaltered by inclusion of assumed data of no change for the 46 subjects who did not complete the full 20-month study. Between baseline and 20 months all participants reduced their pain by 20%, depression by 14%, and visits to physicians by 35% (P less than 0.01). There were no trends toward loss of these effects over time. These findings indicate that the effects of a self-care intervention were sustained over 20 months and that the tested forms of reinforcement did not alter those effects.

Aged↗
PubMed1988

A nursing perspective on the assessment of function in persons with arthritis.

The psychometric properties of two self-administered measures of function were examined: the Disability Score of the Health Assessment Questionnaire (HAQ) and the Total Health Score of the Arthritis Impact Measurement Scales (AIMS). Data from 140 respondents were analyzed. Respondents had diagnoses of osteoarthritis, rheumatoid arthritis, or diabetes mellitus; resided in rural and urban areas; and were for the most part elderly, female, and white, with educational levels of high school or below. Reliabilities (test-retest and internal consistency) of both measures were high. The concurrent validity also was high. Content analysis suggested the HAQ represented the scope of nursing practice better than the AIMS. An exploratory principal components analysis confirmed that the HAQ is relevant to nursing practice.

Activities of Daily Living↗
PubMed1988

A cognitive-behavioral treatment for rheumatoid arthritis.

This experiment tested a cognitive-behavioral rheumatoid arthritis treatment designed to confer skills in managing stress, pain, and other symptoms of the disease. We hypothesized that a mediator of the magnitude of treatment effects might be enhancement of perceived self-efficacy to manage the disease. It was predicted that the treatment would reduce arthritis symptoms and possibly would improve both immunologic competence and psychological functioning. The treatment provided instruction in self-relaxation, cognitive pain management, and goal setting. A control group received a widely available arthritis helpbook containing useful information about arthritis self-management. We obtained suggestive evidence of an enhancement of perceived self-efficacy, reduced pain and joint inflammation, and improved psychosocial functioning in the treated group. No change was demonstrated in numbers or function of T-cell subsets. The magnitude of the improvements was correlated with degree of self-efficacy enhancement.

Adult↗
PubMed1987

Arthritis patient education: a review of the literature.

Arthritis is one of the most prevalent chronic diseases and the number one disabler of the elderly. Even though arthritis is a major cause of morbidity and a contributor to early mortality, relatively few studies have been undertaken to examine effects of arthritis patient education. This review was undertaken to (1) provide a summary of arthritis patient education studies, (2) summarize the effectiveness of arthritis patient education in changing knowledge, behavior, psychological status, and health status, (3) address critical issues/problems in arthritis patient education study methodology, and (4) suggest guidelines for future design, implementation, and evaluation of arthritis patient education programs. In addition, we discuss implications of past studies for future practice.

Arthritis↗
PubMed1987

Efficacy of psychoeducational interventions on pain, depression, and disability in people with arthritis: a meta-analysis.

Meta-analysis is a technique which combines data from several properly and similarly designed controlled studies so as to increase the power of the relevant statistical analysis. Fifteen studies on the effects of psychoeducational interventions on disability, pain and depression in individuals with chronic rheumatoid arthritis or osteoarthritis were analyzed by this method. The results indicate that patient education can indeed contribute to improving the health status of such patients.

Adult↗