Enhancing Autonomy and Self-Management Behaviors Through a Patient-Centered Communication Program for Older Adults with Hypertension: A Randomized Controlled Trial
Keywords:
Autonomy, Hypertension, Older adults, Patient-centered communication, Randomized controlled trial, Self-management behaviorsAbstract
Autonomy and self-management behaviors are crucial for people living with any chronic disease and need to be enhanced. This randomized control trial tested the effectiveness of the Patient-centered Communication Program for improving autonomy and self-management behaviors among Thai older adults with hypertension. Sixty participants receiving care at a medical out-patient department in a university hospital in Northern Thailand were randomly assigned equally using the permuted block design into an experiment group (n = 30) who received the program and a control group (n = 30) who received only the regular communication care. Data were collected before, immediately after, and three months after the program using the Maastricht Personal Autonomy Questionnaire, and Self-Management Behaviors Questionnaire. Data were analyzed using one-way and two-way repeated measures ANOVA and independent sample t-test.
The findings revealed that the autonomy and self-management behaviors of participants in the experimental group immediately post-intervention and 3 months after were significantly higher than the control group after the intervention. It can be concluded that this patientcentered communication program was beneficial for older adults with hypertension. Although the program needs further testing and possible refinement, it has potential for nurses and other health professionals to implement this program to encourage older adults with hypertension to take an active role in their care and continuously help themselves to control their hypertension.
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20. Lee AA, Piette JD, Heisler M, Janevic MR, Rosland AM. Diabetes self-management and glycemic control: the role of autonomy support from informal health supporters. Health Psychol. 2019; 38(2): 122-32. doi: 10.1037/hea0000710.
21. Bae EJ, Kim, YH. Mediation effects of basic psychological needs between autonomy support from healthcare providers and self-management among cancer survivors. Osong Pub Health Res Persp. 2019; 10(6): 365-93. doi: 10. 24171/ j.phrp.
22. Mahoney FI, Barthel DW. Functional evaluation: the Barthel Index. Md State Med J. 1965; 14: 61-5. doi: 10.1097/PHM.0b013e3182466162.
23. Kahn RL, Goldfarb AI, Pollack M, Peck A. Brief objective measures for the determination of mental status in the aged. Am J Psych. 1960; 117: 326-8. doi: 10.1176/ajp.117.4.326.
24. Mars GM, Eijk JT, Post MW, Proot IM, Mesters I, Kempen GI. Development and psychometric properties of the Maastricht Personal Autonomy Questionnaire (MPAQ) in older adults with a chronic physical illness. Qual Life
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25. World Health Organization. Process of translation and adaptation of instruments [Internet]. WHO, 2016. [cited 2018 Jan 8]. Available from: http://www.who.int/substance_abuse/research_tools/translation/en/
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27. Jutterstrom L, Hornsten A, Sandstrom H, Stenlund H, Isaksson U. Nurse-led patient-centered self-management support improves HbA1c in patients with type 2 diabetes A randomized study. Patient Educ Couns. 2016; 99(11): 1821-29. doi: 10.1016/j.pec.2016.06.016.
28. Beverly EA, Worley MF, Court AB, Prokopakis KE, Ivanov NN. Patient-physician communication and diabetes self-care. J Commun Healthc. 2016; 23(11): 509-18. doi.org/10.1177/1742395318782378.
29. Liu SL, Na HY, Li WH, Yun QP, Jiang XW, Liu JN, Chang C. Effectiveness of self-management behavior intervention on type 2 diabetes based on self-determination theory. Beijing Da Xue Xue Bao Yi Xue Ban. 2018; 18;50(3): 474-81
(in Chinese) PMID: 29930416.
30. Koponen A, Simonsen N, Suominen S. Quality of primary health care and autonomous motivation for effective diabetes self-management among patients with type 2 diabetes [Internet]. Health Psychol. 2017 [cited 2018 Jan 8]. A vailable from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5438041/pdf/10.1177_2055102917707181.pdf. Doi: 10.1177/2055102917707181
31. Najafi S S, Shaabani M, Momennassab M, Aghasadeghi K. The nurse-led telephone follow-up on medication and dietary adherence among patients after myocardial infarction: a randomized controlled clinical trial. Int J Comm Based
Nurs Mid. 2016; 4(3): 199–208. https:// www.ncbi.nlm. nih.gov/pmc/articles/ PMC4925999/ PMID: 27382586
32. Becker TAC , Teixeira CRS , Zanetti ML, Pace AE, Almeida FA, Torquato TCG. Effects of supportive telephone counseling in the metabolic control of elderly people with diabetes mellitus. Rev Bras Enferm [Internet]. 2017 [cited 2018 Sep 18].
Available from: https://www.scielo.br/pdf/reben/v70n4/0034-7167-reben-70-04-0704.pdf. Doi: 10.1590/0034-7167-2017-0089
2. Department of Disease Control. Situation on NCDs prevention and control in Thailand. Nonthaburi: Ministry of Public Health [Internet]. 2017 [cited 2017 Dec 23]. Available from: http://bps.moph.go.th/new_bps/sites/default/files/
stratistics 60.pdf (in Thai)
3. Foundation of Gerontology Research and Development Institute and Institute for Population and Social Research. Situation of the Thai Elderly 2015l [Internet]. [cited 2018 Jan 8]. Available from: https://thaitgri.org/?wpdmpro=situationof-
the-thai-elderly-20174 (in Thai)
4. Thongtang P, Seesawang J. Taking care of myself: role of self-care in management of hypertension among Thai older adults with hypertension. Science Intern. (Lahore). 2018; 30(2):143-7. http:// www.sci- int.com/pdf/ 6365878
47215194248. edited-5%20IPN.pdf
5. Ryan RM, Deci EL. Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. Health Psychol. 2000; 55:68-78. https://selfdetermination theory.org/SDT/documents/2000_RyanDeci_SDT.pdf
6. Robinson SA, Zocchi MS, Netherton D, Ash A, Purington CM, Connolly SL, Vimalananda VG, Hogan TP, Shimada SL. Secure messaging, diabetes self-management, and the Importance of patient autonomy: a mixed methods study. J Gen Intern Med. 2020; 35(10): 2955-62. doi: 10. 1007/s11606-020-05834-x.
7. Johnson KR, McMorris BJ, MapelLentz S, Scal P. Improving self-management skills through patient-centered communication. J Adolesc Health. 2015; 57(6):666-72. doi: 10.1016/j.jadohealth.2015.08.009.
8. Keea JWY, Khoob HS , Limb I, Kohc MYH. Communication skills in patient-doctor interactions: learning from patient complaints. J Contin Educ Health Prof. 2018; 4(2): 97-106. doi.org/10.1016/j.hpe.2017.03.006.
9. Skar L, Soderberg S. Patients’ complaints regarding healthcare encounters and communication. Nurs Open. 2018; 5(2):224–32. doi: 10.1002/nop2.132.
10. Epstein RM, Franks P, Fiscella K, Shields CG, Meldrum SC, Kravitz RL, Duberstein PR. Measuring patient-centered communication in patient-physician consultations: theoretical and practical issues. Soc Sci Med. 2005; 61(7): 1516-28. doi: 10.1016/j.socscimed.2005.02.001.
11. Cegala DJ, Post DM, McClure L. The effects of patient communication skills training on the discourse of older patients during a primary care interview. J Am Geriatr Soc. 2001; 49(11): 1505-11. doi: 10.1046/j.1532-5415. 2001.4911244.x.
12. Creer LT. Self-management of chronic illness. Handbook of self-regulation. California: Academic; 2000, pp. 601-29. doi.org/10.1016/B978-012109890-2/50047-0.
13. Lorig KR, Holman H. Self-management education: history, definition, outcomes and mechanisms. Ann Behav Med. 2003; 26: 1-7. doi: 10.1207/S15324796ABM2601_01.
14. Naik AD, Dyer CB, Kunik ME, McCullough LB. Patient autonomy for the management of chronic conditions: a two-component re-conceptualization. Am J Bioeth. 2009; 9(2): 23-30. doi: 10.1080/15265160802654111.
15. Gardener L, Desha L, Bourke-Taylor H, Ziviani J. Responsibility sharing for adolescents with type 1 diabetes: a scoping review. Chron Illness [Internet]. 2020 [cited 2020 Jan 8]. Available from: https://Doi.org/10.1177/1742395320959406
16. Karlsen B, Oftedal B, Lie SS, Rokne B, Peyrot M, Zoffmann V, Graue M. Assessment of a web-based guided selfdetermination intervention for adults with type 2 diabetes in general practice: a study protocol [Internet]. BMJ. 2016 [cited 2019 Dec 23]. Available from: https://bmjopen. bmj.com/content/bmjopen/6/12/e013026.full.pdf. doi:10.1136/bmjopen-2016- 013026.
17. Ryan RM, Deci EL. Self-regulation and the problem of human autonomy: does psychology need choice, self-determination, and will? J Pers. 2006; 74(6):1557-85. https://self determinationtheory.org/SDT/documents/2006_Ryan Deci_Self-RegulationProblemofHumanAutonomy.pdf
18. Anh, DTT, Shih YW, Miao NF, Liao YM, Chuang YH, Chang HJ, et al. Differences of self-management in controlling blood pressure between patients with hypertension and healthy people in Vietnam. POJ Nurs Prac & Res. 2017; 1(1):1-8. doi:10.32648/2577-9516/1/1/004.
19. Karamched KR, Hao W, Song PX, Carpenter L, Steinberg J, Baptist AP. The impact of patient autonomy on older adults with asthma. Ann Allergy Asthma Immunol. 2018; 121(1): 65‐8. doi:org/10.1016/j.anai.2018.04.024.
20. Lee AA, Piette JD, Heisler M, Janevic MR, Rosland AM. Diabetes self-management and glycemic control: the role of autonomy support from informal health supporters. Health Psychol. 2019; 38(2): 122-32. doi: 10.1037/hea0000710.
21. Bae EJ, Kim, YH. Mediation effects of basic psychological needs between autonomy support from healthcare providers and self-management among cancer survivors. Osong Pub Health Res Persp. 2019; 10(6): 365-93. doi: 10. 24171/ j.phrp.
22. Mahoney FI, Barthel DW. Functional evaluation: the Barthel Index. Md State Med J. 1965; 14: 61-5. doi: 10.1097/PHM.0b013e3182466162.
23. Kahn RL, Goldfarb AI, Pollack M, Peck A. Brief objective measures for the determination of mental status in the aged. Am J Psych. 1960; 117: 326-8. doi: 10.1176/ajp.117.4.326.
24. Mars GM, Eijk JT, Post MW, Proot IM, Mesters I, Kempen GI. Development and psychometric properties of the Maastricht Personal Autonomy Questionnaire (MPAQ) in older adults with a chronic physical illness. Qual Life
Res. 2014; 23(6): 1777-87. doi: 10.1007/s11136-013-0619.
25. World Health Organization. Process of translation and adaptation of instruments [Internet]. WHO, 2016. [cited 2018 Jan 8]. Available from: http://www.who.int/substance_abuse/research_tools/translation/en/
26. Epstein RM. Duberstein PR, Fenton JJ, Fiscella K, Hoerger M, Tancredi DJ, et al. Effect of a patient-centered communication intervention on oncologist-patient communication, quality of life, and health care utilization in advanced cancer: the
VOICE randomized clinical trial. JAMA Oncol. 2017; 3(1): 92-100. doi: 10.1001/jamaoncol.2016.4373.
27. Jutterstrom L, Hornsten A, Sandstrom H, Stenlund H, Isaksson U. Nurse-led patient-centered self-management support improves HbA1c in patients with type 2 diabetes A randomized study. Patient Educ Couns. 2016; 99(11): 1821-29. doi: 10.1016/j.pec.2016.06.016.
28. Beverly EA, Worley MF, Court AB, Prokopakis KE, Ivanov NN. Patient-physician communication and diabetes self-care. J Commun Healthc. 2016; 23(11): 509-18. doi.org/10.1177/1742395318782378.
29. Liu SL, Na HY, Li WH, Yun QP, Jiang XW, Liu JN, Chang C. Effectiveness of self-management behavior intervention on type 2 diabetes based on self-determination theory. Beijing Da Xue Xue Bao Yi Xue Ban. 2018; 18;50(3): 474-81
(in Chinese) PMID: 29930416.
30. Koponen A, Simonsen N, Suominen S. Quality of primary health care and autonomous motivation for effective diabetes self-management among patients with type 2 diabetes [Internet]. Health Psychol. 2017 [cited 2018 Jan 8]. A vailable from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5438041/pdf/10.1177_2055102917707181.pdf. Doi: 10.1177/2055102917707181
31. Najafi S S, Shaabani M, Momennassab M, Aghasadeghi K. The nurse-led telephone follow-up on medication and dietary adherence among patients after myocardial infarction: a randomized controlled clinical trial. Int J Comm Based
Nurs Mid. 2016; 4(3): 199–208. https:// www.ncbi.nlm. nih.gov/pmc/articles/ PMC4925999/ PMID: 27382586
32. Becker TAC , Teixeira CRS , Zanetti ML, Pace AE, Almeida FA, Torquato TCG. Effects of supportive telephone counseling in the metabolic control of elderly people with diabetes mellitus. Rev Bras Enferm [Internet]. 2017 [cited 2018 Sep 18].
Available from: https://www.scielo.br/pdf/reben/v70n4/0034-7167-reben-70-04-0704.pdf. Doi: 10.1590/0034-7167-2017-0089
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2021-09-02
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Audthiya P, Pothiban L, Panuthai S, Chintanawat R. Enhancing Autonomy and Self-Management Behaviors Through a Patient-Centered Communication Program for Older Adults with Hypertension: A Randomized Controlled Trial. PRIJNR [Internet]. 2021 Sep. 2 [cited 2024 Dec. 22];25(4):525-38. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/253312
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