The current study examines how organizational career management – i.e. activities undertaken by schools in order to plan and manage teachers’ careers – relates to teachers’ career self-management – i.e. teachers steering their careers by means of searching for opportunities, networking, or seeking supervisory support. Moreover, it examines the mediating roles of occupational self-efficacy and learning goal orientation in this relationship. Mediation analysis in SPSS, using the PROCESS macro of survey data from 220 Dutch secondary school teachers, showed that positive relationships between organizational career management and career self-management were mediated by occupational self-efficacy and learning goal orientation.
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Introduction: Self-management is considered a potential answer to the increasing demand for family medicine by people suffering from a chronic condition or multi-morbidity. A key element of self-management is goal setting. Goal setting is often defined as a moment of agreement between a professional and a patient. In the self-management literature, however, goal setting is regarded as a circular process. Still, it is unclear how professionals working in family medicine can put it into practice. This background paper aims to contribute to the understanding of goal setting within self-management and to identify elements that need further development for practical use. Debate: Four questions for debate emerge in this article: (1) What are self-management goals? (2) What is necessary to accomplish the process of goal setting within self-management? (3) How can professionals decide on the degree of support needed for goal setting within self-management? (4) How can patients set their goals and how can they be supported? Implications: Self-management goals can be set for different (life) domains. Using a holistic framework will help in creating an overview of patients’ goals that do not merely focus on medical issues. It is a challenge for professionals to coach their patients to think about and set their goals themselves. More insight in patients’ willingness and ability to set self-management goals is desirable. Moreover, as goal setting is a circular process, professionals need to be supported to go through this process with their patients.
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Patients diagnosed with esophageal cancer have to deal with the consequences, such as major impact on their physical status and quality of life. A digital self-management tool could be a solution to support these patients in their self-management during the peri-operative period. This dissertation resulted in a better understanding of patients' needs and desires for (digital) self-management support during pre- (and post-operative) care. In addition, a core set consisting of the most relevant topics for self-management was developed. Differences were found between esophageal cancer patients in their expectations and needs regarding self-management and eHealth for self-management support. It is important to apply a diversity of forms of support given the increased desire to provide person-centered care and the fact that no single approach will meet the needs of all patients at all times. The development of a new (digital) self-management intervention to support these patients can be based on the results of the various studies in this dissertation.
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This study explores the evaluation of research pathways of self-management health innovations from discovery to implementation in the context of practice-based research. The aim is to understand how a new process model for evaluating practice-based research provides insights into the implementation success of innovations. Data were collected from nine research projects in the Netherlands. Through document analysis and semi-structured interviews, we analysed how the projects start, evolve, and contribute to the healthcare practice. Building on previous researchevaluation approaches to monitor knowledge utilization, we developed a Research Pathway Model. The model’s process character enables us to include and evaluate the incremental work required throughout the lifespan of an innovation project and it helps to foreground that innovation continues during implementation in real-life settings. We found that in each researchproject, pathways are followed that include activities to explore a new solution, deliver a prototype and contribute to theory. Only three projects explored the solution in real life and included activities to create the necessary changes for the solutions to be adopted. These three projects were associated with successful implementation. The exploration of the solution in a real-life environment in which users test a prototype in their own context seems to be a necessaryresearch activity for the successful implementation of self-management health innovations.
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Background Literature on self-management innovations has studied their characteristics and position in healthcare systems. However, less attention has been paid to factors that contribute to successful implementation. This paper aims to answer the question: which factors play a role in a successful implementation of self-management health innovations? Methods We conducted a narrative review of academic literature to explore factors related to successful implementation of self-management health innovations. We further investigated the factors in a qualitative multiple case study to analyse their role in implementation success. Data were collected from nine self-management health projects in the Netherlands. Results Nine factors were found in the literature that foster the implementation of self-management health innovations: 1) involvement of end-users, 2) involvement of local and business partners, 3) involvement of stakeholders within the larger system, 4) tailoring of the innovation, 5) utilisation of multiple disciplines, 6) feedback on effectiveness, 7) availability of a feasible business model, 8) adaption to organisational changes, and 9) anticipation of changes required in the healthcare system. In the case studies, on average six of these factors could be identified. Three projects achieved a successful implementation of a self-management health innovation, but only in one case were all factors present. Conclusions For successful implementation of self-management health innovation projects, the factors identified in the literature are neither necessary nor sufficient. Therefore, it might be insightful to study how successful implementation works instead of solely focusing on the factors that could be helpful in this process.
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Objective: Self-management is a core theme within chronic care and several evidence-based interventions (EBIs) exist to promote self-management ability. However, these interventions cannot be adapted in a mere copy-paste manner. The current study describes and demonstrates a planned approach in adapting EBI’s in order to promote self-management in community-dwelling people with chronic conditions. Methods: We used Intervention Mapping (IM) to increase the intervention’s fit with a new context. IM helps researchers to take decisions about whether and what to adapt, while maintaining the working ingredients of existing EBI’s. Results: We present a case study in which we used IM to adapt EBI’s to the Flemish primary care context to promote self-management in people with one or more chronic disease. We present the reader with a contextual analysis, intervention aims, and content, sequence and scope of the resulting intervention. Conclusion: IM provides an excellent framework in providing detailed guidance on intervention adaption to a new context, while preserving the essential working ingredients of EBI’s. Practice Implications: The case study is exemplary for public health researchers and practitioners as a planned approach to seek and find EBI’s, and to make adaptations.
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Abstract Aim: To gain insight into the relationship between self-management abilities (taking initiatives, investment behaviour, variety, multifunctionality, self-efficacy, positive frame of mind) and physical, psychological and social frailty. Design: A cross-sectional study. Methods: 145 community-dwelling older people receiving home-care completed a questionnaire on sociodemographic factors, the Self-Management-Ability-Scale and the Tilburg Frailty Indicator. After determining correlations, sequential multiple linear regression analyses were executed. Results: All self-management abilities are negatively associated with physical frailty; five (except multifunctionality) are negatively associated with psychological frailty. Variety in resources and positive frame of mind are negatively associated with social frailty. Sociodemographic characteristics, chronic diseases and self-management abilities together significantly explain participants’physical (34.9%), psychological (21.4%) and social (43.9%) frailty. After controlling for sociodemographic characteristics and chronic diseases, the self-management abilities together significantly explain 11 per cent of psychological and 6.8 per cent of social frailty. Having a positive frame of mind significantly negatively influences social frailty.
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Background: Self-management support is considered an important component in the physiotherapeutic treatment of people with chronic low back pain. The stratified blended physiotherapy intervention e-Exercise Low Back Pain is an example of a self-management intervention. More insight may contribute to improving blended interventions to stimulate self-management after treatment and thus hopefully prevent chronicity and/or relapses in patients with chronic low back pain. Objectives: The aim of this study was to gain an in-depth understanding of the self-management behaviour after a physiotherapist guided blended self-management intervention in people with chronic low back pain. Design: A qualitative study with semi-structured interviews nested within a randomized controlled trial on the (cost-)effectiveness of e-Exercise Low Back Pain was conducted. Method: Thematic analysis was used to analyse the transcriptions. A hybrid process of both deductive and inductive approaches was used. Results: After 12 interviews, data saturation was reached. Analysis of the data yielded six themes related to self-management behaviour: illness beliefs, coping, cognitions, social support and resource utilization, physiotherapeutic involvement and motivation. Conclusions: In our study the majority of the participants seemed to show adequate self-management behaviour when experiencing low back pain. Most participants first try to gain control over their low back pain themselves when experiencing a relapse before contacting the physiotherapist. Participants struggle in continuing health behaviour in pain free periods between relapses of low back pain. Physiotherapists are recommended to encourage long-term behaviour change. Additionally, better facilitation by the physiotherapist or additional functionalities in the app to stimulate social support might have a useful contribution.
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Objective: To examine the underlying factor structure and psychometric properties of the Assessment of Self-management in Anxiety and Depression (ASAD) questionnaire, which was specifically designed for patients with (chronic) anxiety and depressive disorders. Moreover, this study assesses whether the number of items in the ASAD can be reduced without significantly reducing its precision. Methods: The ASAD questionnaire was completed by 171 participants across two samples: one sample comprised patients with residual anxiety or depressive symptoms, while the other consisted of patients who have been formally diagnosed with a chronic anxiety or depressive disorder. All participants had previously undergone treatment. Both exploratory (EFA) and confirmatory factor analyses (CFA) were conducted. Internal consistency and test–retest reliability were also assessed. Results: Both EFA and CFA indicated three solid factors: Seeking support, Daily life strategies and Taking ownership [Comparative Fit Index = 0.80, Tucker Lewis Index = 0.78, Root Mean Square Error of Approximation = 0.09 (CI 0.08–1.00), Standardized Root Mean Square Residual = 0.09 ($2 = 439.35, df = 168)]. The ASAD was thus reduced from 45 items to 21 items, which resulted in the ASAD-Short Form (SF). All sub-scales had a high level of internal consistency (> a = 0.75) and test–retest reliability (ICC > 0.75). Discussion: The first statistical evaluation of the ASAD indicated a high level of internal consistency and test–retest reliability, and identified three distinctive factors. This could aid patients and professionals’ assessment of types of self-management used by the patient. Given that this study indicated that the 21-item ASAD-SF is appropriate, this version should be further explored and validated among a sample of patients with (chronic or partially remitted) anxiety and depressive disorders. Alongside this, to increase generalizability, more studies are required to examine the English version of the ASAD within other settings and countries.
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