Enhancing Self-Management: The Importance of Patient/Provider Interactions, Adaptive Work and Adaptive Leadership

2.50
Hdl Handle:
http://hdl.handle.net/10755/304425
Category:
Abstract
Type:
Presentation
Title:
Enhancing Self-Management: The Importance of Patient/Provider Interactions, Adaptive Work and Adaptive Leadership
Author(s):
Anderson, Ruth A.; Bailey, Donald E.
Lead Author STTI Affiliation:
Beta Epsilon
Author Details:
Ruth A. Anderson, RN, PhD, ruth.anderson@duke.edu; Donald E. Bailey, PhD, RN;
Abstract:

Session presented on: Friday, July 26, 2013

Purpose: Treatment for chronic hepatitis C had changed dramatically because of a blood test for a genetic polymorphism near the interleukin 28B gene and two new protease inhibitors that enhance treatment response.  The polymorphism is a strong predictor of cure for patients with genotype 1 infection.  However, the protease inhibitors add complexity and worsen symptoms compared to prior treatments. This study explored how providers share the genetic information and examined how genetic information influence patents’ self-management (SM) of symptoms during treatment.  The adaptive leadership framework was used to describe patient-provider relationships by distinguishing between technical work (done by provider), adaptive work (done by the patient) and adaptive leadership and how these promoted or posed barriers to patients’ SM in the context of the genetic marker.

Methods: In a mixed-methods longitudinal case study (n=8), we interviewed patients and providers immediately after the index encounter, followed by patient telephone-interviews over 12-weeks (8 data collection points). We analyzed interviews using open coding and theme identification.  We collected quantitative scores on self-management, illness perception, symptoms, and viral load and these were analyzed with qualitative data to plot symptom trajectories in relation to SM and adaptive work.

Results: Adaptive challenges (e.g., fatigue, adherence, side effects) were overwhelming. Severity of symptoms fluctuated with patients’ adaptive capacity for SM.  Providers’ adaptive leadership strategies were limited primarily to raising the patients’ awareness of expected symptom challenges of treatment.  Providers focused on relaying technical information about medication and adherence.  Missed opportunities for assisting patients with adaptive work to improve self-management were evident.  Providers placed little emphasis on expected treatment response predicted by genotype.

 Conclusion: The study provided knowledge for developing interventions for enhancing adaptive leadership behaviors of providers that facilitate adaptive capacity of patients. System changes may be needed because too much information is transferred in the index encounter.

Keywords:
self-management; Adaptive Leadership; chronic hepitis C
Repository Posting Date:
22-Oct-2013
Date of Publication:
22-Oct-2013
Conference Date:
2013
Conference Name:
24th International Nursing Research Congress
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Prague, Czech Republic
Description:
24th International Nursing Research Congress Theme: Bridge the Gap Between Research and Practice Through Collaboration. Held at the Hilton Prague Hotel.
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleEnhancing Self-Management: The Importance of Patient/Provider Interactions, Adaptive Work and Adaptive Leadershipen_GB
dc.contributor.authorAnderson, Ruth A.en_GB
dc.contributor.authorBailey, Donald E.en_GB
dc.contributor.departmentBeta Epsilonen_GB
dc.author.detailsRuth A. Anderson, RN, PhD, ruth.anderson@duke.edu; Donald E. Bailey, PhD, RN;en_GB
dc.identifier.urihttp://hdl.handle.net/10755/304425-
dc.description.abstract<p>Session presented on: Friday, July 26, 2013</p><b>Purpose: </b>Treatment for chronic hepatitis C had changed dramatically because of a blood test for a genetic polymorphism near the interleukin 28B gene and two new protease inhibitors that enhance treatment response.  The polymorphism is a strong predictor of cure for patients with genotype 1 infection.  However, the protease inhibitors add complexity and worsen symptoms compared to prior treatments. This study explored how providers share the genetic information and examined how genetic information influence patents’ self-management (SM) of symptoms during treatment.  The adaptive leadership framework was used to describe patient-provider relationships by distinguishing between technical work (done by provider), adaptive work (done by the patient) and adaptive leadership<a href="/stti/congrs13/researchsymp/uploadabstract.cgi?RecordType=Paper&Recordid=56810&Hash=96547fe6a33589c6ec69498461d90609&step=6&StepEntry=1016-Paper56810&password=275278#_ENREF_7" title="Audulv, 2010 #47"></a> and how these promoted or posed barriers to patients’ SM in the context of the genetic marker. <p><b>Methods: </b>In a mixed-methods longitudinal case study (n=8), we interviewed patients and providers immediately after the index encounter, followed by patient telephone-interviews over 12-weeks (8 data collection points). We analyzed interviews using open coding and theme identification.  We collected quantitative scores on self-management, illness perception, symptoms, and viral load and these were analyzed with qualitative data to plot symptom trajectories in relation to SM and adaptive work. <p><b>Results: </b>Adaptive challenges (e.g., fatigue, adherence, side effects) were overwhelming. Severity of symptoms fluctuated with patients’ adaptive capacity for SM.  Providers’ adaptive leadership strategies were limited primarily to raising the patients’ awareness of expected symptom challenges of treatment.  Providers focused on relaying technical information about medication and adherence.  Missed opportunities for assisting patients with adaptive work to improve self-management were evident.  Providers placed little emphasis on expected treatment response predicted by genotype. <p> <b>Conclusion: </b>The study provided knowledge for developing interventions for enhancing adaptive leadership behaviors of providers that facilitate adaptive capacity of patients. System changes may be needed because too much information is transferred in the index encounter.en_GB
dc.subjectself-managementen_GB
dc.subjectAdaptive Leadershipen_GB
dc.subjectchronic hepitis Cen_GB
dc.date.available2013-10-22T20:35:38Z-
dc.date.issued2013-10-22-
dc.date.accessioned2013-10-22T20:35:38Z-
dc.conference.date2013en_GB
dc.conference.name24th International Nursing Research Congressen_GB
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen_GB
dc.conference.locationPrague, Czech Republicen_GB
dc.description24th International Nursing Research Congress Theme: Bridge the Gap Between Research and Practice Through Collaboration. Held at the Hilton Prague Hotel.en_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission.en_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.