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A new theory to promote self-management of symptom clusters and healthcare quality in patients with decompensated cirrhosis

Patients with decompensated cirrhosis, a symptomatic phase of cirrhosis, commonly experience multiple symptoms concurrently, referred to as symptom clusters. Effective self-management of symptoms is known to improve outcomes in various chronic diseases. However, a theory for self-management of sympt...

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Autores principales: Liu, Zhen, Luo, Ling, Zhang, Yunzhi, Chen, Rong, Liu, Anlin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10470793/
https://www.ncbi.nlm.nih.gov/pubmed/37653778
http://dx.doi.org/10.1097/MD.0000000000034595
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author Liu, Zhen
Luo, Ling
Zhang, Yunzhi
Chen, Rong
Liu, Anlin
author_facet Liu, Zhen
Luo, Ling
Zhang, Yunzhi
Chen, Rong
Liu, Anlin
author_sort Liu, Zhen
collection PubMed
description Patients with decompensated cirrhosis, a symptomatic phase of cirrhosis, commonly experience multiple symptoms concurrently, referred to as symptom clusters. Effective self-management of symptoms is known to improve outcomes in various chronic diseases. However, a theory for self-management of symptom clusters in decompensated cirrhosis is lacking. In this study, we applied grounded theory research methodology to construct a new theory of self-management of symptom clusters in these patients. This qualitative study prospectively enrolled 20 patients with decompensated cirrhosis within 1 week after hospital admission. Data related to patients’ experiences, needs, perspectives, and abilities related to their symptoms were collected via a semi-structured, in-depth interview and analyzed with Nvivo version 20 software. Grounded theory methodology with 3 coding steps (open, axial, and selective coding) was applied to generate a theory of self-management of symptom clusters. From the step-by-step coding process, 2 core categories or major themes were identified: patients’ experiences with symptoms and coping with symptoms. The first major theme included symptom clustering, multidimensionality, recurrence, and specificity, while the second consisted of endogenous motivation, endogenous resistance, and external support needs. A new theory of self-management of symptom clusters was then constructed and delineated to enhance self-management among patients with decompensated cirrhosis. Using patient experience data, we developed a new theory of self-management of symptom clusters in patients with decompensated cirrhosis. Use of this theory has the potential to promote patient self-management and guide healthcare providers in planning optimal treatments and implementing timely interventions, ultimately improving in patient outcomes.
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spelling pubmed-104707932023-09-01 A new theory to promote self-management of symptom clusters and healthcare quality in patients with decompensated cirrhosis Liu, Zhen Luo, Ling Zhang, Yunzhi Chen, Rong Liu, Anlin Medicine (Baltimore) Research Article: Observational Study Patients with decompensated cirrhosis, a symptomatic phase of cirrhosis, commonly experience multiple symptoms concurrently, referred to as symptom clusters. Effective self-management of symptoms is known to improve outcomes in various chronic diseases. However, a theory for self-management of symptom clusters in decompensated cirrhosis is lacking. In this study, we applied grounded theory research methodology to construct a new theory of self-management of symptom clusters in these patients. This qualitative study prospectively enrolled 20 patients with decompensated cirrhosis within 1 week after hospital admission. Data related to patients’ experiences, needs, perspectives, and abilities related to their symptoms were collected via a semi-structured, in-depth interview and analyzed with Nvivo version 20 software. Grounded theory methodology with 3 coding steps (open, axial, and selective coding) was applied to generate a theory of self-management of symptom clusters. From the step-by-step coding process, 2 core categories or major themes were identified: patients’ experiences with symptoms and coping with symptoms. The first major theme included symptom clustering, multidimensionality, recurrence, and specificity, while the second consisted of endogenous motivation, endogenous resistance, and external support needs. A new theory of self-management of symptom clusters was then constructed and delineated to enhance self-management among patients with decompensated cirrhosis. Using patient experience data, we developed a new theory of self-management of symptom clusters in patients with decompensated cirrhosis. Use of this theory has the potential to promote patient self-management and guide healthcare providers in planning optimal treatments and implementing timely interventions, ultimately improving in patient outcomes. Lippincott Williams & Wilkins 2023-08-25 /pmc/articles/PMC10470793/ /pubmed/37653778 http://dx.doi.org/10.1097/MD.0000000000034595 Text en Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC) (https://creativecommons.org/licenses/by-nc/4.0/) , where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal.
spellingShingle Research Article: Observational Study
Liu, Zhen
Luo, Ling
Zhang, Yunzhi
Chen, Rong
Liu, Anlin
A new theory to promote self-management of symptom clusters and healthcare quality in patients with decompensated cirrhosis
title A new theory to promote self-management of symptom clusters and healthcare quality in patients with decompensated cirrhosis
title_full A new theory to promote self-management of symptom clusters and healthcare quality in patients with decompensated cirrhosis
title_fullStr A new theory to promote self-management of symptom clusters and healthcare quality in patients with decompensated cirrhosis
title_full_unstemmed A new theory to promote self-management of symptom clusters and healthcare quality in patients with decompensated cirrhosis
title_short A new theory to promote self-management of symptom clusters and healthcare quality in patients with decompensated cirrhosis
title_sort new theory to promote self-management of symptom clusters and healthcare quality in patients with decompensated cirrhosis
topic Research Article: Observational Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10470793/
https://www.ncbi.nlm.nih.gov/pubmed/37653778
http://dx.doi.org/10.1097/MD.0000000000034595
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