Motors of influenza vaccination uptake and vaccination advocacy in healthcare workers:Development and validation of two short scales

Healthcare workers (HCWs) are an important priority group for vaccination against influenza, yet, flu vaccine uptake remains low among them. Psychosocial studies of HCWs’ decisions to get vaccinated have commonly drawn on subjective expected utility models to assess predictors of vaccination, assuming HCWs’ choices result from a rational information-weighing process. By contrast, we recast those decisions as a commitment to vaccination and we aimed to understand why HCWs may want to (rather than believe they need to) get vaccinated against the flu. This article outlines the development and validation of a 9-item measure of cognitive empowerment towards flu vaccination (MoVac-flu scale) and an 11-item measure of cognitive empowerment towards vaccination advocacy. Both scales were administered to 784 frontline NHS HCWs with direct patient contact between June 2014 and July 2015. The scales exhibited excellent reliability and a clear unidimensional factor structure. An examination of the nomological network of the cognitive empowerment construct in relation to HCWs’ vaccination against the flu revealed that this construct was distinct from traditional measures of risk perception and the strongest predictor of HCWs’ decisions to vaccinate. Similarly, cognitive empowerment in relation to vaccination advocacy was a strong predictor of HCWs’ engagement with vaccination advocacy. These findings suggest that the cognitive empowerment construct has important implications for advancing our understanding of HCWs’ decisions to vaccinate as well as their advocacy behavior

Guidelines for Facilitating a Patient Empowerment Program

The traditional medical treatment model often ignores the emotional, spiritual, social, and cognitive aspects of living with a chronic disease such as diabetes. Empowerment programs address these psychosocial areas by helping individuals develop skills and self-awareness in goal setting, problem solving, stress management, coping, social support, and motivation. Although many diabetes educators have been taught to use an empowerment curriculum to facilitate self-management, there is minimal research concerning the actual process of providing such programs to patients. We evaluated an empowerment curriculum (Empowerment: A Personal Path to Self-Care) with a diverse group of individuals with diabetes to determine the key elements of planning and implementing a successful diabetes patient empowerment program.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68728/2/10.1177_014572179502100408.pd

Development and content validation of a questionnaire measuring patient empowerment in cancer follow-up

Purpose: The aim of this study was to develop and ensure the content validity of a new patient-reported outcome measure, the Cancer Patient Empowerment Questionnaire (CPEQ), to measure the level of, desire for, and enablement of empowerment among cancer patients in follow-up. Methods: An iterative process based on: (i) empowerment theories by Zimmerman and Tengland, (ii) a systematic review of questionnaires measuring empowerment or related concepts among cancer patients, (iii) qualitative data from 18 semi-structured interviews with Danish cancer patients in follow-up, (iv) input from a group of eight cancer patients involved as co-researchers and from an expert steering group, and (v) cognitive interviews with 15 cancer patients in follow-up. Results: The items for the CPEQ were developed and revised and 12 versions of the questionnaire were evaluated. The final version consists of 67 items, covering three different dimensions of empowerment: (A) empowerment outcomes consisting of three components: (A1) the intrapersonal-, (A2) interactional-, and (A3) behavioral component, (B) empowerment facilitators (enablement), and (C) the value of empowerment. Conclusions: This study documents the theoretical and empirical basis for the development of the CPEQ and its content validity. The CPEQ provides a tool for researchers to assess the level of, desire for, and enablement of empowerment among cancer patients. The next steps will be to use the CPEQ in a nationwide study of empowerment in cancer follow-up and subsequently shorten the CPEQ based on psychometric methods in order to make it more relevant in clinical studies

Presence and rehabilitation: toward second-generation virtual reality applications in neuropsychology

Virtual Reality (VR) offers a blend of attractive attributes for rehabilitation. The most exploited is its ability to create a 3D simulation of reality that can be explored by patients under the supervision of a therapist. In fact, VR can be defined as an advanced communication interface based on interactive 3D visualization, able to collect and integrate different inputs and data sets in a single real-like experience. However, "treatment is not just fixing what is broken; it is nurturing what is best" (Seligman & Csikszentmihalyi). For rehabilitators, this statement supports the growing interest in the influence of positive psychological state on objective health care outcomes. This paper introduces a bio-cultural theory of presence linking the state of optimal experience defined as "flow" to a virtual reality experience. This suggests the possibility of using VR for a new breed of rehabilitative applications focused on a strategy defined as transformation of flow. In this view, VR can be used to trigger a broad empowerment process within the flow experience induced by a high sense of presence. The link between its experiential and simulative capabilities may transform VR into the ultimate rehabilitative device. Nevertheless, further research is required to explore more in depth the link between cognitive processes, motor activities, presence and flow

Model of Empowerment to Improve Autonomy Directly Observed Treatment (DOT) Tuberculosis Patients

Empowerment as not yet optimal health promotion efforts done to enhance the autonomy of Directly Observed Treatment (DOT), which affect the success of the recovery of patients with pulmonary tuberculosis. The purpose of research was to develop a model empowerment based on Health Promotion and Health Literacy with approach to nursing intervention in an effort enhance the autonomy of the DOT - pulmonary TB patients. The method was an observational analytic with cross sectional approach. Multistage random sampling was DOT-pulmonary TB patients to decide the district and simple random sampling was assigned to choose the participants, a total of 253 DOT- pulmonary TB patients new case with acid resistant bacilli positive on the advanced phase in this study. The study conducted in five districts in Surabaya City (center, north, south, east and west). Data were collected by questionnaire on variables namely personal, cognitive and affective, nursing intervention, commitment, family supports, health literacy and DOT- autonomy. Structural Equation Modeling (SEM) with LISREL is used for constructing predictive model. Result : This study found a new model which was developed based on combination of Health Promotion Model (HPM) and Health Literacy (HL). Statistical result confirm that personal, cognitive and affective, health literacy and family support considered as important factors in improving DOT-autonomy. Conclusion : DOT- autonomy will improve by considering four main factors, personal, cognitive and affective, health literacy, family support. This model can be adapted by District Health Office Surabaya City as the main actor regional health development. In addition, this model may become a reference for other district in improving their nursing intervention in community setting

Trust, choice and power in mental health

The original publication is available at www.springerlink.co

Empowerment or Engagement? Digital Health Technologies for Mental Healthcare

We argue that while digital health technologies (e.g. artificial intelligence, smartphones, and virtual reality) present significant opportunities for improving the delivery of healthcare, key concepts that are used to evaluate and understand their impact can obscure significant ethical issues related to patient engagement and experience. Specifically, we focus on the concept of empowerment and ask whether it is adequate for addressing some significant ethical concerns that relate to digital health technologies for mental healthcare. We frame these concerns using five key ethical principles for AI ethics (i.e. autonomy, beneficence, non-maleficence, justice, and explicability), which have their roots in the bioethical literature, in order to critically evaluate the role that digital health technologies will have in the future of digital healthcare

A psychological approach to providing self-management education for people with type 2 diabetes : the diabetes manual

Background: The objectives of this study were twofold (i) to develop the Diabetes Manual, a selfmanagement educational intervention aimed at improving biomedical and psychosocial outcomes (ii) to produce early phase evidence relating to validity and clinical feasibility to inform future research and systematic reviews. Methods: Using the UK Medical Research Council's complex intervention framework, the Diabetes Manual and associated self management interventions were developed through preclinical, and phase I evaluation phases guided by adult-learning and self-efficacy theories, clinical feasibility and health policy protocols. A qualitative needs assessment and an RCT contributed data to the pre-clinical phase. Phase I incorporated intervention development informed by the preclinical phase and a feasibility survey. Results: The pre-clinical and phase I studies resulted in the production in the Diabetes Manual programme for trial evaluation as delivered within routine primary care consultations. Conclusion: This complex intervention shows early feasibility and face validity for both diabetes health professionals and people with diabetes. Randomised trial will determine effectiveness against clinical and psychological outcomes. Further study of some component parts, delivered in alternative combinations, is recommended

The Health Empowerment Program: A Primary Care – Area Agency on Aging Partnership

Educational Objectives 1. Appreciate the benefits of a primary care-area agency on aging collaboration. 2. Identify strategies for enhancing this cross-organizational partnership