Das Selbstmanagement-Modell der Flinders University

Please note: this article is in German.Ein australisches Modell zur Unterstützung von Selbstmanagement bei chronisch erkrankten Patienten verhilft Ärzten zu einer neuen Rolle. Arzt und Patient begründen eine Partnerschaft, wobei der Patient Entscheidungen trifft und der Arzt sich als Moderator, Coach und Berater versteht. Das Flinders-Modell wird bereits bei Patienten mit ganz unterschiedlichen Erkrankungen erfolgreich angewandt

Capabilities for supporting prevention and chronic condition self-management: a resource for educators of primary health care professionals

The Australian Government Department of Health and Ageing, through the Australian Better Health Initiative (ABHI), determined that education and training of the existing and future health workforce was a key element in assisting patients to better manage their chronic conditions. To begin to build an understanding of what this education and training might entail, two separate but related projects were conducted. These projects aimed to (a) develop a curriculum framework for self-management support education of the future workforce, and (b) determine the skills required for prevention and self-management support of chronic conditions by the current PHC workforce

Gender by Preferred Gambling Activity in Treatment Seeking Problem Gamblers: A Comparison of Subgroup Characteristics and Treatment Outcomes

Author version made available following 12 month embargo from date of publication [April 25 2016] in accordance with publisher copyright policy. The final publication is available at Springer via http://dx.doi.org/10.1007/s10899-016-9614-x.Background: Problem gambling is a growing public health concern and treatment incompletion levels remain high. The study aims to support and extend previous studies in relation to the heterogeneity of the gambling population based on gender and gambling type, and the implications of subgroup differences on treatment outcomes. Additionally, the concept of drop-out is addressed in terms of categorical treatment measures. The empirical findings are examined in the context of the theoretical framework of the pathways model. Methods: Participants were recruited from the Statewide Gambling Therapy Service and stratified into subgroups based on gender and gambling mode preference (Electronic Gambling Machines [EGM] or track race betters). Baseline predictors collected and analysed using multinomial logistical regression included demographic information as well as gambling variables, while treatment outcomes consisted of three therapist rated measures. Results: Significant differences between the subgroups were found for age, marital and employment status, gambling duration, alcohol use and the Kessler 10 measure of psychological distress. Specifically, male track race gamblers were younger, married, employed, had a longer duration of gambling, higher alcohol use and lower psychological distress relative to EGM users. No difference was found in any of the treatment outcomes, however, consistent with previous studies, all subgroups had high treatment incompletion levels. Conclusion: The findings demonstrate the importance of screening, assessing and treating problem gamblers as a heterogeneous group with different underlying demographics and psychopathologies. It is also hoped future studies will continue to address treatment incompletion with a re-conceptualisation of the term drop-out

Health workers’ views of a program to facilitate physical health care in mental health settings: implications for implementation and training

Author version made available in accordance with the publisher's policyObjective Physical co morbidities shorten the lifespans of people with severe mental illness. Mental health clinicians need to support service users in risk factor-related behaviour change. We investigated mental health care workers’ views of a physical health self-management support program to identify implementation requirements. Method Qualitative interviews were conducted with workers who had differing levels of experience with a self-management support program. Themes were identified using interpretive descriptive analysis and then matched against domains used in implementation models to draw implications for successful practice change. Results Three main themes related to (i) understandings of disease management within job roles (ii) requirements for putting self-management support into practice and (iii) challenges of coordination in disease management. Priority domains from implementation models were inner and outer health service settings. Conclusion While staff training is required, practice change for care which takes account of both mental and physical health also requires changes in organisational frameworks

The internal consistency and construct validity of the Partners in Health scale: validation of a patient rated chronic condition self-management measure

The purpose of this study was to test the internal consistency and construct validity of the revised 12-item self-rated Partners in Health (PIH) scale used to assess patients' chronic condition self-management knowledge and behaviours. The PIH scale exhibits construct validity and internal consistency. It therefore is both a generic self-rated clinical tool for assessing self-management in a range of chronic conditions as well as an outcome measure to compare populations and change in patient self-management knowledge and behaviour over time. The four domains of self-management provide a valid measure of patient competency in relation to the self-management of their chronic condition

Does gender moderate the subjective measurement and structural paths in behavioural and cognitive aspects of gambling disorder in treatment-seeking adults?

© 2014. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/ .Highlights - We assess for gender differences in conceptualising gambling symptoms. - We model urge and cognition paths to gambling disorder moderated by gender. - Gambling symptom constructs were equally salient between men and women. - Men reported stronger levels of urge and interpretive bias. Abstract Introduction Gender differences have been observed in the pathogenesis of gambling disorder and gambling related urge and cognitions are predictive of relapse to problem gambling. A better understanding of these mechanisms concurrently may help in the development of more directed therapies. Methods We evaluated gender effects on behavioural and cognitive paths to gambling disorder from self-report data. Participants (N = 454) were treatment-seeking problem gamblers on first presentation to a gambling therapy service between January 2012 and December 2014. We firstly investigated if aspects of gambling related urge, cognitions (interpretive bias and gambling expectancies) and gambling severity were more central to men than women. Subsequently, a full structural equation model tested if gender moderated behavioural and cognitive paths to gambling severity. Results Men (n = 280, mean age = 37.4 years, SD = 11.4) were significantly younger than women (n = 174, mean age = 48.7 years, SD = 12.9) (p < 0.001). There was no gender difference in conceptualising latent constructs of problem gambling severity, gambling related urge, interpretive bias and gambling expectancies. The paths for urge to gambling severity and interpretive bias to gambling severity were stronger for men than women and statistically significant (p < 0.001 and p = 0.004, respectively) whilst insignificant for women (p = 0.164 and p = 0.149, respectively). Structural paths for gambling expectancies to gambling severity were insignificant for both men and women. Conclusion This study detected an important signal in terms of theoretical mechanisms to explaining gambling disorder and gender differences. It has implications for treatment development including relapse prevention