7 results on '"Selzler, Anne-Marie"'
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2. Implementation and maintenance of an enhanced pulmonary rehabilitation program in a single centre: An implementation study.
- Author
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van der Braak, Kim, Wald, Joshua, Tansey, Catherine M., Paes, Thais, Sedeno, Maria, Selzler, Anne-Marie, Stickland, Michael K., Bourbeau, Jean, and Janaudis-Ferreira, Tania
- Abstract
Background: Pulmonary rehabilitation (PR) has major benefits for patients with chronic obstructive pulmonary disease (COPD). An enhanced PR program was developed with a self-management education intervention. The objective of our study was to evaluate the implementation of the enhanced PR program into a single centre. Methods: Pre-post implementation study consisted of two evaluation periods: immediately after implementation and 18 months later. Guided by the RE-AIM framework, outcomes included: Reach, Effectiveness, Adoption, Implementation and Maintenance. Results: Reach: 70-75% of referred patients agreed to a PR program (n = 26). Effectiveness: Clinically important improvements occurred in some patients in functional exercise capacity (64% of the patients achieved clinical important difference in 6-min walk test in the first evaluation period and 44% in the second evaluation period), knowledge, functional status, and self-efficacy in both evaluation periods. Adoption: All healthcare professionals (HCPs) involved in PR (n = 8) participated. Implementation: Fidelity for the group education sessions ranged from 76 to 95% (first evaluation) and from 82 to 88% (second evaluation). Maintenance: The program was sustained over 18 months with minor changes. Patients and HCPs were highly satisfied with the program. Conclusions: The enhanced PR program was accepted by patients and HCPs and was implemented and maintained at a single expert center with good implementation fidelity. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
3. An experimental assessment of the influence of exercise versus social implementation intentions on physical activity during and following pulmonary rehabilitation
- Author
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Rodgers, Wendy M., Selzler, Anne-Marie, Haennel, Robert G., Holm, Siri, Wong, Eric Y. L., and Stickland, Michael K.
- Published
- 2014
- Full Text
- View/download PDF
4. Evaluation of an Enhanced Pulmonary Rehabilitation Program: A Randomized Controlled Trial.
- Author
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Selzler, Anne-Marie, Jourdain, Tina, Wald, Joshua, Sedeno, Maria, Janaudis-Ferreira, Tania, Goldstein, Roger, Bourbeau, Jean, and Stickland, Michael K.
- Subjects
RESPIRATORY diseases ,MEDICAL rehabilitation ,HEALTH outcome assessment ,PHYSICAL activity ,SELF-managed learning (Personnel management) ,RESEARCH ,EXERCISE tolerance ,RESEARCH methodology ,MEDICAL cooperation ,EVALUATION research ,SELF-efficacy ,COMPARATIVE studies ,RANDOMIZED controlled trials ,QUALITY of life ,OBSTRUCTIVE lung diseases ,EXERCISE - Abstract
Rationale: Pulmonary rehabilitation (PR) is the most effective strategy to improve health outcomes in people with chronic obstructive pulmonary disease (COPD), although it has had limited success in promoting sustained physical activity. PR with a strong focus on disease self-management may better facilitate long-term behavior change. Objectives: To compare a newly developed enhanced PR (EPR) program with a traditional PR program on outcome achievement. Methods: In this randomized parallel-group controlled trial, PR classes were block-randomized to EPR or traditional PR and were delivered over 16 sessions each. The EPR program incorporated new and updated "Living Well with COPD" education modules, which had a stronger focus on chronic disease self-management. Fidelity of the intervention for content and delivery was assessed. Physical activity, self-efficacy, exercise tolerance, and health-related quality of life (HRQoL) were collected before, after, and 6 months after PR. Healthcare visits were collected 2 years before PR and 1 year after. Mortality was recorded 1 year after PR. Results: Of the 207 patients with COPD enrolled, 108 received EPR and 99 received traditional PR. Physical activity (steps) and self-efficacy improved from before to after PR in both programs, with no differences between groups. These effects were not sustained at 6 months. Exercise tolerance and HRQoL improved from before to after PR with no between-group differences and were maintained at 6 months. Visits to primary care providers and respiratory specialists decreased in the EPR program relative to the traditional PR program. EPR was delivered as intended, and there was no meaningful cross-contamination between the two programs. Conclusions: Enhancing PR to have a greater emphasis on chronic disease self-management did not result in a superior improvement of physical activity and health outcomes compared with traditional PR except for reduced resource usage from primary and specialist physician visits in the EPR program.Clinical trial registered with ClinicalTrials.gov (NCT02917915). [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
5. Self-efficacy in Patients with Chronic Obstructive Pulmonary Disease
- Author
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Selzler, Anne-Marie
- Subjects
- disease management, vicarious experience, modeling, pulmonary rehabilitation, self-efficacy, chronic obstructive pulmonary disease, physical activity, exercise
- Abstract
Abstract: Self-efficacy, defined as behaviour specific confidence, is a consistent correlate of physical activity and other health behaviours. In people with Chronic Obstructive Pulmonary Disease (COPD), self-efficacy has been found to be related to key clinical-health outcomes and is deemed an important contributor to disease self-management. The purpose of this dissertation was to (i) contribute to the understanding of how pulmonary rehabilitation (PR) and vicarious experiences (i.e., observing someone) impact self-efficacy types among patients with COPD, and (ii) examine the relationships of several different types of self-efficacy (i.e., task self-efficacy for exercise, coping self-efficacy for exercise, scheduling self-efficacy for exercise, coping self-efficacy for breathlessness, and walking self-efficacy) to clinical-health and behavioural outcomes: functional exercise capacity, health status, and physical activity. In study 1 (Chapter 2), self-efficacy increased as much or more with PR in COPD patients recently hospitalized for an acute exacerbation of COPD (AECOPD) compared to COPD patients without a recent AECOPD (stable COPD). Among the AECOPD patients, PR delivered within one month or between three and four months after an AECOPD did not impact the amount of improvement in self-efficacy observed. Study 1 also found that among both AECOPD and stable patients self-efficacy for walking was a superior predictor of all clinical-health and behavioural outcomes than self-efficacy for managing breathlessness. Additionally, the association between self-efficacy and physical activity was stronger among stable COPD patients compared to AECOPD patients at both pre- and post-PR. In Chapter 3, a two-part pilot study examined salient exercise-model characteristics to COPD patients and examined patient experiences with cardiopulmonary exercise tests (CPET). The results of this study informed the creation of the intervention evaluated in study 3 (Chapter 4), which examined the effects of coping and mastery model interventions on self-efficacy for walking and exercise (i.e., task self-efficacy for exercise, coping self-efficacy for exercise, scheduling self-efficacy for exercise, coping self-efficacy for breathlessness) in patients with COPD within the context of a CPET. Both the coping and mastery intervention conditions were found to enhance all types of self-efficacy, with the coping condition more strongly enhancing coping self-efficacy for exercise than the mastery condition. Coping self-efficacy for exercise was also the type of self-efficacy that was most strongly related to physical activity in patients with COPD the week following contact. The findings of this dissertation support the delivery of PR in both AECOPD and stable COPD patients and suggest that AECOPD and stable COPD patients may have different salient challenges/needs in PR which should be addressed accordingly. This dissertation highlights the role of self-efficacy within PR environments and provides insight into intervention content that may improve clinical-health and behavioural outcomes among people with COPD.
- Published
- 2018
6. Relationships between Self-Talk Characteristics, Social Cognitive Constructs, and Pulmonary Rehabilitation Outcomes
- Author
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Selzler, Anne-Marie
- Subjects
- Beliefs, Self-talk, Pulmonary rehabilitation, Exercise, Cognition
- Abstract
Abstract: Background: Exercise cognitions and beliefs are key associates of exercise behaviour. Self-talk is an intrapersonal communication system that may be a useful technique for studying exercise-related beliefs in pulmonary rehabilitation (PR) patients. The purpose of this research was to determine the relationships for self-talk, social-cognition, and clinical indicators in PR. Method: The following measures were assessed in 78 PR patients during the first two weeks of PR: the 6-minute walk test, St. George’s Respiratory Questionnaire, Exercise Self-talk Questionnaire, Self-talk Function Scale, and Social-Cognitive Questionnaire. Results: Moderate correlations were found for self-talk, cognition, and clinical indicator relationships that varied by gender. Self-efficacy, perceived severity, perceived difficulty, and personal physical evaluation self-talk had the strongest relationships to cognitions, and clinical indicators. Conclusions: Self-talk is related to social-cognitive constructs, health status, lung function, and functional exercise capacity in PR patients. Gender differences may be due to functional ability differences or gendered socialization experiences.
- Published
- 2013
7. Peer educator vs. respiratory therapist support: Which form of support better maintains health and functional outcomes following pulmonary rehabilitation?
- Author
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Wong, Eric Y., Jennings, Cally A., Rodgers, Wendy M., Selzler, Anne-Marie, Simmonds, Lindsay G., Hamir, Rashida, and Stickland, Michael K.
- Subjects
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PEERS , *RESPIRATORY therapists , *HEALTH outcome assessment , *MEDICAL rehabilitation , *QUESTIONNAIRES , *FOLLOW-up studies (Medicine) , *OBSTRUCTIVE lung diseases - Abstract
Abstract: Objective: This study examined if ongoing support delivered by telephone following pulmonary rehabilitation (PR) assisted chronic obstructive pulmonary disease (COPD) patients to maintain health outcomes. Methods: Phase one (n =79) compared post-rehabilitation telephone-based support delivered by peers compared to usual care (UC). The second phase (n =168) compared post-rehabilitation support from peer educators, respiratory therapists (RT), or UC. Primary outcome variables were St. George's Respiratory Questionnaire (SGRQ) total score and the six minute walk test (6MWT). Measures were obtained at baseline, immediately following PR, and six-months post PR. Results: Six-month follow-up data for phase one was collected for 66 COPD patients (n =35 peer support, n =31 UC) and 142 for phase two (n =42 peer support, n =52 RT support, n =48 UC). Per-protocol and intention to treat (ITT) analysis in both phases found no significant group by time differences for SGRQ or 6MWT. Conclusion: Providing peer or RT support via telephone following PR was not more effective than UC for maintaining health outcomes. Practice implications: There are concerns with using peers to provide ongoing support to COPD patients. Additionally, COPD patients require a higher level of care than telephone support can provide. [Copyright &y& Elsevier]
- Published
- 2014
- Full Text
- View/download PDF
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