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Chronic Illness

Justin T McDaniel, Robert J McDermott, Mary P Martinasek, Robin M White
Objective We sought to determine variables associated with asthma among children from military and non-military families. Methods We performed secondary data analysis on the 2016 Behavioral Risk Factor Surveillance System. Parents with and without military experience ( n = 61,079) were asked whether a child ever had asthma and currently has asthma. We used two multiple logistic regression models to determine the influence of rurality and geographic region on "ever" and "current" asthma in children of military and non-military families, while controlling for socio-demographic and behavioral variables...
October 18, 2018: Chronic Illness
Alexandra Gray-Renfrew, Barbara Kimbell, Anne Finucane
Introduction Patients with advanced liver disease live mainly in the community with treatment of complications provided for in-hospital. The illness trajectory of advanced liver disease is uncertain and most do not have access to end of life care. Gaps in knowledge and understanding of the patient experience of this condition have been identified. Methods Secondary analysis of 15 transcripts from in-depth interviews with people with advanced liver disease collected as part of a previous longitudinal study on the experience of liver disease...
October 4, 2018: Chronic Illness
Kimberly R Powell, Chelsea Deroche
Objective To explore predictors of portal use by patients (registered portal users) with multiple chronic conditions according to demographic characteristics and use of specific features hypothesized to support self-management. Methods Two data sources were used in this analysis: electronic health records and 12 months of data from web server log files. Patients ( n = 500) included in the analysis were 45 years or older, registered portal users, and diagnosed with at least two chronic conditions. We fit a negative binomial regression model to predict portal use (number of logins) based on practice size and location, demographic characteristics, and use of specific portal features (secure messaging and patient-entered data)...
October 4, 2018: Chronic Illness
Guy Fagherazzi, Clélia Chambraud, Courtney Dow, Francesca Romana Mancini, Aurélie Affret, Beverley Balkau, Dianna J Magliano, Marie-Christine Boutron-Ruault, Fabrice Bonnet
Objectives Identification of characteristics associated with a negative experience with type 2 diabetes may help to develop novel intervention to improve the outlook of people with the disease. Our aim was to identify determinants of a self-reported concerned vision about the future when living with type 2 diabetes. Methods In 2630 women with type 2 diabetes from the E3N-AfterDiab study, we used multivariable logistic regression models to derive odds-ratios and 95% confidence intervals. Results Women with elevated HbA1c levels (OR = 2...
October 3, 2018: Chronic Illness
J P Real, M C Lafuente, S D Palma, L I Tártara
Objectives To estimate the direct medical costs associated with the management of patients with primary open-angle glaucoma and to compare the costs of patients according to the degree of severity. Methods A longitudinal retrospective study was carried out using all patients with primary open-angle glaucoma that recorded follow-up from May 2010 to June 2013 at the Hospital Privado de Córdoba. We estimated the cost of the disease from the perspectives of the institution, with a bottom-up approach. Results The three-year follow-up after treatment of 104 patients revealed that the average cost of care for a patient with primary open-angle glaucoma was US$2746 ± 1560...
September 30, 2018: Chronic Illness
Nicole Saxby, Sean Beggs, Nadish Kariyawasam, Malcolm Battersby, Sharon Lawn
Objectives To determine whether evidence-based practice guidelines promote developmentally appropriate chronic condition self-management for children with asthma, type 1 diabetes mellitus, and cystic fibrosis. Methods Systematic review of clinical guidelines current as at 22 September 2017, including assessment of quality of each guideline using the iCAHE 'Guideline Quality Checklist', and mapping of the supporting evidence. Results Fifteen guidelines were identified: asthma ( n=7) and type 1 diabetes mellitus ( n=7), CF ( n=1)...
September 23, 2018: Chronic Illness
Lorna M West, Ruth Borg Theuma, Maria Cordina
Objective The 'Necessity-Concerns Framework' is an important framework which can support healthcare professionals in targeting patients' medication beliefs and decisions on adherence. Our aim was to determine how the interdependence of 'necessity' and 'concerns' beliefs for medication adherence compares across three chronic conditions. Methods Patients diagnosed with asthma, cardiovascular conditions or diabetes attending out-patient clinics completed a self-administered questionnaire. The questionnaire gathered information regarding demographics, medication adherence using the 'Tool for Adherence Behaviour Screening', presence of unused medication in households and medication beliefs using the 'Beliefs about Medicines Questionnaire-Specific'...
September 20, 2018: Chronic Illness
Lea An Christoffersen, Anne K Hansen, Regitze As Pals, Ingrid Willaing, Volkert Siersma, Kasper Olesen
Objective To assess the effect of a participatory group-based education programme for individuals with type 2 diabetes, Next Education. Method In a quasi-experimental study, individuals with type 2 diabetes were recruited from 14 Danish municipalities with a patient education programme. Eight municipalities using Next Education were intervention sites; six control sites used usual group-based education programmes. Data were collected through questionnaires at baseline and at 3 and 12 months after programmes ended...
September 18, 2018: Chronic Illness
Alexandra B Ryborg Joensson, Ann Dorrit Guassora, Morten Freil, Susanne Reventlow
Objectives Adherence to treatment has proven to require the involvement of patients in treatment and care planning. This process involves incorporating patient knowledge, or knowledge about the patients' everyday life, into the clinical encounter. This article explores the disclosure practices of such knowledge from older adults with multimorbidity. Methods This was an 18-month qualitative study among 14 older adults with multimorbidity living in Denmark. A thematic analysis was applied, focusing on perceptions of patient knowledge and disclosure practices among the participating patients...
September 13, 2018: Chronic Illness
Rachel Schwartz, Donna Zulman, Caroline Gray, Mary K Goldstein, Ranak Trivedi
Objectives Parkinson's disease presents an evolving challenge for patients and families due to an unpredictable disease trajectory and symptoms that complicate social interactions. In this study, we explore neurologists' perspectives on the challenges Parkinson's disease presents for families and the strategies they use to improve communication and quality of life. Methods We conducted hour-long semi-structured interviews with 16 neurologists at 4 care delivery institutions in the San Francisco Bay Area, focusing on techniques neurologists use to support families through the Parkinson's disease journey...
September 12, 2018: Chronic Illness
George W Koutsouras, Kimberly Levine, Nathalie Duroseau, Christina Ciraco, Vivian Chan, Kathleen Pergament, Thomas Chan, Jayme D Mancini, Adena N Leder, Bhuma Krishnamachari
Objectives There is limited literature describing the effect exercise may have on depression and an individual's health-related quality of life (HRQoL) in Parkinson's Disease (PD). We aim to quantify this effect. Methods A cross-sectional questionnaire was administered to 60 PD subjects. The Parkinson's Disease Questionnaire-39 (PDQ-39) summary index and the Geriatric Depression Scale-30 were used to quantify HRQoL and depression, respectively. Data were obtained on exercise habits. ANOVA and multivariate linear regression analysis were used to calculate mean differences in HRQoL...
September 5, 2018: Chronic Illness
Allison R Heid, Andrew R Gerber, David S Kim, Stefan Gillen, Seran Schug, Rachel Pruchno
Objectives Over two-thirds of older individuals live with multiple chronic conditions, yet chronic diseases are often studied in silos. Taking a lifespan approach to understanding the development of multiple chronic conditions in the older population helps to further elucidate opportunities for targeted interventions that address the complexities of multiple chronic conditions. Methods Semi-structured interviews were conducted with 38 older adults (age 64+) diagnosed with at least two chronic health conditions...
September 4, 2018: Chronic Illness
Helen Francis, Jenny Carryer, Jill Wilkinson
Objectives The study aimed to explore how people with complex, established co-morbidities experience long-term condition care in New Zealand. Despite the original conception as appropriate for people with early stage disease, in New Zealand the self-management approach dominates the care provided to people at all stages of diagnosis with long-term conditions, something reinforced through particular funding mechanisms. Methods A multiple case study followed the lives of 16 people with several long-term conditions...
August 31, 2018: Chronic Illness
Riana Rahmawati, Beata Bajorek
Objectives This study assessed medication adherence and hypertension knowledge, and their predictive factors, in people with hypertension, living in rural communities in Indonesia. Methods Data were acquired from 384 people living in eight rural villages via a researcher-administered questionnaire, a validated adherence scale, and a standardized hypertension knowledge survey. Multivariate analysis was used to identify the predictors of adherence and knowledge. Results Fifty-nine (15%) participants had good hypertension knowledge (score ≥ 8 out of 10)...
September 2018: Chronic Illness
Zephanie Tyack, Suzanne Kuys, Petrea Cornwell, Kerrie-Anne Frakes, Steven M McPhail
Objective To evaluate the reproducibility, longitudinal validity, and interpretability of the disease burden morbidity assessment in people with chronic conditions including multimorbidity. Methods The study was conducted using a longitudinal cohort design. A large consecutive sample of adult patients at an Australian community-based rehabilitation service was included with testing at baseline and three-month follow-up (testing longitudinal validity and interpretability). A smaller subsample of patients completed a one-week test-retest (testing reproducibility)...
August 13, 2018: Chronic Illness
David Hevey, Jennifer Wilson O'Raghallaigh, Veronica O'Doherty, Katie Lonergan
Objectives The Chronic Disease Self-Management Program (CDSMP) is a standardized self-management intervention for patients with various chronic diseases. CDSMP provides self-management skills to enhance patient health, well-being, and coping skills. The present study evaluates the effectiveness of CDSMP delivered in routine clinical services on health, health behaviors and healthcare utilization in patients with various chronic illnesses. Methods A pragmatic single group pre-post design evaluated the effectiveness of the CDSMP in an Irish cohort using self-report data collected by service providers in hospital, community health and patient organizations...
August 8, 2018: Chronic Illness
Dan Grabowski, Tue Helms Andersen
Objectives In families living with type 2 diabetes, relatives have a significantly heightened risk of developing the disease. In many families, both the person with type 2 diabetes and his/her relatives lack detailed knowledge about this risk. One obstacle to constructive intra-familial prevention and risk reduction is the lack of perceived familial disease relevance. The objective of the present study is to explore barriers to prevention in families with at least one adult with type 2 diabetes. Methods Data were gathered during eight problem assessment and ideation workshops with families...
August 4, 2018: Chronic Illness
Jane McCusker, Mark Yaffe, Sylvie D Lambert, Martin Cole, Manon de Raad, Eric Belzile, Antonio Ciampi, Ella Amir, Marcela Hidalgo
Objectives To describe unmet needs of caregivers of hospitalized older adults during the transition from hospital back home, and identify subgroups with different needs. Methods Patients and family caregivers were recruited from an acute care hospital in Montreal, Canada. Measures included Instrumental Activities of Daily Living (IADL), Hospital Anxiety and Depression Scale (HADS), Zarit burden scale, and Family Inventory of Needs. Dimensions of unmet needs were explored with principal component analysis; regression tree models were used to identify subgroups with different unmet needs...
August 4, 2018: Chronic Illness
Stephen Hughes, Sophie Lewis, Karen Willis, Anne Rogers, Sally Wyke, Lorraine Smith
Objectives Increasing self-management skills in people with long-term conditions is widely advocated in policies and guidelines. Group programmes are a common format; yet, how self-management support objectives are enacted in their delivery is poorly understood. Our aim is to explore the perspectives of group programme facilitators. Methods We undertook thematic analysis of transcribed data from in-depth semi-structured interviews with health professional facilitators (n = 13) from six diverse self-management support group programmes (of obesity, diabetes and chronic obstructive pulmonary disease)...
August 1, 2018: Chronic Illness
N Schwennesen, A Barghadouch, K Olesen
Aims The aim of this study was to investigate health literacy and self-care among visually impaired people with type 1 diabetes in Denmark. Methods Survey data from 1425 Danes with type 1 diabetes were categorised in two groups according to visual status: visually impaired ( n = 38) and sighted ( n = 1387). Using the Health Literacy Questionnaire and the Summary of Diabetes Self-Care Activities Scale, health literacy and self-care activities were assessed. Visually impaired respondents were compared to sighted respondents using t-tests and chi-squared tests...
July 28, 2018: Chronic Illness
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