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Chronic Illness

Shams Rahman, Abu-Sayeef Mirza, Deanna Wathington, Shikerria Green, Yeshuwa Mayers, Elhaam Iranmanesh, Laurie Woodard
OBJECTIVES: Uninsured patients represent an understudied population. The current study aimed to estimate the burden of 10 common chronic conditions and to investigate the associated factors among patients who use free clinics for their health care needs. METHODS: Patient charts from four free clinics were reviewed from January to December of 2015. Proportion of prevalence, adjusted odds ratios (AOR), and 95% confidence intervals (CI) for associations between participant characteristics and chronic conditions are reported...
February 19, 2019: Chronic Illness
Merja Sallinen, Anne Marit Mengshoel
OBJECTIVES: The purpose of the study was to explore the impact of perceived cognitive problems on daily life in men with fibromyalgia. METHOD: The data were collected through life-story interviews of eight men with fibromyalgia. Narrative analysis was conducted to create model narratives that comprise the content and storylines across the data. RESULTS: Three model narratives are presented in the findings to describe the scope and severity of the cognitive problems...
December 26, 2018: Chronic Illness
Kylie J McKenzie, David Pierce, Stewart W Mercer, Jane M Gunn
OBJECTIVES: To examine whether motivational interviewing is used by GPs in consultations with patients living with mental-physical multimorbidity. METHODS: Secondary analysis of selected videos from an existing database of routine general practice consultations with adult patients in Glasgow, Scotland. Consultations involving patients with mental-physical multimorbidity were selected and coded using the Motivational Interviewing Treatment Integrity (MITI) coding system...
December 22, 2018: Chronic Illness
Anne B Arreskov, Anette H Graungaard, Mads T Kristensen, Jens Søndergaard, Annette S Davidsen
OBJECTIVES: Due to a growing population with both cancer and chronic diseases, we explored patients' experiences of living with a cancer diagnosis and comorbidities, the possible effects on everyday living and management of comorbidities. METHODS: Semi-structured interviews were conducted during 2016 with 15 patients in Denmark, with finished cancer treatment and preexisting comorbidities. Analysis was performed by Systematic Text Condensation. RESULTS: Symptoms which disrupted everyday function were given attention, regardless of the disease from which the symptoms originated...
December 11, 2018: Chronic Illness
Pernille Ravn Jakobsen, Anne Pernille Hermann, Jens Søendergaard, Uffe Kock Wiil, Charlotte Myhre Jensen, Jane Clemensen
OBJECTIVES: Women diagnosed with asymptomatic osteoporosis need better support to understand the implications of the condition and how to practice self-management in their daily lives. In contrast, physicians report that asymptomatic osteoporosis is not a serious chronic condition and do not pay much attention to the condition compared to other chronic conditions. Therefore, the aim of this study was to investigate the gap between women's needs, when diagnosed with asymptomatic osteoporosis, and what is provided by the healthcare system...
December 10, 2018: 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
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
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
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
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