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Kew CL, Washington TR, Bergeron CD, Merianos AL, Sherman LD, Goidel K, Smith ML. Caregiver strain among non-Hispanic Black and Hispanic male caregivers with self-reported chronic health conditions. ETHNICITY & HEALTH 2023; 28:1161-1177. [PMID: 37312247 DOI: 10.1080/13557858.2023.2222341] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 06/02/2023] [Indexed: 06/15/2023]
Abstract
OBJECTIVES Caregiver strain often stems from unmet needs and is a risk factor for poor physical and psychological health. This study aims to identify factors associated with caregiver strain among middle-aged and older non-Hispanic Black and Hispanic male caregivers living with one or more chronic conditions. DESIGN Data were analyzed from 418 male caregivers collected through Qualtrics Online Panels using an internet-delivered survey instrument (55.7% non-Hispanic Black, 44.3% Hispanic). Three ordinal regression models were fitted to assess factors associated with Caregiver Strain Scale tertiles: one for all men, one for non-Hispanic Black men only; and one for Hispanic men only. RESULTS Similarities and differences were observed between the two groups in terms of factors associated with higher caregiver strain (i.e. lower disease self-management efficacy scores, providing ≥20 h of care per week). Uniquely for Non-Hispanic Black male caregivers, higher caregiver strain was associated with living with more children under the age of 18 (β = 0.35, P = 0.011) and feeling more socially disconnected (β = 0.41, P = 0.008). Uniquely for Hispanic male caregivers, higher caregiver strain levels were associated with experiencing lower pain levels (β = -0.14, P = 0.040) and higher fatigue levels (β = 0.23, P < 0.001). CONCLUSION Findings from this study suggest that non-Hispanic Black and Hispanic men with chronic conditions have differing caregiving experiences. While bolstering social connectedness and caregiver support services may offset caregiver strain, tailored mental health and disease management programming are needed to meet the specific needs of non-Hispanic Black and Hispanic male caregivers.
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Affiliation(s)
- Chung Lin Kew
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX, USA
- Center for Community Health and Aging, School of Public Health, Texas A&M University, College Station, TX, USA
| | | | | | - Ashley L Merianos
- School of Human Services, University of Cincinnati, Cincinnati, OH, USA
| | - Ledric D Sherman
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX, USA
- Center for Health Equity and Evaluation Research, School of Public Health, Texas A&M University, College Station, TX, USA
| | - Kirby Goidel
- Public Policy Research Institute & Department of Political Science, Texas A&M University, College Station, TX, USA
| | - Matthew Lee Smith
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX, USA
- Center for Community Health and Aging, School of Public Health, Texas A&M University, College Station, TX, USA
- Center for Health Equity and Evaluation Research, School of Public Health, Texas A&M University, College Station, TX, USA
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Sherman LD, Cisneros-Franco CL, Prochnow T, Patterson MS, Johannes BL, Alexander J, Merianos AL, Bergeron CD, Smith ML. Personal Agency and Social Supports to Manage Health Among Non-Hispanic Black and Hispanic Men With Diabetes. Am J Mens Health 2023; 17:15579883231211057. [PMID: 38032066 PMCID: PMC10691323 DOI: 10.1177/15579883231211057] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 10/05/2023] [Accepted: 10/09/2023] [Indexed: 12/01/2023] Open
Abstract
The prevalence of type 2 diabetes (T2D) is increasing among non-Hispanic Black and Hispanic communities, especially among men who develop this chronic condition at earlier ages. Personal agency and social support are vital aspects to diabetes management. However, less is known about the relationship between these variables among men living with diabetes. The purposes of this study were to identify (1) levels of personal agency to manage health, (2) sources of social supports to manage health based on personal agency levels, and (3) factors associated with lower personal agency to manage health. Cross-sectional data from non-Hispanic Black (n = 381) and Hispanic (n = 292) men aged 40 years or older with T2D were collected using an internet-delivered questionnaire. Three binary logistic regression models were fitted to assess sociodemographics, health indicators, and support sources associated with weaker personal agency to manage health. About 68% of participants reported having the strongest personal agency relative to 32.1% reporting weaker personal agency. Men who relied more on their spouse/partner (odds ratio [OR] = 1.22, p = .025), coworkers (OR = 1.59, p = .008), or faith-based organizations (OR = 1.29, p = .029) for ongoing help/support to improve their health and manage health problems were more likely to have weaker personal agency. Conversely, men who relied more on their health care providers for ongoing help/support to improve their health and manage health problems were less likely to have weaker personal agency to manage health (OR = 0.74, p < .001). Findings suggest personal agency may influence men's support needs to manage T2D, which may also be influenced by cultural, socioeconomics, and the composition of social networks.
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Affiliation(s)
- Ledric D. Sherman
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX, USA
- Center for Health Equity and Evaluation Research, Texas A&M University, College Station, TX, USA
| | | | - Tyler Prochnow
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX, USA
- Center for Health Equity and Evaluation Research, Texas A&M University, College Station, TX, USA
| | - Megan S. Patterson
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX, USA
| | | | - Janae Alexander
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX, USA
| | | | | | - Matthew Lee Smith
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX, USA
- Center for Health Equity and Evaluation Research, Texas A&M University, College Station, TX, USA
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Contextualizing the Chronic Care Model among Non-Hispanic Black and Hispanic Men with Chronic Conditions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063655. [PMID: 35329342 PMCID: PMC8951030 DOI: 10.3390/ijerph19063655] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 02/18/2022] [Accepted: 03/01/2022] [Indexed: 02/01/2023]
Abstract
Middle-aged and older men of color with chronic conditions have low utilization of preventive health services. In the context of the Chronic Care Model (CCM), the objective of this study was to identify perceptions about being informed, activated patients and having productive interactions in healthcare settings among non-Hispanic Black and Hispanic middle-aged and older men with chronic health conditions in the United States. Using an internet-based survey deployed nationally using a Qualtrics panel, data were collected from a sample of non-Hispanic Black and Hispanic men aged 40 years and older with one or more self-reported chronic conditions (n = 2028). Chi-square tests and one-way ANOVAs were used to describe this national sample by race/ethnicity and age group (40–64 years and ≥65 years). Results suggest that most health-related factors differed more on age than by race/ethnicity. Younger age groups reported less preventive care, greater barriers to self-care, mental health issues, and risky behavior. Findings from this study provide insight into the health status and healthcare utilization of racial/ethnic men with one or more chronic conditions. Results may help inform prevention and treatment interventions for middle-aged and older men of color.
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Hayek S, Derhy S, Smith ML, Towne SD, Zelber-Sagi S. Patient satisfaction with primary care physician performance in a multicultural population. Isr J Health Policy Res 2020; 9:13. [PMID: 32213194 PMCID: PMC7098152 DOI: 10.1186/s13584-020-00372-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 03/19/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A key component of the quality of health care is patient satisfaction, particularly in regard to Primary Care Physician (PCP), which represents the first contact with health care services. Patient satisfaction is associated with ethnic, regional and socio-demographic differences, due to differences in service quality, patient-doctor communication, and the patient's perceptions. The aim of this study was to evaluate patients' satisfaction related to primary care physicians' (PCP) performance and to explore potential differences by ethnicity in a multicultural population. METHODS A national cross-sectional telephone survey was conducted, among a random sample of the Israeli population aged ≥25 years. Satisfaction level from performance of PCP was assessed using a validated questionnaire (30 items; 6 different domains). RESULTS The final sample included (n = 827 Jews; n = 605 Arabs, mean age 54.7(±14.9). In the adjusted logistic regression models, Arabs reported lower general satisfaction related to PCPs' performance as compared to Jews (adjusted odds ratio (AOR), 0.63; (95% CI: 0.40-0.98). Arabs reported lower satisfaction related to PCPs' performance across the following domains: communication skills (AOR, 0.42; 95% CI, 0.22-0.82); interpersonal manners (AOR, 0.37; 95% CI, 0.24-0.58); and time spent with the patients (AOR, 0.60; 95% CI, 0.43-0.85). CONCLUSIONS Jews and Arabs were very satisfied with PCPs' performance. However, there are ethnic differences in the extent of satisfaction level related to the performance of PCP. Satisfaction from PCPs' performance may be achieved by improving the communication skills of the PCP, encouraging interpersonal interaction between the PCP and the patient, and devoting more time to the patient during the visits.
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Affiliation(s)
- Samah Hayek
- School of Public Health, University of Haifa, Haifa, Israel. .,, Memphis, USA.
| | - Shany Derhy
- School of Public Health, University of Haifa, Haifa, Israel
| | - Mathew Lee Smith
- Center for Population Health and Aging, Texas A&M University, College Station, TX, 77843, USA.,Department of Environmental and Occupational Health, School of Public Health, Texas A &M University, College Station, TX, 77843, USA.,Department of Health Promotion and Behavior, College of Public Health, The University of Georgia, Athens, GA, 30602, USA
| | - Samuel D Towne
- Center for Population Health and Aging, Texas A&M University, College Station, TX, 77843, USA.,Department of Health Management and Informatics, University of Central Florida, Orlando, FL, 32816, USA.,Disability, Aging and Technology Faculty Cluster Initiative, University of Central Florida, Orlando, FL, 32816, USA
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Bartlett SJ, Lambert SD, McCusker J, Yaffe M, de Raad M, Belzile E, Ciampi A, Di Carlo M, Lyddiatt A. Self-management across chronic diseases: Targeting education and support needs. PATIENT EDUCATION AND COUNSELING 2020; 103:398-404. [PMID: 31575442 DOI: 10.1016/j.pec.2019.08.038] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 07/27/2019] [Accepted: 08/27/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES Among Canadian adults with chronic disease: 1) to identify groups that differ in self-management task frequency and self-efficacy; 2) to compare group characteristics and preferences for self-management support. METHODS Using data from an online survey, cluster analysis was used to identify groups that differed in self-management task frequency and self-efficacy. Multivariable regression was used to explore relationships with patient characteristics and preferences. RESULTS Cluster analysis (n = 247) revealed three groups:Vulnerable Self-Managers (n = 55), with the highest task frequency and lowest self-efficacy; Confident Self-Managers (n = 73), with the lowest task frequency and highest self-efficacy; and Moderate Needs Self-Managers (n = 119), with intermediate task frequency and self-efficacy. Vulnerable Self-Managers, when compared with the Confident group, were more often: on illness-related employment disability or unemployed; less well educated; diagnosed with emotional problems or hypertension, and had greater multimorbidity. They participated less often in self-management programs, and differed in support preferences. CONCLUSIONS Knowing the characteristics of vulnerable self-managers can help in targeting those in greater need for self-management support that matches their preferences. PRACTICE IMPLICATIONS Different approaches are needed to support self-management in the vulnerable population.
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Affiliation(s)
- Susan J Bartlett
- Divisions of Clinical Epidemiology, Rheumatology and Respiratory Epidemiology and Clinical Trials Unit, McGill University, 5252 de Maisonneauve #3D.57, Montreal, QC, H4A 3S5, Canada; McGill University Health Centre, Centre for Outcomes Research and Evaluation, 5252 de Maisonneauve #3D.57, Montreal, QC, H4A 3S5, Canada.
| | - Sylvie D Lambert
- Ingram School of Nursing, McGill University, 680 Sherbrooke West, Suite 1800 Montreal, QC, H3A 2M7, Canada; St. Mary's Hospital Research Centre, Hayes Pavilion, 3830 Lacombe Ave, Suite 4720, Montreal, QC, H3T 1M5, Canada.
| | - Jane McCusker
- St. Mary's Hospital Research Centre, Hayes Pavilion, 3830 Lacombe Ave, Suite 4720, Montreal, QC, H3T 1M5, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Purvis Hall, 1020 Pine Ave West, Montreal, QC, H3A 1A2, Canada.
| | - Mark Yaffe
- St. Mary's Hospital Research Centre, Hayes Pavilion, 3830 Lacombe Ave, Suite 4720, Montreal, QC, H3T 1M5, Canada; Department of Family Medicine, McGill University, 5858 Chemin de la Côte-des-Neiges, Montreal, QC, H3S 1Z1, Canada; Family Medicine Centre, St. Mary's Hospital Center, Hayes Pavilion, 3830 Lacombe Ave, Montreal, QC, H3T 1M5, Canada
| | - Manon de Raad
- St. Mary's Hospital Research Centre, Hayes Pavilion, 3830 Lacombe Ave, Suite 4720, Montreal, QC, H3T 1M5, Canada.
| | - Eric Belzile
- St. Mary's Hospital Research Centre, Hayes Pavilion, 3830 Lacombe Ave, Suite 4720, Montreal, QC, H3T 1M5, Canada.
| | - Antonio Ciampi
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Purvis Hall, 1020 Pine Ave West, Montreal, QC, H3A 1A2, Canada.
| | - Mario Di Carlo
- Patient partner, Central Users' Committee, McGill University Health Centre, MUHC Users' Committee, Glen Site, Room D. 04. 7514, 1001 Décarie Blvd, Montreal, QC, H4A 3J1, Canada.
| | - Anne Lyddiatt
- Patient partner, Patient Partners in Arthritis, 393 University Avenue, Suite 1700, Toronto, ON, M5G 1E6, Canada.
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Factors Associated With Interest in Worksite Health-Related Discussions/Events Among Employed Adults With Chronic Conditions. J Occup Environ Med 2018; 59:e145-e149. [PMID: 28609354 DOI: 10.1097/jom.0000000000001059] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Worksite health promotion interventions have the potential to reach half of Americans nationally, but low participation rates hinder optimal intervention effectiveness. This study examines factors associated with employee interest in worksite health-related discussions/events. METHOD We analyzed cross-sectional survey data from a representative sample of employed adults in California with one or more chronic conditions. An ordinal regression model was developed. RESULTS Employees who reported more interest in worksite health-related discussions/events had higher coworkers support, perceived greater value from learning health-related knowledge and getting practical tips from others, and reported higher interest in health discussions/events held in community settings. CONCLUSION Efforts are needed to enhance the culture of worksite health and encourage communication and support among workers. Practitioners should consider connecting different settings to enhance reach and accessibility, and applying multiple delivery strategies to increase employee interest and engagement.
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Meek KP, Bergeron CD, Towne SD, Ahn S, Ory MG, Smith ML. Restricted Social Engagement among Adults Living with Chronic Conditions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E158. [PMID: 29351193 PMCID: PMC5800257 DOI: 10.3390/ijerph15010158] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 01/06/2018] [Accepted: 01/15/2018] [Indexed: 01/15/2023]
Abstract
Background: Social engagement is key to health and quality of life. Little is known about social engagement patterns of middle-aged and older adults who live with one or more chronic illnesses. This study investigated social engagement restrictions among middle-aged and older adults with chronic conditions and factors associated with these restrictions. Methods: Cross-sectional representative data from the National Council on Aging Chronic Care Survey were examined for relationships between social engagement restrictions and chronic conditions, health status, support, quality of life implications, self-care barriers, caregiving, and demographics. Associations were tested using bivariate analyses and binary logistic regression. Results: Participants were 793 middle-aged (age 44-64) and older adults (age 65+) with one or more chronic conditions. Factors associated with social engagement restrictions included having higher education, receiving care, having more physician visits and hospitalizations, being disabled, being unemployed, and having higher Emotional and Physical Problems Scale scores. Conclusions: Findings reveal the prevalence of social engagement restrictions among middle-aged and older adults with chronic conditions. Results highlight the importance of promoting research, assessments, and interventions to increase social engagement among this aging population.
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Affiliation(s)
- Kayla P Meek
- College of Public Health, The University of Georgia, Athens, GA 30602, USA.
| | - Caroline D Bergeron
- Bexar County Community Health Collaborative, San Antonio, TX 78212, USA.
- Center for Population Health and Aging, Texas A&M University, College Station, TX 77843, USA.
| | - Samuel D Towne
- Center for Population Health and Aging, Texas A&M University, College Station, TX 77843, USA.
- School of Public Health, Texas A&M University, College Station, TX 77843, USA.
- Southwest Rural Health Research Center, Texas A&M University, College Station, TX 77843, USA.
| | - SangNam Ahn
- Center for Population Health and Aging, Texas A&M University, College Station, TX 77843, USA.
- School of Public Health, The University of Memphis, Memphis, TN 38152, USA.
| | - Marcia G Ory
- Center for Population Health and Aging, Texas A&M University, College Station, TX 77843, USA.
- School of Public Health, Texas A&M University, College Station, TX 77843, USA.
| | - Matthew Lee Smith
- College of Public Health, The University of Georgia, Athens, GA 30602, USA.
- Center for Population Health and Aging, Texas A&M University, College Station, TX 77843, USA.
- School of Public Health, Texas A&M University, College Station, TX 77843, USA.
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Smith ML, Bergeron CD, Riggle SD, Meng L, Towne SD, Ahn S, Ory MG. Self-care difficulties and reliance on support among vulnerable middle-aged and older adults with chronic conditions: A cross-sectional study. Maturitas 2017; 104:1-10. [PMID: 28923169 DOI: 10.1016/j.maturitas.2017.06.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 06/27/2017] [Accepted: 06/29/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Chronic conditions are pervasive among middle-aged and older adults. This study identified: (1) factors associated with participants reporting difficulties self-managing their chronic condition(s); and (2) factors associated with participants' reliance on external sources for ongoing help and support to improve their health and manage their health conditions. STUDY DESIGN Cross-sectional data were collected using the National Council on Aging Chronic Care Survey, a nationally representative telephone survey of adults aged 45 years and older with at least one chronic condition. MAIN OUTCOME MEASURES Self-care difficulties among middle-aged and older adults with one or more chronic conditions and factors associated with reliance on ongoing help and support were examined. RESULTS Among 731 middle-aged and older adults with one or more chronic conditions, 31% of participants reported their health condition(s) made it difficult for them to care for themselves. Participants who were Hispanic (OR=3.08, P=0.009), had three or more chronic conditions (OR=3.05, P <0.001), took more medications daily (OR=1.07, P=0.046), and experienced certain healthcare-related frustrations (P≤0.023) were more likely to report difficulties self-managing their chronic condition(s). Participants relied on healthcare providers (40%), friends/relatives (20%), internet (9%), people with similar problems (6%), and community groups (3%) for help and support. Reliance on sources of support varied with participants' sociodemographic factors as well as healthcare and medication use. CONCLUSIONS Simultaneously considering patients' disease profiles, patient characteristics, difficulties managing their chronic conditions at home, and interactions with the healthcare system can inform tailored approaches and strategies to enhance patient education and resource identification, and can support service linkages.
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Affiliation(s)
- Matthew Lee Smith
- College of Public Health, The University of Georgia, 102 Spear Road, #101 Hudson Hall, Athens, GA 30602, USA; Texas A&M School of Public Health, 212 Adriance Lab Rd., 1266 TAMU, College Station, TX 77843, USA.
| | - Caroline D Bergeron
- Bexar County Community Health Collaborative, 3010 North Saint Mary's Street, Suite 1101, San Antonio, TX, 78212, USA.
| | - Seth D Riggle
- College of Public Health, The University of Georgia, 102 Spear Road, #101 Hudson Hall, Athens, GA 30602, USA.
| | - Lu Meng
- College of Public Health, The University of Georgia, 102 Spear Road, #101 Hudson Hall, Athens, GA 30602, USA.
| | - Samuel D Towne
- Texas A&M School of Public Health, 212 Adriance Lab Rd., 1266 TAMU, College Station, TX 77843, USA.
| | - SangNam Ahn
- Texas A&M School of Public Health, 212 Adriance Lab Rd., 1266 TAMU, College Station, TX 77843, USA; School of Public Health, The University of Memphis, Memphis, 133 Robison Hall, Memphis, TN 38152, USA.
| | - Marcia G Ory
- Texas A&M School of Public Health, 212 Adriance Lab Rd., 1266 TAMU, College Station, TX 77843, USA.
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Smith ML, Bergeron CD, Adler CH, Patel A, Ahn S, Towne SD, Bien M, Ory MG. Factors associated with healthcare-related frustrations among adults with chronic conditions. PATIENT EDUCATION AND COUNSELING 2017; 100:1185-1193. [PMID: 28117194 DOI: 10.1016/j.pec.2016.12.033] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 12/22/2016] [Accepted: 12/29/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Healthcare-related frustrations (HRFs) are common occurrences in patient-provider interactions. Little is known about HRFs experienced by individuals with chronic conditions. The purposes of this study were to: 1) identify the frequency of six HRFs among adults with chronic conditions; 2) assess factors associated with these HRFs; and 3) examine factors associated with multiple HRFs. METHODS Data were analyzed from 589 middle-aged and older adults with 1+ chronic conditions. A series of logistic regression models were fitted to identify factors associated with each frustration, and an ordinal regression model was fitted to identify factors associated with increasing frustrations. RESULTS Participants reported at least two of the six HRFs. The most commonly reported HRFs included feeling tired of describing the same condition (46%) and wishing their doctor had more time to speak with them during visits (44%). Having functional limitations (Beta=0.58, P=0.004), reporting more self-care barriers (Beta=0.41, P<0.001), visiting a physician more frequently (P<0.05), and having less support (Beta=-0.64, P=0.013) were associated with increasing HRFs. CONCLUSION Reducing HRFs may improve patient-provider interactions, chronic disease management, and patients' overall quality of life. PRACTICE IMPLICATIONS Care coordination, communication and cultural competency training, and a review of materials may help address these frustrations.
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Affiliation(s)
- Matthew Lee Smith
- College of Public Health, The University of Georgia, #101 Hudson Hall, Health Sciences Campus, Athens, GA 30602, USA; School of Public Health, Texas A&M University, College Station, TX, USA.
| | | | - Colin H Adler
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Aakash Patel
- College of Public Health, The University of Georgia, #101 Hudson Hall, Health Sciences Campus, Athens, GA 30602, USA
| | - SangNam Ahn
- School of Public Health, The University of Memphis, Memphis, TN, USA; School of Public Health, Texas A&M University, College Station, TX, USA
| | - Samuel D Towne
- School of Public Health, Texas A&M University, College Station, TX, USA
| | - Michael Bien
- College of Public Health, The University of Georgia, #101 Hudson Hall, Health Sciences Campus, Athens, GA 30602, USA
| | - Marcia G Ory
- School of Public Health, Texas A&M University, College Station, TX, USA
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Pettus AJ, Mendez-Luck CA, Bergeron CD, Ahn S, Towne SD, Ory MG, Smith ML. Internet-Based Resources for Disease Self-Care Among Middle-Aged and Older Women with Chronic Conditions. J Womens Health (Larchmt) 2016; 26:222-233. [PMID: 27779440 DOI: 10.1089/jwh.2016.5843] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE This two-part study analyzed data collected from middle-aged (age 44-64) and older women (age 65+) with one or more chronic conditions who completed the National Council on Aging Chronic Care Survey. MATERIALS AND METHODS Part One analyzed data from 418 women to describe sociodemographics, disease types, and healthcare utilization associated with Internet use among middle-aged and older women with 1 or more chronic diseases. Part Two analyzed data from the 251 Internet-using women to identify the online self-care resources they are using (format, host organization) and for what purposes. RESULTS Approximately 31% of participants were age 65 years or older, 30% reported having three or more chronic condition types, and 65% reported using the Internet. A significantly larger proportion of older women reported multiple chronic conditions, and a significantly fewer number of older women reported using the Internet. A significantly smaller proportion of Internet users were non-Hispanic white, more educated, and employed. A significantly larger proportion of non-Internet users reported needing help learning what to do to manage their health conditions and needing help learning how to care for their health conditions. Among only Internet-using women, 18.7% participated in online discussions/chatrooms/listserv and 45.2% read about the experiences of others with chronic diseases. Interest in websites and online courses varied. CONCLUSION Understanding Internet use among women with chronic conditions can inform targeted efforts to increase Internet availability, educate potential users about the benefits of online resources, and effectively tailor Internet-based materials to self-care needs.
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Affiliation(s)
- Amanda J Pettus
- 1 Department of Health Promotion and Behavior, College of Public Health, The University of Georgia , Athens, Georgia .,2 School of Social Work, The University of Georgia , Athens, Georgia
| | - Carolyn A Mendez-Luck
- 3 College of Public Health and Human Services, Oregon State University , Corvallis, Oregon
| | | | - SangNam Ahn
- 5 Division of Health Systems Management and Policy, School of Public Health, The University of Memphis , Memphis, Tennessee.,6 Department of Health Promotion and Community Health Sciences, Texas A&M School of Public Health , College Station, Texas
| | - Samuel D Towne
- 6 Department of Health Promotion and Community Health Sciences, Texas A&M School of Public Health , College Station, Texas
| | - Marcia G Ory
- 6 Department of Health Promotion and Community Health Sciences, Texas A&M School of Public Health , College Station, Texas
| | - Matthew Lee Smith
- 1 Department of Health Promotion and Behavior, College of Public Health, The University of Georgia , Athens, Georgia .,6 Department of Health Promotion and Community Health Sciences, Texas A&M School of Public Health , College Station, Texas
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Forjuoh SN, Ory MG, Jiang L, Vuong AM, Bolin JN. Impact of chronic disease self-management programs on type 2 diabetes management in primary care. World J Diabetes 2014; 5:407-414. [PMID: 24936263 PMCID: PMC4058746 DOI: 10.4239/wjd.v5.i3.407] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Accepted: 04/16/2014] [Indexed: 02/05/2023] Open
Abstract
AIM: To assess the effectiveness of the Chronic Disease Self-Management Program (CDSMP) on glycated hemoglobin A1c (HbA1c) and selected self-reported measures.
METHODS: We compared patients who received a diabetes self-care behavioral intervention, the CDSMP developed at the Stanford University, with controls who received usual care on their HbA1c and selected self-reported measures, including diabetes self-care activities, health-related quality of life (HRQOL), pain and fatigue. The subjects were a subset of participants enrolled in a randomized controlled trial that took place at seven regional clinics of a university-affiliated integrated healthcare system of a multi-specialty group practice between January 2009 and June 2011. The primary outcome was change in HbA1c from randomization to 12 mo. Data were analyzed using multilevel statistical models and linear mixed models to provide unbiased estimates of intervention effects.
RESULTS: Demographic and baseline clinical characteristics were generally comparable between the two groups. The average baseline HbA1c values in the CDSMP and control groups were 9.4% and 9.2%, respectively. Significant reductions in HbA1c were seen at 12 mo for the two groups, with adjusted changes around 0.6% (P < 0.0001), but the reductions did not differ significantly between the two groups (P = 0.885). Few significant differences were observed in participants’ diabetes self-care activities. No significant differences were observed in the participants’ HRQOL, pain, or fatigue measures.
CONCLUSION: The CDSMP intervention may not lower HbA1c any better than good routine care in an integrated healthcare system. More research is needed to understand the benefits of self-management programs in primary care in different settings and populations.
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Stamp KD. Women with Heart Failure: Do They Require a Special Approach for Improving Adherence to Self-Care? Curr Heart Fail Rep 2014; 11:307-13. [DOI: 10.1007/s11897-014-0199-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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