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Shim EJ, Park SJ, Im GH, Hackett RA, Zaninotto P, Steptoe A. Trajectories of depressive symptoms in Korean adults with diabetes: Individual differences and associations with life satisfaction and mortality. Br J Health Psychol 2024. [PMID: 39048530 DOI: 10.1111/bjhp.12742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 07/09/2024] [Indexed: 07/27/2024]
Abstract
OBJECTIVE We examined trajectories of depressive symptoms and their predictors in adults with diabetes. We assessed whether these trajectories were related to life satisfaction and mortality. DESIGN Longitudinal, prospective observational study. METHODS We analysed data from 1217 adults with diabetes (aged ≥45 years) in the Korean Longitudinal Study of Aging (2006-2018). RESULTS Three trajectories of depressive symptomology were identified in growth mixture models: low/stable (i.e., low and stable levels of symptoms; 85.56%), high/decreasing (i.e., high levels of symptoms with a decreasing trajectory; 7.47%), and moderate/increasing (i.e., moderate levels of symptoms with an increasing trajectory; 6.98%). Participants with poor perceived health status at baseline were more likely to be in the moderate/increasing or high/decreasing classes than in the low/stable class. The moderate/increasing class had the lowest satisfaction with quality of life, followed by the high/decreasing and low/stable classes. The moderate/increasing and the high/decreasing classes had lower satisfaction with relationships with spouse and children than the low/stable class. The high/decreasing class had a higher mortality risk than the low/stable class. CONCLUSIONS Long-term monitoring of depressive symptoms in adults with diabetes is warranted given their potential adverse impact on life satisfaction and mortality.
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Affiliation(s)
- Eun-Jung Shim
- Department of Psychology, Pusan National University, Busan, Korea
| | - Sang Jin Park
- Department of Psychology, Pusan National University, Busan, Korea
| | - Gyu Hyeong Im
- Department of Psychology, Pusan National University, Busan, Korea
| | - Ruth A Hackett
- Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Paola Zaninotto
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, UK
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Yi K, Kim S. Patient Perspectives of Chronic Disease Management and Unmet Care Needs in South Korea: A Qualitative Study. J Patient Exp 2023; 10:23743735231213766. [PMID: 38026059 PMCID: PMC10666679 DOI: 10.1177/23743735231213766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023] Open
Abstract
Understanding and incorporating patients' perspectives are necessary to address the emerging challenge of chronic disease management. Our study examined patients' perceptions and experiences for the current chronic disease management system in South Korea. Focus group interviews were conducted on 23 patients and 11 themes emerged by qualitative content analysis. The participants experienced in terms of provider-patient interaction: doctors only prescribe medicine, doctors who provide conventional advice, doctors who do not respect the patients' opinion, long wait times and inadequate consultations, lack of personalized care, and freedom to select another doctor. They also experienced in their community and health system: struggling alone, commercial media and folk remedies, lack of IT technologies for care, demanding visiting services, and lack of collaboration in the community. We found that patients needed comprehensive and personalized care, respect from providers, and self-management support and collaborated care with the community using information technologies advancement. Our findings suggest that a fundamental change in the South Korean healthcare system paradigm is required for successful chronic care, including payment and healthcare delivery systems.
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Affiliation(s)
- Kyunghee Yi
- The University of Suwon, Gyeonggi, South Korea
| | - Sujin Kim
- Korea Institute for Health and Social Affairs, Sejong, South Korea
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Kim JH, Yang HM. Moderating Effect of Self-Esteem on the Relationship between Depression and Family Conflict Coping Strategies in the Elderly with Chronic Diseases in Korea. Healthcare (Basel) 2023; 11:2569. [PMID: 37761766 PMCID: PMC10531067 DOI: 10.3390/healthcare11182569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 09/09/2023] [Accepted: 09/16/2023] [Indexed: 09/29/2023] Open
Abstract
(1) Background: The elderly with chronic diseases often experience high levels of depression, which can negatively affect their family conflict coping strategies. Additionally, as the level of depression increases, self-esteem tends to decrease. This study aims to investigate whether self-esteem plays a moderating role in the relationship between depression and family conflict coping strategies among the elderly with chronic diseases. (2) Method: The subjects were 2501 older adults with chronic diseases included in the 16th Korean Welfare Panel Study. The CES-D scale, Rosenberg Self-Esteem Scale, and the tool of Family Conflict Coping Strategies were used. (3) Results: Depression was negatively correlated with self-esteem and coping strategies for family conflict, while self-esteem was positively correlated with coping strategies for family conflict. In the multiple regression model, self-esteem had a moderating effect (F = 43.20, p < 0.001). This result indicated that as self-esteem increases, the negative influence of depression on family conflict coping strategies becomes weaker (β = -0.08, t = -3.04, p = 0.002). (4) Conclusions: When addressing family conflict coping strategies in the elderly with chronic diseases, it is crucial to focus on enhancing self-esteem. Additionally, it may be beneficial to classify the elderly into groups based on their level of self-esteem.
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Affiliation(s)
| | - Hwa-Mi Yang
- Department of Nursing, Daejin University, Pocheon-si 11159, Republic of Korea;
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Experiences of implementing a coping mechanism for the elderly who face chronic diseases while living with the family: a phenomenology study. FRONTIERS OF NURSING 2022. [DOI: 10.2478/fon-2022-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract
Objective
Physical and psychological stress causes harm to the health status of the elderly with chronic diseases. This study aimed to understand coping mechanisms of the elderly with chronic conditions who live with their family.
Methods
This study was conducted using a descriptive phenomenology method from the experience of 13 older adults with chronic disease. The study processes were interviewed, tape recorded, transcribed, and explored from the transcripts using Colaizzi's descriptive phenomenological method. The steps of the descriptive phenomenology process are bracketing, intuiting, analyzing, and describing.
Results
The coping mechanisms used by the elderly with chronic diseases are (1) the behavioral focus coping ways by doing sports, and physical activities; (2) Focus on spirituality has been implemented by fasting, chanting, dhikr, and prayer; (3) The cognitive focus by working on hobbies or habitual activities and helping each other; (4) The social interaction focus was by interacting with friends, family, and neighbors.
Conclusions
This shows that elderly adults with disease conditions try to adapt various forms of coping mechanisms, which positively affects their psychological state. Families which have elderly with chronic diseases are expected to provide nurturing and psychological support to them so that the elderly can consistently apply coping mechanisms to overcome and tackle chronic diseases. Understanding the coping mechanism implementation of the elderly who have chronic diseases by their family can guide health specialists in designing psychological and spiritual approach interventions.
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Kang E, Kim S, Rhee YE, Yun YH. Development and validation of the Highly Effective Health Behavior Pattern Inventory - Short Form. Chronic Illn 2021; 17:81-94. [PMID: 30987434 DOI: 10.1177/1742395319843166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The purpose of this study was to develop and validate a short form (SF) of the highly effective health behavior pattern inventory (HEBPI) for chronic disease patients for comfort to use. METHODS HEBPI-SF is a self-reported questionnaire based on highly effective health behaviors associated with building healthy habits. HEBPI-SF was validated by calculating adjusted odds ratios (aOR) for the 12 HEBPI-SF health behavior subscales and the maintenance of the 12 corresponding health habits. RESULTS HEBPI-SF developed in this study comprised 12 subscales and 53 items, utilizing patient data (N = 724) derived from the original HEBPI (12 subscales and 131items). HEBPI-SF demonstrated high reliability (Cronbach's α of 0.703-0.859) and showed that the 12 health behaviors included in the HEBPI are associated with the maintenance of the corresponding health habits (aOR: 2.29-8.42). The scores of the HEBPI-SF showed a positive correlation with physical, mental, social, spiritual and general health status, quality of life, and self-management strategies. DISCUSSION HEBPI-SF is a reliable tool for the assessment of health behaviors of chronically ill patients. Considering previous findings of simple health behaviors significantly affecting health status, this survey tool for the assessment of health behaviors is useful for promotion and maintenance of healthy habits.
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Affiliation(s)
- Eunkyo Kang
- Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Soojeong Kim
- Department of Biomedical Science, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ye E Rhee
- Department of Biomedical Science, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Young H Yun
- Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea.,Department of Biomedical Science, Seoul National University College of Medicine, Seoul, Republic of Korea
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Yeom HE. Causal beliefs about hypertension and self-care behaviour in Korean patients. Collegian 2021. [DOI: 10.1016/j.colegn.2020.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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David D, Dalton J, Magny-Normilus C, Brain MM, Linster T, Lee SJ. The Quality of Family Relationships, Diabetes Self-Care, and Health Outcomes in Older Adults. Diabetes Spectr 2019; 32:132-138. [PMID: 31168284 PMCID: PMC6528399 DOI: 10.2337/ds18-0039] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The purpose of the study was to investigate the relationship between family support, diabetes self-care, and health outcomes in older, community-dwelling adults. Using the theoretical framework of the Self-Care of Chronic Illness Theory and a cross-sectional design, 60 participants completed questionnaires related to diabetes self-care activities of the individual, supportive and nonsupportive diabetes behaviors of the family, and the quality of family relations. Participants indicated that diabetes self-care behaviors were performed frequently, with exercise reported as the least-performed behavior. Multiple regression analyses revealed that the quality of family relations as measured by the Family Relationship Index contributed significantly (26.0%) to the variability in A1C levels (R 2 = 0.260, F(1, 40) = 14.037, P = 0.001). Neither family supportive behavior nor the quality of family relations contributed to diabetes self-care. It is recommended that health care providers include family members to assess diabetes family support and family relationships in the care of older adults with diabetes.
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Affiliation(s)
- Daniel David
- San Francisco VA Medical Center, Geriatrics and Palliative Care, San Francisco, CA
- University of California San Francisco, School of Nursing, Department of Community Health Systems, San Francisco, CA
| | - Joanne Dalton
- Regis College, School of Nursing, Weston, MA
- Beth Israel Deaconess Medical Center, Boston, MA
| | | | | | | | - Sei J. Lee
- San Francisco VA Medical Center, Geriatrics and Palliative Care, San Francisco, CA
- University of California San Francisco, School of Medicine, Division of Geriatrics and Palliative Care, San Francisco, CA
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Seo K, Song Y. Self-stigma among Korean patients with diabetes: A concept analysis. J Clin Nurs 2019; 28:1794-1807. [PMID: 30667129 DOI: 10.1111/jocn.14789] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 12/01/2018] [Accepted: 01/14/2019] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To conduct a concept analysis of self-stigma among patients with diabetes and introduce an operational definition of self-stigma. BACKGROUND Due to fears of being monitored, patients with diabetes often conceal their disease and/or withdraw from social relationships. These behaviours negatively affect patients' self-care and socialisation. DESIGN A concept analysis was conducted using a three-phase (theoretical phase, fieldwork phase and final analysis phase) hybrid method by Schwartz-Barcott and Kim (Nursing research methodology: Issues and implementations, 1986, Rockville, MD: Aspen). METHODS During the theoretical phase, a literature search was conducted using PubMed and CINAHL. Using COREQ guidelines, in the fieldwork phase, in-depth interviews were conducted with nine participants with diabetes. The recorded data were analysed using a grounded theory approach. Results from both were included in the analytic phase. RESULTS In the fieldwork phase, nine patients with diabetes (four men and five women; mean age = 57.00 ± 21.93 years) participated in the interview. The mean duration of diabetes was 21.44 ± 12.39 years. The self-stigma concept included three categories with nine attributes: affective (negative feelings and feeling sorry for others who have concerns about me), cognitive (low self-esteem and self-efficacy, perceived weakness, low expectations for the future, worry for children and disease burden) and behavioural factors (social withdrawal and avoiding disease disclosure). The nine attributes included 23 indicators. CONCLUSIONS Self-stigma among patients with diabetes is defined as a state in which patients develop negative self-feelings as they deal with the disease. This can cause diminished self-esteem and self-efficacy, as well as a tendency to avoid disclosing the illness along with social withdrawal. RELEVANCE TO CLINICAL PRACTICE Based on this self-stigma concept analysis, we clarified the attributes of diabetes self-stigma and distinguished it from social stigma in nurse professionals during patient education and clinical assessment.
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Affiliation(s)
- Kawoun Seo
- College of Nursing, Chungnam National University, Daejeon, South Korea.,Department of Nursing, Joongbu University, Chungnam, Republic of Korea
| | - Youngshin Song
- College of Nursing, Chungnam National University, Daejeon, South Korea
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Yi S, Ngin C, Tuot S, Chhoun P, Fleming T, Brody C. Utilization of traditional, complementary and alternative medicine and mental health among patients with chronic diseases in primary health care settings in Cambodia. Int J Ment Health Syst 2017; 11:58. [PMID: 29021821 PMCID: PMC5612333 DOI: 10.1186/s13033-017-0167-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 09/18/2017] [Indexed: 12/23/2022] Open
Abstract
Background Coping with chronic illnesses often involves major lifestyle changes that may lead to poor mental health. Furthermore, in order to treat the chronic conditions, many sufferers in Asia turn to traditional, complementary and alternative medicines (TCAM). This study explores prevalence of TCAM use and factors associated with anxiety and depressive symptoms among patients with chronic diseases in Cambodia. Methods In 2015, this cross-sectional study was conducted with outpatients receiving treatment and care for chronic diseases in two urban and two rural primary health centers. Every eligible patient was randomly selected at the health centers using a systematic sampling procedure. Symptoms of anxiety and depression were assessed by using the Hospital Anxiety and Depression Scale (HADS). Multivariate logistic regression models were constructed to explore factors associated with anxiety and depressive symptoms. Results The study participants included 1528 patients, of whom 77.2% were female, with a mean age of 46.5 years (SD = 15.3). After adjustment, patients with depressive symptoms remained significantly more likely to be in the age groups between 41 and 60 years old and to be married, separated/divorced or widowed compared to those without depressive symptoms. Regarding the use of TCAM, patients with depressive symptoms remained significantly more likely to report using an herbalist, practicing visualization and praying for own health, but less likely to report using vitamins or supplements in the past 12 months. For quality of life, patients with depressive symptoms remained significantly less likely to agree that they had enough energy for their everyday life and had enough money to meet their daily needs. Similar risk factors were also found to be significantly associated with anxiety symptoms. Conclusions Cambodian patients with chronic diseases who experienced symptoms of anxiety or depression were more likely to report reduced quality of life, greater chronic disease-related stigma and more TCAM use. Given the potential interaction of TCAM, mental health and other chronic conditions, a history of TCAM use and mental health should be elicited in clinical practices in primary health care settings, particularly in developing countries.
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Affiliation(s)
- Siyan Yi
- KHANA Center for Population Health Research, No. 33, Street 71, Phnom Penh, Cambodia.,Public Health Program, Touro University California, Vallejo, CA USA
| | - Chanrith Ngin
- KHANA Center for Population Health Research, No. 33, Street 71, Phnom Penh, Cambodia
| | - Sovannary Tuot
- KHANA Center for Population Health Research, No. 33, Street 71, Phnom Penh, Cambodia
| | - Pheak Chhoun
- KHANA Center for Population Health Research, No. 33, Street 71, Phnom Penh, Cambodia
| | - Tyler Fleming
- Public Health Program, Touro University California, Vallejo, CA USA
| | - Carinne Brody
- Public Health Program, Touro University California, Vallejo, CA USA
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Jacobs B, Men C, Bigdeli M, Hill PS. Limited understanding, limited services, limited resources: patients' experiences with managing hypertension and diabetes in Cambodia. BMJ Glob Health 2017; 2:e000235. [PMID: 29291130 PMCID: PMC5717921 DOI: 10.1136/bmjgh-2016-000235] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Revised: 05/08/2017] [Accepted: 05/19/2017] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Health system responses to the emergence of non-communicable diseases (NCDs) in many Southeast Asian nations, Cambodia included, have been insufficient. Little is known about how people suffering from such conditions behave in constrained contexts. We examined the experience of patients with NCDs as they seek care for their conditions and manage them. METHODS In-depth interviews with 28 purposively selected patients with hypertension and/or diabetes using an interview guide to capture the trajectory followed by interviewees from the development and recognition of symptoms to adherence to treatment. A general outline of major topics to be discussed was used instead of a predetermined list of specific questions. RESULTS All interviewees had experienced symptoms for a substantial period of time, sometimes many years, before being diagnosed. Initial treatment focused on symptoms instead of underlying conditions, often at considerable financial cost. Following diagnosis, many struggled to take medicines daily for their condition and adhering to the required behaviour changes. Many resorted to complementary medicine. Lack of financial resources was a common reason to discontinue treatment. Many reported loss of income and assets such as livestock and productive land and increasingly relied on others. CONCLUSION In order to assist people with NCDs in Cambodia, there is a need for a multipronged approach focusing on communities and healthcare providers. Information campaigns could focus on the timely recognition by communities of symptoms indicative of the conditions, together with instigating demand for routine screening at qualified health providers. Peer support is considerable, and locally adjusted approaches based on this principle should be considered.
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Affiliation(s)
- Bart Jacobs
- Social Health Protection Programme, Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ), Phnom Penh, Cambodia
| | | | - Maryam Bigdeli
- Department for Health Systems Governance and Financing, World Health Organization, Geneva, Switzerland
| | - Peter S Hill
- Department of Public Health, The University of Queensland, Brisbane, Queensland, Australia
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Choi SE, Kwon I, Chang E, Araiza D, Thorpe CL, Sarkisian CA. Developing a culturally tailored stroke prevention walking programme for Korean immigrant seniors: a focus group study. Int J Older People Nurs 2016; 11:255-265. [PMID: 26778221 DOI: 10.1111/opn.12114] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 12/18/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To gain better understanding of (i) beliefs and knowledge about stroke; (ii) attitudes about walking for stroke prevention; and (iii) barriers and facilitators to walking among Korean seniors for the cultural tailoring of a stroke prevention walking programme. BACKGROUND Physical inactivity is a major risk factor for stroke. Korean immigrant seniors are one of the most sedentary ethnic groups in the United States. DESIGN An explorative study using focus group data. Twenty-nine Korean immigrant seniors (64-90 years of age) who had been told by a doctor at least once that their blood pressure was elevated participated in 3 focus groups. Each focus group consisted of 8-11 participants. METHODS Focus group audiotapes were transcribed and analysed using standard content analysis methods. RESULTS Participants identified physical and psychological imbalances (e.g. too much work and stress) as the primary causes of stroke. Restoring 'balance' was identified as a powerful means of stroke prevention. A subset of participants expressed that prevention may be beyond human control. Overall, participants acknowledged the importance of walking for stroke prevention, but described barriers such as lack of personal motivation and unsafe environment. Many participants believed that providing opportunities for socialisation while walking and combining walking with health information sessions would facilitate participation in and maintenance of a walking programme. CONCLUSIONS Korean immigrant seniors believe strongly that imbalance is a primary cause of stroke. Restoring balance as a way to prevent stroke is culturally special among Koreans and provides a conceptual base in culturally tailoring our stroke prevention walking intervention for Korean immigrant seniors. IMPLICATIONS FOR PRACTICE A stroke prevention walking programme for Korean immigrant seniors may have greater impact by addressing beliefs about stroke causes and prevention such as physical and psychological imbalances and the importance of maintaining emotional well-being.
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Affiliation(s)
- Sarah E Choi
- School of Nursing, University of California, Los Angeles, CA, USA
| | - Ivy Kwon
- Department of Medicine/Division of Geriatrics, School of Medicine, University of California, Los Angeles, CA, USA
| | - Emiley Chang
- Department of Medicine/Division of General Internal Medicine, School of Medicine, University of California, Los Angeles, CA, USA
| | - Daniel Araiza
- Department of Medicine/Division of Geriatrics, School of Medicine, University of California, Los Angeles, CA, USA
| | | | - Catherine A Sarkisian
- Department of Medicine/Division of Geriatrics, School of Medicine, University of California, Los Angeles, CA, USA
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