How social isolation and loneliness effect medication adherence among elderly with chronic diseases: An integrated theory and validated cross-sectional study

2020 ◽  
Vol 90 ◽  
pp. 104154
Author(s):  
Jiao Lu ◽  
Na Zhang ◽  
Danhui Mao ◽  
Yuan Wang ◽  
Xiaoli Wang
2021 ◽  
Author(s):  
Xiangxiang Liu ◽  
Hong-jie Yu ◽  
Yan Gao ◽  
Jing Zhou ◽  
Mingchao Zhou ◽  
...  

Abstract BackgroundMultiple chronic diseases (MCDs) and social isolation are independent risk factors related with stroke and disability, but it is unknown whether the combination of these two conditions resulted from ageing related to functional disability in stroke patients. The purpose of this study was to probe the relationship between combination of MCDs, social isolation and functional disability in elderly stroke patients.MethodsA multicentre and cross-sectional study was conducted in the Departments of Rehabilitation Medicine of 103 hospitals located in 23 cities across China. Stroke patients aged over 60 years were selected as participants. Demographic characteristics, lifestyles and clinical information were investigated by questionnaire and medical records. Multi-nominal logistic regression model was used to explore the association of MCDs, social isolation and their combination with functional disability assessed by Barthel Index Scale.ResultsA total of 4281 elderly stroke patients were included in the final analysis. The proportion of social isolation and MCDs (>1) increased by the severity of functional disability. Social isolation was associated with increased risks for mild (33%), moderate (175%), and severe (833%) functional disability significantly in their comparisons with those without social isolation and MCDs. The intragroup odds ratio (OR) of MCDs increased by its number and the intergroup of OR increased by the severity of functional disability significantly. Social isolation and ≥3 MCDs associated the highest risk for severe (OR= 38.24, 95%CI: 14.76-99.07) and moderate (OR = 9.74, 95%CI: 3.62-26.22) functional disability, but not significant for mild group.ConclusionsMCDs, social isolation, and their combination were associated with functional disability in Chinese elderly stroke patients. Future secondary prevention and rehabilitation for functional disability in this population should underscore both social activity and the combined treatments of MCDs.Clinical Trial Registration NOChiCTR2000034067.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiangxiang Liu ◽  
Hong-jie Yu ◽  
Yan Gao ◽  
Jing Zhou ◽  
Mingchao Zhou ◽  
...  

Abstract Background Multiple chronic diseases (MCDs) and social isolation are independent risk factors related to stroke and disability, but it is unknown whether the combination of these two conditions resulted from aging-related to functional disability in stroke patients. This study aimed to probe the relationship between the combination of MCDs, social isolation, and functional disability after stroke in elderly patients. Methods A multicenter and cross-sectional study was conducted in the Departments of Rehabilitation of 103 hospitals located in 23 cities across China. Stroke patients aged 60–90 years were selected for analysis. Demographic characteristics, lifestyles, and clinical information were investigated by questionnaires and medical records. MCDs (hypertension/ diabetes/ hyperlipidemia/heart disease/kidney disease) were categorized into three levels: 0, 1, and ≥ 2. Functional disability was assessed by the Barthel Index and categorized into four groups: no, mild, moderate, and severe disability. The multi-nominal logistic regression model was used to explore the independent and combined association of MCDs and social isolation with functional disability. Results A total of 4046 elderly stroke patients (55 % males) were included in the final analysis. The prevalence of social isolation, MCDs ≥ 2, and severe disability increased with aging. In the fully adjusted model, patients with social isolation or MCDs had a higher risk of functional disability significantly than those without. Patients with social isolation combined MCDs ≥ 2 were 35 times (95 % CI: 18.89–64.69) more likely to suffer severe disability after stroke, and 8 times (95 % CI: 18.89–64.69) for moderate disability than those without social isolation and MCDs. Conclusions MCDs, social isolation, and their combination were associated with a higher risk of functional disability after stroke in Chinese elderly patients. The elderly population should be encouraged to participate in more social activities, particularly in those with MCDs. Future secondary prevention and rehabilitation treatments to the functional ability of elderly stroke patients should underscore both social activity and the combined treatments of MCDs. Trial registration NO: ChiCTR2000034067.


Author(s):  
Júlia Cristina Leite Nóbrega ◽  
Juliana Barbosa Medeiros ◽  
Tácila Thamires de Melo Santos ◽  
Saionara Açucena Vieira Alves ◽  
Javanna Lacerda Gomes da Silva Freitas ◽  
...  

Objective: To evaluate the association between socioeconomic factors, health status, and Functional Capacity (FC) in the oldest senior citizens in a metropolis and a poor rural region of Brazil. Method: Cross-sectional study of 417 seniors aged ≥80 years, data collected through Brazil’s Health, Well-being and Aging survey. FC assessed by self-reporting of difficulties in Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs). Chi-square tests and multiple logistic regression analyses were performed using “R” statistical software. Results: Socioeconomic and demographic inequalities in Brazil can influence FC in seniors aged 80 years and older. Comparatively, urban long-lived people had a higher prevalence of difficulties for ADLs and rural ones showed more difficulties for IADLs. Among urban oldest seniors, female gender and lower-income were correlated with difficulties for IADLs. Among rural oldest seniors, female gender, stroke, joint disease, and inadequate weight independently were correlated with difficulties for ADLs, while the number of chronic diseases was associated with difficulties for IADLs. Conclusion: Financial constraints may favor the development of functional limitations among older seniors in large urban centers. In poor rural areas, inadequate nutritional status and chronic diseases may increase their susceptibility to functional decline.


Author(s):  
Marion J. Wessels‐Bakker ◽  
Eduard A. van de Graaf ◽  
Johanna M. Kwakkel‐van Erp ◽  
Harry G. Heijerman ◽  
Wiepke Cahn ◽  
...  

Author(s):  
Suganya Ganesan ◽  
Nitya Selvaraj ◽  
Vinoth Krishna Dass ◽  
Nalinidevi Jayabalan ◽  
Meher Ali Rajamohammad ◽  
...  

Background: In spite of many progresses in treatment of psychiatric disorders, medication nonadherence plays an important role in worsening of clinical condition and affects quality of life among psychiatric patients. There are numerous factors contributing for medication nonadherence among patients with mental illness. So, this study was conducted to assess psychiatric patients’ adherence of medication and to improve their quality of life with psychiatric disorder. The objectives of the study were to analyze impact of pharmacophilia and pharmacophobia on medication adherence among patients with psychiatric disorders at a tertiary care hospital and to assess quality of life among pharmacophilic and pharmacophobic patients.Methods: A cross-sectional study was conducted in outpatient psychiatric department for a period of two months. After obtaining informed voluntary consent, patient’s socio-demographic details, diagnosis, and treatment were recorded from prescription slip. Patients above 18yr age with psychiatric diagnosis as per International Classification of Diseases 10 (ICD-10) and receiving at least one psychotropic medication for >1 month were enrolled in study and assessed using: Drug attitude inventory classification (DAI-10); Medication Rating Scale (MARS); Quality of life enjoyment and satisfaction Questionnaire-Short Form (Q-LES-Q-SF).Results: Among 130 patients, 116 were pharmacophilic and 14 were pharmacophobic as per DAI-10 scale. 81.9% of pharmacophilic were adherent to prescribed medication assessed using MARS scale only 14.3% were pharmacophobic. The quality of life was better in pharmacophilic compared to pharmacophobic group (p=0.002) using Q-LES-Q-SF.Conclusions: This study concluded that pharmacophilic patients have higher adherence and good quality of life index compared to pharmacophobic. Proper counselling of pharmacophobic patients by psychiatrists could improve adherence and QOL.


2020 ◽  
Vol 33 (2) ◽  
pp. e100180
Author(s):  
Eram Ansari ◽  
Sudha Mishra ◽  
Adarsh Tripathi ◽  
Sujita Kumar Kar ◽  
Pronob Kumar Dalal

BackgroundPatients suffering from psychiatric disorders tend to stigmatise themselves which had been linked to poor adherence to treatment.AimsThe aim of the present study was to study internalised stigma and medication adherence and to assess the relationship between them in patients with obsessive compulsive disorder (OCD).MethodsA cross-sectional study was conducted on 112 patients diagnosed with OCD who were attending the Out-patient's department at Department of Psychiatry of a tertiary care hospital in North India. Internalised stigma and current medication adherence were assessed with Internalized Stigma of Mental Illness Scale (ISMI) and Medication Adherence Rating Scale, respectively. Yale-Brown Obsessive Compulsive Scale was used to assess the current severity of OCD symptoms. Sociodemographic and clinical details were also obtained from the patients by using a semistructured sociodemographic proforma.ResultsMost of the patients reported moderate level of internalised stigma with a mean ISMI score of 77.98 (10.82). Most of the patients were compliant while 41.96% reported poor medication adherence. Internalised stigma was negatively correlated with the current medication adherence. Current severity of OCD symptoms also showed a significant positive correlation with internalised stigma and a significant negative correlation with medication adherence.ConclusionHigh levels of internalised stigma were associated with lower adherence to treatment which suggests that internalised stigma may be a very important factor influencing medication adherence in patients with OCD.


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