Perception of Life-Control Is Associated With Medical Care Satisfaction in Chronically Ill Rural Older Adults

Abstract Prior studies show patient populations have varied experiences with healthcare systems, and this may influence satisfaction with medical care. Patients feeling control over life circumstances may have resilience and ability to adapt to adverse situations. Given socioeconomic and medical differences in older adults we examined factors influencing satisfaction with medical care in the setting of chronic conditions and pain. 100 older adults in rural West Alabama with chronic illnesses and pain were recruited from community senior centers and interviewed with a structured questionnaire. Participants were queried about medical interventions for chronic conditions and satisfaction with medical care. Overall assessment of life-control was measured by the West Haven Yale Multidimensional Pain Index (WHYMPI). Bivariate correlation and multivariate analysis were conducted. Correlations between satisfaction with medical intervention and life-control scores were significantly positive (r=.21, p<.05). Satisfaction with medical intervention and other covariates explained approximately 14.1% variance in life-control scores, R2=.141. Multivariate regression results confirmed those highly satisfied with medical intervention were marginally significantly likely to have increased life-control scores, b=.20, SE=.12, p=.088. Married persons were more likely to have higher life-control scores than those with other marital statuses, b=.84, SE=.34, p<.05. Income was positively associated with life-control scores, b=.18, SE=.08, p<.05. Older adults may perceive greater satisfaction from medical care if they feel greater control over life circumstances. Socioeconomic factors (marital status, income) are associated with life control. These findings can help predict satisfaction with healthcare and find ways to make healthcare more accessible to all.

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Case Studies of Chronically Ill Children

Chronic Illness and Long-Term Care ◽

10.4018/978-1-5225-7122-3.ch016 ◽

2019 ◽

pp. 303-336

Author(s):

Thomas C. Gibbon ◽

Christopher L. Schwilk ◽

Jenifer Cline ◽

Kimberly Matthews ◽

Katie Sweigart ◽

...

Keyword(s):

Public Schools ◽

Case Studies ◽

Chronic Conditions ◽

Teacher Educators ◽

Chronically Ill ◽

Chronic Illnesses ◽

Respiratory Illnesses ◽

Number Of Children ◽

Medical Advances ◽

Severe Epilepsy

Medical advances have increased the number of children who have survived and are now living with chronic medical conditions (Irwin & Elam, 2011; Singer 2012). Diseases and conditions that as recently as a decade ago were considered fatal or completely debilitating are now increasingly treated as chronic conditions. Among these are several types of cancer, HIV/AIDS, respiratory illnesses, and severe epilepsy. Increasingly, students with severe chronic conditions are educated in public schools instead of home or hospital settings. The purpose of this chapter is to present case studies of real children and families that will allow educators and others a personal glimpse into the lives of children with chronic illness and their families. Suggestions for analyzing the case studies are provided that will help teachers, administrators, and teacher educators to examine the complex issues surrounding the educational needs of children with chronic illnesses.

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Exploring perceptions and use of the patient portal by young adults with type 1 diabetes: A qualitative study

Health Informatics Journal ◽

10.1177/1460458220911780 ◽

2020 ◽

Vol 26 (4) ◽

pp. 2586-2596

Author(s):

Kathy K Marsh ◽

Ruth A Bush ◽

Cynthia D Connelly

Keyword(s):

Qualitative Study ◽

Emerging Adults ◽

Chronic Conditions ◽

Type I Diabetes ◽

Chronically Ill ◽

Chronic Illnesses ◽

Self Management ◽

Type I ◽

Patient Portal

Emerging adults have been raised in the digital age and are therefore prime candidates for using a patient portal to manage chronic conditions. The limited body of research both identifies the underutilization of the patient portal and suggests increased use of the portal for the chronically ill as a tool to alleviate caregiver stress, as well as a potential modality to assist emerging adults to manage their chronic illnesses. This qualitative study was completed to obtain an understanding of emerging adults familiarity with the electronic patient portal and to elicit the perception of the usefulness of the portal to support self-management of type I diabetes. Findings provide a preliminary understanding of how a sampling of emerging adults with type I diabetes uses, perceives the benefits of, and wants to improve technology for diabetes self-management.

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Computerized Monitoring Protocols as a Pharmaceutical Care Practice Enhancement: A Conceptual Illustration Using Diabetes Mellitus

Annals of Pharmacotherapy ◽

10.1177/106002809302700726 ◽

1993 ◽

Vol 27 (7-8) ◽

pp. 963-966

Author(s):

Alan F. Boyd ◽

Abraham G. Hartzema

Keyword(s):

Diabetes Mellitus ◽

Medical Care ◽

Computer System ◽

Patient Outcomes ◽

Chronically Ill ◽

Care Practice ◽

Medline Search ◽

Medical Interventions ◽

Routine Medical Care ◽

Monitoring Protocols

OBJECTIVE: To illustrate how a computer system used in an ambulatory care pharmacy setting might enhance care of patients with diabetes by prospectively monitoring and prompting them to seek routine medical care. DATA SOURCES: A MEDLINE search to identify existing works on informatics was conducted. An epidemiology and general medical literature review of diabetes mellitus was also performed via MEDLINE. Additionally, known textbooks on the disease were consulted. CONCLUSIONS: Programming a computer system to prompt pharmacists to remind their patients of necessary medical interventions could save medical resources by warning chronically ill patients not to ignore routine medical care. Also, this would allow the pharmacist to prospectively monitor patient outcomes. By knowing when medical interventions are due and obtaining feedback from patients on the results of the medical contact, pharmacists increase their knowledge about patient outcomes and the rationale behind changes in pharmacotherapy. It is expected that such a system would prevent the inconspicuous development of chronic complications.

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Managing Chronic Illness

Journal of Applied Gerontology ◽

10.1177/0733464815602115 ◽

2016 ◽

Vol 36 (4) ◽

pp. 462-479 ◽

Cited By ~ 3

Author(s):

Mark Toles ◽

Helene Moriarty ◽

Ken Coburn ◽

Sherry Marcantonio ◽

Alexandra Hanlon ◽

...

Keyword(s):

Older Adults ◽

Care Coordination ◽

Chronically Ill ◽

Well Being ◽

Models Of Care ◽

Chronic Illnesses ◽

Demonstration Program ◽

Health Quality ◽

The Impact ◽

Improve Health

Models of care coordination can significantly improve health outcomes for older adults with chronic illnesses if they can engage participants. The purpose of this study was to examine the impact of nursing contact on the rate of participants’ voluntary disenrollment from a care coordination program. In this retrospective cohort study using administrative data for 1,524 participants in the Health Quality Partners Medicare Care Coordination Demonstration Program, the rate of voluntary disenrollment was approximately 11%. A lower risk of voluntary disenrollment was associated with a greater proportion of in-person (vs. telephonic) nursing contact (Hazard Ratio [HR] 0.137, confidence interval [CI] [0.050, 0.376]). A higher risk of voluntary disenrollment was associated with lower continuity of nurses who provided care (HR 1.964, CI [1.724, 2.238]). Findings suggest that in-person nursing contact and care continuity may enhance enrollment of chronically ill older adults and, ultimately, the overall health and well-being of this population

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Medical Rehabilitation Through the Prism of Legally Approved Definitions

Journal of restorative medicine and rehabilitation ◽

10.38025/2078-1962-2020-99-5-19-25 ◽

2020 ◽

Vol 99 (5) ◽

pp. 19-25

Author(s):

A.V. Kochubey ◽

O.B. Chernyakhovsky ◽

G.E. Salamadina ◽

V.V. Kochubey ◽

A.K. Burtsev

Keyword(s):

Medical Care ◽

Medical Intervention ◽

Medical Rehabilitation ◽

Federal Law ◽

Target Orientation ◽

Medical Interventions ◽

Current Definition ◽

Analytical Review ◽

The Russian Federation ◽

Definition Of

As part of an analytical review of federal law “On the basics of protecting the health of citizens in the Russian Federation”, an attempt was made to distinguish the conceptual independence of medical rehabilitation among categories such as medical care and treatment. The analysis showed that the definition of “treatment” indicates the same goal as for the hierarchically higher category “medical care”. For this reason, the definition of treatment meets the goal of another hierarchically equal category of “medical rehabilitation”. The absence of an ideological difference between the concepts of “treatment” and “medical rehabilitation” raises doubts about the independence of the latter term. The approved definitions of other hierarchically equal categories “prevention”, “diagnostics”, “medical rehabilitation” have their own independent target orientation, cascading with the purpose of providing medical care. Due to the identity of “treatment” and “medical rehabilitation” terms it is impossible to divide them according to objects or methods of exposure. Within the framework of the fixed concepts, treatment and rehabilitation impacts the same objects: structures, functions, and categories of life. There are no differences in the methods of exposure during treatment and medical rehabilitation, i.e. between medical interventions and interventions of a medico-psychological nature, whereas the current definition of “medical intervention” includes manipulations performed by a nonmedical professional, concerning persons’ physical or mental state of and having a rehabilitation orientation. Dividing the concepts of “treatment” and “medical rehabilitation” by subjects responsible for achieving the goal is not enough to distinguish the category of “treatment”. The independence of this category could be emphasized by narrowing the definition of treatment, defining its purpose solely as “elimination or relief of the disease or condition manifestations”. Such a concept meets the boundaries of medical care goal, but refers only to its part, it has its own hierarchy level in the medical care compounds, but it does not occupy the area of “medical rehabilitation” and other hierarchically equal categories.

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Chronic Illness

Encyclopedia of Social Work ◽

10.1093/acrefore/9780199975839.013.56 ◽

2013 ◽

Cited By ~ 1

Author(s):

Patricia A. Fennell ◽

Sara Rieder Bennett

Keyword(s):

Social Workers ◽

Acute Care ◽

Paradigm Shift ◽

Chronic Conditions ◽

Chronically Ill ◽

Chronic Illnesses ◽

Care Model ◽

New Models ◽

Care Models ◽

Acute Care Model

There is a paradigm shift occurring in medicine, from models focused on treating acute illnesses to those concerned with managing chronic conditions. This shift coincides with the higher prevalence of chronic illnesses resulting from factors such as lower mortality from formerly fatal illnesses and an aging population. The chronically ill do not fare well in an acute care model, and as a result, it has become imperative to develop new models effective for these chronic conditions. These new care models will require comprehensive, coordinated case management, an activity in which social workers can play a significant role.

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Depression Symptoms and Unmet Need for Medical Care in Chronically Ill Older Adults Living in Traditionally Underserved Communities

American Journal of Geriatric Psychiatry ◽

10.1016/j.jagp.2014.12.111 ◽

2015 ◽

Vol 23 (3) ◽

pp. S112-S113

Author(s):

Angela Ghesquiere ◽

Carolina Villanueva ◽

Daniel Gardner ◽

Jean Callahan ◽

Cara Kenien ◽

...

Keyword(s):

Older Adults ◽

Medical Care ◽

Unmet Need ◽

Chronically Ill ◽

Depression Symptoms ◽

Underserved Communities

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Older adults with non-communicable chronic conditions and their health care access amid COVID-19 pandemic in Bangladesh: Findings from a cross-sectional study

PLoS ONE ◽

10.1371/journal.pone.0255534 ◽

2021 ◽

Vol 16 (7) ◽

pp. e0255534

Author(s):

Sabuj Kanti Mistry ◽

A. R. M. Mehrab Ali ◽

Uday Narayan Yadav ◽

Saruna Ghimire ◽

Md. Belal Hossain ◽

...

Keyword(s):

Older Adults ◽

Health Care ◽

Health Services ◽

Medical Care ◽

Chronic Conditions ◽

Health Care Services ◽

Care Delivery ◽

Cross Sectional ◽

Care Services ◽

Routine Medical Care

Background Burgeoning burden of non-communicable disease among older adults is one of the emerging public health problems. In the COVID-19 pandemic, health services in low- and middle-income countries, including Bangladesh, have been disrupted. This may have posed challenges for older adults with non-communicable chronic conditions in accessing essential health care services in the current pandemic. The present study aimed at exploring the challenges experienced by older Bangladeshi adults with non-communicable chronic conditions in receiving regular health care services during the COVID-19 pandemic. Materials and methods The study followed a cross-sectional design and was conducted among 1032 Bangladeshi older adults aged 60 years and above during October 2020 through telephone interviews. Self-reported information on nine non-communicable chronic conditions (osteoarthritis, hypertension, heart disease, stroke, hypercholesterolemia, diabetes, chronic respiratory diseases, chronic kidney disease, cancer) was collected. Participants were asked if they faced any difficulties in accessing medicine and receiving routine medical care for their medical conditions during the COVID-19 pandemic. The association between non-communicable chronic conditions and accessing medication and health care was analysed using binary logic regression model. Results Most of the participants aged 60–69 years (77.8%), male (65.5%), married (81.4%), had no formal schooling (58.3%) and resided in rural areas (73.9%). Although more than half of the participants (58.9%) reported having a single condition, nearly one-quarter (22.9%) had multimorbidity. About a quarter of the participants reported difficulties accessing medicine (23%) and receiving routine medical care (27%) during the pandemic, and this was significantly higher among those suffering from multimorbidity. In the adjusted analyses, participants with at least one condition (AOR: 1.95, 95% CI: 1.33–2.85) and with multimorbidity (AOR: 4.75, 95% CI: 3.17–7.10) had a higher likelihood of experiencing difficulties accessing medicine. Similarly, participants with at least one condition (AOR: 3.08, 95% CI: 2.11–4.89) and with multimorbidity (AOR: 6.34, 95% CI: 4.03–9.05) were significantly more likely to face difficulties receiving routine medical care during the COVID-19 pandemic. Conclusions Our study found that a sizeable proportion of the older adults had difficulties in accessing medicine and receiving routine medical care during the pandemic. The study findings highlight the need to develop an appropriate health care delivery pathway and strategies to maintain essential health services during any emergencies and beyond. We also argue the need to prioritise the health of older adults with non-communicable chronic conditions in the centre of any emergency response plan and policies of Bangladesh.

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Correlates of Influenza Vaccination Among Underserved Latinx Middle-Aged and Older Adults: A Cross-sectional Survey

10.21203/rs.3.rs-366966/v1 ◽

2021 ◽

Author(s):

Mohsen Bazargan ◽

Adrienne Martinez-Hollingsworth ◽

Sharon Cobb ◽

Lucy Kibe

Keyword(s):

Older Adults ◽

Influenza Vaccine ◽

Influenza Vaccination ◽

Medical Care ◽

Chronic Conditions ◽

Vaccine Uptake ◽

Financial Strain ◽

Cross Sectional Survey ◽

Cross Sectional

Abstract Background: Vaccination is a powerful tool in the fight against seasonal influenza, among underserved, middle-age and older, Latinx adults. Yet, vaccine hesitancy and inconsistent uptake in this population continues to represent a substantial challenge to public health. A better understanding of factors impacting influenza vaccination behaviors in this group could result in more effective messaging and initiatives promoting universal vaccination among Latinx. Methods: In this cross-sectional survey, we explore correlates of influenza vaccination uptake among underserved, Latinx, older adults. Our focus was on the role of socio-demographics, living arrangements, financial strain, access and satisfaction with medical care, and the presence of major chronic conditions in terms of vaccine uptake. Middle-aged and older Latinx residents diagnosed with diabetes and/or hypertension (n=165), were recruited from the South Los Angeles Service Plan Area (SPA), a historically under-resourced community. Bi-variate and multi-variate logistical regression were performed on survey data to explore independent correlates of influenza vaccination.Results: Almost half of underserved Latinx older adults in our study (45%) reported influenza vaccination within the 12 months prior to the study. The majority (~85%) reported receiving this recommendation from their primary care provider. However, one-third (30%) of those receiving this advice did not get the vaccine. A decreased likelihood of vaccination was significantly associated with living alone (p=0.026), lacking Medicare coverage (0.028), or higher levels of financial strain (0.020). Difficulty accessing medical care (p=0.008) or dissatisfaction with these experiences (p=0.001) were also strongly associated with decreased likelihood of vaccination. Participants diagnosed with COPD had 9.5 (CI: 1.76 – 51.3) higher odds of being vaccinated compared to those without; no correlation was detected for other chronic conditions.Conclusion: The high number of unvaccinated Latinx participants receiving a vaccine recommendation from a provider is consistent with studies among other ethnic/racial minority older adults and highlights the pivotal role of the provider in influenza vaccine adoption. Additional findings reflect negative impact of Social Determinates of Health (SDoH) on preventive care efforts in this group. Further efforts to quantify these associations are needed to explore structural and human factors impacting influenza vaccine uptake.

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