Concept Analysis of Medication Adherence in the Elderly with Chronic Disease: Hybrid Model

2021 ◽  
Vol 26 (2) ◽  
pp. 143-156
Author(s):  
Sook Kang ◽  
Jeong Sun Kim
2021 ◽  
Vol 28 (1) ◽  
pp. 67-82
Author(s):  
Il Sun Ko ◽  
Hyunju Ji ◽  
Soyun Hong ◽  
Eunyoung Jung

Purpose: This study was done clarify the concept of illness acceptance in patients with chronic disease.Methods: This study was conducted using a hybrid model of concept analysis that consists of three phases. In the theoretical phase, a working definition was formulated through a systematic review. In the fieldwork phase, five participants who had diabetes or hypertension for at least one year were interviewed. In the third phase, the results were combined in the final analysis.Results: There are three phases of accepting an illness: experiencing the limits, disease management, and designing new life. At the experience of the limits and disease management stages, the attributes of physical, psychological and social domains were derived, but at the stage of designing their new life, integrated attributes of these three domains were derived.Conclusion: Illness acceptance of chronic disease was defined as a continuous and dynamic process in three phases. First, patients experience limitations due to the disease, such as physical illness, psychological instability, and difficulty performing social roles. Second, patients manage the disease by engaging in self-management, psychological coping strategies, and establishing social support. Third, patients design their new life by seeking better health-related quality of life and integrating the illness into their everyday life. However, patients experienced negative changes when disease management was not performed properly. The fact that illness acceptance could be cyclic means the difference between illness and loss/death acceptance. Nurse should develop and provide an integrated nursing intervention that is appropriate for phases of illness acceptance.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ka Chun Chong ◽  
Hong Fung ◽  
Carrie Ho Kwan Yam ◽  
Patsy Yuen Kwan Chau ◽  
Tsz Yu Chow ◽  
...  

Abstract Background The elderly healthcare voucher (EHCV) scheme is expected to lead to an increase in the number of elderly people selecting private primary healthcare services and reduce reliance on the public sector in Hong Kong. However, studies thus far have reported that this scheme has not received satisfactory responses. In this study, we examined changes in the ratio of visits between public and private doctors in primary care (to measure reliance on the public sector) for different strategic scenarios in the EHCV scheme. Methods Based on comments from an expert panel, a system dynamics model was formulated to simulate the impact of various enhanced strategies in the scheme: increasing voucher amounts, lowering the age eligibility, and designating vouchers for chronic conditions follow-up. Data and statistics for the model calibration were collected from various sources. Results The simulation results show that the current EHCV scheme is unable to reduce the utilization of public healthcare services, as well as the ratio of visits between public and private primary care among the local aging population. When comparing three different tested scenarios, even if the increase in the annual voucher amount could be maintained at the current pace or the age eligibility can be lowered to include those aged 60 years, the impact on shifts from public-to-private utilization were insignificant. The public-to-private ratio could only be marginally reduced from 0.74 to 0.64 in the first several years. Nevertheless, introducing a chronic disease-oriented voucher could result in a significant drop of 0.50 in the public-to-private ratio during the early implementation phase. However, the effect could not be maintained for an extended period. Conclusions Our findings will assist officials in improving the design of the EHCV scheme, within the wider context of promoting primary care among the elderly. We suggest that an additional chronic disease-oriented voucher can serve as an alternative strategy. The scheme must be redesigned to address more specific objectives or provide a separate voucher that promotes under-utilized healthcare services (e.g., preventive care), instead of services designed for unspecified reasons, which may lead to concerns regarding exploitation.


1999 ◽  
Vol 55 (3) ◽  
pp. 9-14
Author(s):  
C. J. Eales

Health care systems for elderly people should aim to delay the onset of illness, reducing the final period of infirmity and illness to the shortest possible time. The most effective way to achieve this is by health education and preventative medicine to maintain mobility and function. Changes in life style even in late life may result in improved health, effectively decreasing the incidence of chronic diseases associated with advancing age. This paper presents the problems experienced by elderly persons with chronic diseases and disabilities with indications for meaningful therapeutic interventions.


1998 ◽  
Vol 20 (4) ◽  
pp. 764-771 ◽  
Author(s):  
Rajesh Balkrishnan

2016 ◽  
Vol 25 (8) ◽  
pp. 898-907 ◽  
Author(s):  
Melissa L. Santorelli ◽  
Michael B. Steinberg ◽  
Kim M. Hirshfield ◽  
George G. Rhoads ◽  
Elisa V. Bandera ◽  
...  

2021 ◽  
Vol 14 (3) ◽  
pp. 324-326
Author(s):  
Maria Łukasiewicz ◽  
Marta Swarowska-Skuza

Arterial hypertension, as a very widespread chronic disease, and thus differing in both pathomechanism and course in patients, requires a significant individualization of pharmacotherapy. One such special group is the elderly. Both the low-renin pathomechanism of arterial hypertension and its phenotype (isolated systolic hypertension) imply the choice of a specific pharmacotherapy. Additionally, in this group, side effects should be observed much more vigilantly, while target blood pressure values should be treated more liberally. An example of antihypertensive therapy in a patient belonging to the group described is presented in the following case.


2012 ◽  
Vol 45 (6) ◽  
pp. 531 ◽  
Author(s):  
Yoo Kyung Park ◽  
Yeon Joo Lee ◽  
Sang Sun Lee
Keyword(s):  

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