Chronic Illness最新文献

Objectives: The study delves into the intricacies of cancer-related fatigue (CRF), the quality of life (QoL), and other demographic variables of female adolescent and young adult cancer survivors (AYACS) in the landscape of Kerala, India.

Methods: The cross-sectional study included 288 female AYACS who were selected through purposive sampling and completed self-reported questionnaires on CRF, QoL, and demographic and clinical data. Statistical analyses were applied, including correlation, one-way ANOVA, and regression.

Results: and discussion: The temporal dimension is particularly interesting, as individuals three to five years post-treatment report heightened CRF and QoL scores. Furthermore, the research unveils the pivotal role played by predictors such as marital status, educational attainment, and employment status in shaping QoL. Marital status and education emerge as positive predictors of well-being. The study unveils compelling insights into AYA cancer survivorship, revealing a profound impact of CRF on the quality of life dimensions. The role of spirituality, sometimes affecting social connectedness, adds intrigue.

Conclusion: The findings provide insights into the complex world of female AYACS, compelling researchers to ponder the significance of addressing CRF and tailoring rehabilitation systems during the critical post-treatment phase, with recognition of gender-specific challenges.

Objectives: To contribute to a better understanding of the complexities of social support exchanged within couples coping with Parkinson's disease (PD), the present study aimed to identify costs and complications of support between persons with PD (PWPs) and their partners, as well as how to effectively manage such challenges.

Methods: In-depth interviews were conducted with 63 participants, including 31 PWPs and 32 partners. Interviews were transcribed and analyzed using constant comparative techniques.

Results: Participants reported the following complications and costs of social support: partners' differing approaches to coping can make support difficult, support can be perceived as identity-threatening and controlling, support can lead to dependency, and support can be draining. In addition, participants discussed effectively managing challenges of support by seeking/providing support subtly, taking the other's perspective, and relinquishing control.

Discussion: In health care and interventions, it is important for PWPs and partners to be educated about social support so that couples can anticipate these costs and complications of support and consider which management strategies are likely to be effective for them in various circumstances.

Objective: The aim of this study was to explore the experiences of university students with a chronic illness in Ireland. The study also aimed to gain insight into students' experiences with Disability Support Services (DSS) and identify gaps where additional supports and resources are needed.

Design: Cross-sectional qualitative study.

Methods: Fourteen students from three Irish universities participated in semi-structured interviews. The interviews were audio-recorded, transcribed, and analysed through the six-step process of reflexive thematic analysis.

Results: Four themes were developed: (1) The burden of managing a chronic illness alongside university education; (2) Interruptions, disruptions and alterations to college life; (3) Flexible supports for fluctuating conditions; (4) Achieving in educating while living with a chronic illness.

Conclusions: Participants reported a physical and emotional burden. Despite engaging in rigorous management strategies, many participants missed lectures and socialising with peers. Some found the supports from DSS to be useful, however many were unsure if they qualified for support, or found the supports available to be generic and inadequate for their needs. There is significant scope for the delivery of both teaching and DSS to be improved for this cohort, ensuring that all students, regardless of their health status, have equal opportunities for success.

Objectives: The aim of this study was to determine the relationship between kinesiophobia and adaptation to chronic illness.

Methods: The study was conducted with descriptive design. The questionnaire consists of three parts: a form including questions about socio-demographic characteristics and chronic diseases-related characteristics of the participants, Tampa Scale for Kinesiophobia, and Adaptation to Chronic Illness Scale.

Results: A total of 217 patients participated in the study, consisting of 99 patients with diabetes, 74 with heart failure (HF), and 44 with chronic obstructive pulmonary disease (COPD). The general mean age of the patients participating in the study was 61.03 ± 11.99 years, and the mean duration of disease diagnosis was 9.83 ± 7.16 years. While age, physical adaptation, and psychological adaptation affected the level of kinesiophobia of the patients with COPD and HF by 44.3% and 47.7%, respectively, physical adaptation and psychological adaptation affected the level of kinesiophobia of the patients with DM by 29.6%.

Discussion: While the level of kinesiophobia was found to be high in all disease groups, it was determined that the level of adaptation to the disease was limited. Psychological and physical adaptation to illness was correlated with kinesiophobia.

Objectives: This pilot study aimed to: (a) understand the experiences of Indian patients with type 2 diabetes mellitus and their expectations of their physicians during a medical consultation, (b) serve as a preliminary study to inform the development of a larger project exploring and improving patients' communication experiences, and (c) assess whether the pilot study findings indicate the viability of using the Relationship: Establishment, Development, and Engagement model of communication as the conceptual framework for the larger project.

Methods: Using convenience sampling, 11 patients participated in a focus group discussion. Conventional content analysis was used.

Results: Two themes were generated: (a) A plethora of negative feelings: experiences of the physician's verbal and nonverbal communication styles, and (b) 'I know what I want': Expectations of communication by patients from their physician.

Conclusions: The medical encounter with the physician elicited a range of negative experiences and clear expectations from the patients with type 2 diabetes mellitus. This pilot points to the need for (a) a mixed methods approach to comprehensively examine the communication needs of patients with type 2 diabetes mellitus from their physician, (b) understand physicians' communication practices, and (c) using these findings, culturally adapt and test the Relationship: Establishment, Development, and Engagement to improve physicians' communication skills in India.

Objectives: In this article, we seek to extract the themes that patients share when they express negative emotions in the context of follow-up consultation of chronic illness. We are mainly interested in patients with chronic illnesses, as these pathologies have a significant emotional overload leading to a significant deterioration of the patient's quality of life.

Methods: Our corpus included audio recordings of 12 chronic disease follow-up consultations conducted by physicians practicing in neurology, nutrition, internal medicine and infectiology. The 12 patients participating suffer from various chronic diseases: Parkinson's, HIV, diabetes, etc. We performed thematic content analyses on the emotional sequences in order to extract the themes underlying these emotional expressions.

Results: The 10 themes we have extracted are related to physical aspects, psychological aspects, the healthcare system and/or the healthcare provider, prognostic elements, social life, family life, aspects of professional life, issues of daily life, treatments and finally, aspects related to objectives and disease progress.

Discussion/conclusion: Our results show that follow-up consultations for chronic illnesses are consultations during which patients express emotions for different purposes. These emotional expressions concern particular themes that are not found in other forms of medical consultations. We will compare these results in the discussion part of this article.

Background: The Provider Attitudes toward CR and Referral (PACRR) scale was translated into Simplified Chinese and psychometric validation ensued.

Methods: Brislin's Translation Model was applied, with two independent forward translations followed by back-translation. Experts assessed the face, content and cross-cultural validity of items, and item analysis followed. For validation, 227 physicians from hospitals in 14 Chinese provinces completed the PACRR-C. Structural validity was assessed through exploratory and confirmatory factor analysis. Internal and split-half reliability were assessed.

Results: Some items were rephrased and one item was deleted. The content validity index for the total scale was 0.965. The correlation coefficients between the 18 items and the total scale ranged between 0.28 and 0.76. Consistent with the English version, four factors were extracted (Cronbach's alpha ranged from 0.671-0.959) through the factor analysis, accounting for 71.21% of the total variance. Split-half reliability was 0.945. The greatest factors impacting physician's CR attitudes were inconvenience of the referral process (3.93 ± 0.65/5); lack of standard referral forms (3.92 ± 0.66), perceiving referral as the responsibility of another clinician (3.89 ± 0.67), and need for support in completing the referral form (3.89 ± 0.64).

Conclusions/significance: The reliability, as well as content, face, cross-cultural, and structural validity of the 18-item, 4-subscale PACRR-C, were supported.

Objectives: World Health Organization has recommended enhanced adherence counselling (EAC) for people living with HIV (PLHIV) with virological failure. This study aimed to assess the outcomes of EAC and its associated factors among PLHIV with virological failure.

Methods: Data collected between March 2020 and February 2022 on viral load (VL) testing at antiretroviral therapy (ART) centre in Pune, India were reviewed. PLHIV with viral load ≥1000 copies/ml followed by three EAC sessions and a repeat viral load test were included. Multivariate logistic regression analysis was used to assess the factors associated with virological suppression (<1000 copies/ml).

Results: Of 170 PLHIV, 81 (47.6%) showed virological suppression. Being literate (p = 0.027), females (p = 0.021), on second-line ART regimen (p = 0.020), and with EAC initiation within a month (p = 0.016) were significantly associated with virological suppression. No association was found between reported barriers to treatment adherence and virological suppression.

Discussion: Early initiation of EAC is crucial for virological suppression among PLHIV with high viral load. It is important to highlight the significance of treatment adherence among individuals on first-line ART regimen. The use of effective visual tools during EAC sessions may help in achieving virological suppression among those with low literacy.

Objective: The clinical aspects of lung cancer patients are well-studied. However, healthcare charge patterns have yet to be explored through a large-scale representative population-based sample investigating differences by socioeconomic factors and comorbidities.

Aim: To identify how comorbidities associated with healthcare charges among lung cancer patients.

Methods: We examined the characteristics of the patient sample and the association between comorbidity status (diabetes, hypertension, or both) and healthcare charge. Multivariate survey linear regression models were used to estimate the association. We also investigated sub-group association through various patient and socioeconomic factors.

Results: Of 212,745 lung cancer patients, 68.5% had diabetes and/or hypertension. Hospital charges were higher in the population with comorbidities. The results showed that lung cancer patients with comorbidities had 9.4%, 5.1%, and 12.0% (with diabetes, hypertension, and both, respectively) higher hospital charges than those without comorbidities. In sub-group analysis, Black patients also showed a similar trend across socioeconomic (i.e. household income and primary payer) and racial (i.e. White, Black, Hispanic, and Asian/Pacific Islander) factors.

Discussion: Black patients may be significantly financially burdened because of the prevalence of comorbidities and low-income status. More work is required to ensure healthcare equality and promote access to care for the uninsured, low-income, and minority populations because comorbidities common in these populations can create more significant financial barriers.

Objectives: To identify perceptions and experiences related to caring science and collaborative care in intervention participants of the Collaborative Care to Alleviate Symptoms and Adjust to Illness (CASA) study, a randomized, multi-site clinical trial for patients with chronic heart failure and reduced health status.

Methods: Forty-five participants completed semi-structured, telephone interviews with a focus on intervention components, impact of the intervention on participants' lives, and recommendations for intervention change. Data were analyzed using an inductive content analysis approach focusing on the presence and frequency of text to identify patterns, categories, and themes across participants without an a priori code book. The validity of the identified categories was enhanced through triangulation.

Results: Three themes were identified: (1) intervention providers' caring/helping attitude and caring/helping communication; (2) care team availability to respond to concerns or questions; and (3) help with understanding and navigating the healthcare system.

Discussion: Patients highly value caring attitudes and communication, availability, and empowerment to understand and navigate healthcare systems. These attitudes and behaviors may be important mediators of the success of collaborative care programs. These are consistent with the theory of caring science, a framework that is relevant more broadly to patient-centered and team-based care models.