Chronic Illness最新文献

ObjectivesType 1 diabetes (T1D) is a complex and chronic disease that often requires management within an interpersonal context. Young couples may face unique challenges as they integrate and negotiate diabetes routines into their lives. The purpose of this study is to examine the experiences of young adult couples as they adjust and adapt to the management of T1D in their relationship.MethodsYoung adults (25-40 years) living with T1D and their romantic partners (77 couples, 154 individuals) were separately interviewed. A constant comparison approach was used to qualitatively analyze the data for similarities and differences in perceptions of diabetes management as a dyad. Themes were then identified.ResultsThree themes emerged from the data: learning to incorporate diabetes into the relationship, working together to manage diabetes, and parenting with T1D. Young adult couples are developing coping mechanisms to manage diabetes together. Partners must learn to balance being supportive without being over controlling.DiscussionYoung adults with T1D and partners adjust to diabetes as a couple. Diabetes education for the partner is important to the relationship. Interventions developed to support couples establish collaboration earlier in their relationship may be beneficial for clinical and relationship outcomes.

ObjectivesTo address the challenges of tuberculosis (TB) control in the United States post-COVID-19, focusing on high-risk populations, current diagnostic and treatment strategies, and the importance of addressing clinical and social determinants of health to achieve TB elimination goals.MethodsA review of the latest evidence-based guidelines and literature on TB diagnostics, treatment regimens, and latent TB infection (LTBI) management was conducted. Key public health challenges and interventions targeting socioeconomic disparities, stigma, and healthcare access among high-risk populations were analyzed.ResultsHigh-risk groups, including immigrants and ethnic minorities, continue to bear a disproportionate burden of TB due to socioeconomic disparities and comorbidities. Advancements in diagnostic modalities and treatment regimens offer promising outcomes, but gaps remain in LTBI screening and management. Addressing social determinants, such as healthcare access and stigma, is essential for enhancing TB control efforts.DiscussionEffective TB elimination requires collaborative efforts among healthcare professionals, policymakers, and communities to implement evidence-based strategies. Prioritizing both clinical precision and social interventions is critical for overcoming barriers and achieving national TB control and elimination goals.

Background and PurposeWhile empirical studies in Iraq have examined sociodemographic characteristics and modes of human immunodeficiency virus (HIV) transmission, including but not limited to those involving key populations, there remains a critical lack of synthesizing these studies. Therefore, the purpose of this syetematic review is to comprehensively synthesis the available empirical evidence to understand the sociodemographic characteristics and modes of HIV transmission in Iraq, with the goal of informing future strategies for prevention, treatment, and care.MethodThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was used. Seven electronic databases (PubMed, CINAHL with Full text, PsychINFO, Google Scholar, Web of Science, Scopus, MEDLINE with FULL Text (EBSCO)) were searched between 1986 and December 2024. Inclusion criteria were original studies that reported sociodemographic factors and modes of HIV transmission among people living with HIV. A total of 854325 records were identified, but 6 studies met the inclusion criteria. We synthesized data using a convergent integrated approach to identify key themes.FindingsHIV prevalence was high in urban areas, single, low educational levels, employed, and low economic status people. The most common modes of HIV transmission were heterosexual, followed by blood transfusion, man who have sex with man, bisexual, and mother to infant, and surgery.ConclusionThe HIV is steady increasing. Therefore, enhancing HIV prevention, early detection, and treatment access are required.

ObjectivesTo examine whether illness or healthcare experiences have a more significant influence on living well, and which factors in these experiences have the most influence.MethodsInformation collected included demographic data, illness and healthcare experience, and the LTCQ to measure living well. Data was collected via online survey platform Qualtrics. Two separate 2-stage hierarchical multiple regressions were run to investigate how much variance in living well with long-term conditions is accounted for by established and exploratory illness and healthcare experience factors.Results70 participants met the inclusion criteria of the study, with 54 included in the analysis. Results showed that illness experience had a significant influence on living well while healthcare experience did not. The factors of illness intrusiveness in illness experience and patient assessment of chronic illness care in healthcare experience significantly impacted living well.Discussion: This study examines the influences of illness and healthcare experiences on the ability to live well with LTCs. Future research could focus on specific LTCs and compare which factors they find significantly affect living well. The findings pave the way for future explorations into the factors influencing living well differ between LTCs and the best interventions to improve living well with LTCs.

ObjectivesThis study aims to examine the relationships between health literacy, patient participation and patient activation variables, and to investigate whether patient activation has a mediating effect on the impact of health literacy on patient participation.MethodsThe population of the study consists of individuals with chronic diseases who applied to different outpatient clinics of a city hospital in Türkiye. Data was collected from 671 individuals using the convenience sampling method in the study.ResultsAccording to the results of the correlation analysis conducted in the study, statistically significant, positive relationships were found between health literacy and patient activation, health literacy and patient participation, patient activation and patient participation. The results of the regression analysis showed that health literacy explained 10% of the total variance in patient participation and 8% of the total variance in patient activation, while patient activation explained 11% of the total variance in patient participation. Additionally, the study determined that patient activation plays a statistically significant and positive mediating role in the relationship between health literacy and patient participation.DiscussionThe results show that as the level of health literacy increases in individuals with chronic diseases, patient participation and patient activation may also increase.

ObjectivesThis study aims to evaluate the nursing dependence of patients with lower urinary tract symptoms (LUTS) in communities and nursing homes under the medical consortium model. It also investigates the relationship between sociodemographic factors, LUTS, and nursing dependence.MethodsA cross-sectional survey was conducted from January 2023 to October 2024, involving 213 patients with LUTS from communities and nursing homes in xxx City, xxx Province. Participants completed questionnaires assessing demographic information, LUTS severity, and nursing dependence. Statistical analyses were performed using SPSS 29.0, employing t-tests, Kruskal-Wallis tests, and Pearson correlation tests.ResultsAmong male patients, 48.57% exhibited moderate prostate symptoms, while 65.72% had moderate nursing dependence. Female patients mainly experienced moderate urinary storage (49.07%) and voiding (43.52%) symptoms, with 60.19% showing nursing dependence. Pearson correlation analysis revealed significant positive correlations between the severity of LUTS and nursing dependence (P < 0.01).DiscussionIn communities and nursing homes under the medical consortium model, the severity of LUTS is moderate and strongly correlates with nursing dependence. This highlights the need for targeted interventions to address care needs and improve quality of life for these patients.

ObjectivesIncreased psychological support is required to assist the long-term well-being of the adult Cystic Fibrosis (CF) population. This research aimed to identify relationships between mindfulness, psychological flexibility, and wellbeing, as well as potential mediating effects of mindfulness to increase wellbeing in adults with CF.MethodsIn a cross-sectional study, 114 (56 female, 58 male) adults with CF completed and returned a series of validated questionnaires that assessed mindfulness, psychological flexibility, and wellbeing.ResultsParticipants who demonstrated better psychological flexibility also had higher levels of mindfulness and wellbeing, and similarly, those who reported higher levels of mindfulness had better wellbeing. Mindfulness subscale scores indicated additional associations. Mindfulness partially mediated the relationship between psychological flexibility and wellbeing. A second mediation model suggested that specifically 'acting with awareness' (i.e., a mindfulness subscale) also partially mediated the relationship between psychological flexibility and wellbeing, highlighting the significance of mindfulness within promoting wellbeing through psychological flexibility.DiscussionThis research demonstrates the importance of mindfulness in the relationship between psychological flexibility and wellbeing. The findings provide promising preliminary evidence to suggest that Acceptance and Commitment Therapy (ACT), a therapy enhancing psychological flexibility through mindfulness, to be beneficial for enhancing the wellbeing of adults with CF.

ObjectivesTo understand individuals' experiences of living with, and attempting to manage, trigeminal neuralgia (TN), a rare neurological disorder characterised by sudden episodes of intense, incapacitating unilateral facial pain.MethodsWe undertook in-depth interviews with (n = 25) individuals living with TN in the United Kingdom recruited via online forums. Data were analysed thematically.ResultsParticipants described the far-reaching impact of TN on their everyday lives, with their experiences broadly fitting into three overarching themes: "enduring pain", "avoiding pain" and "treatment burdens". Taken together, these three overlapping experiences comprise what we term the "triple burden" of TN: namely, the burden and assault to self, arising from being in intense and intractable pain; the burden and loss of self-identity resulting from avoiding pain triggers; and the additional burden resulting from having to balance pain relief with severe medication side effects.DiscussionLiving with TN can be a highly disruptive and distressing experience because TN pain and the strategies people employ to try to avoid triggering it can assault and undermine their self-identities and sense of self-worth. We argue that applying sociological concepts, such as Bury's work on biographical disruption, may help to shed light on people's lived experiences of TN and inform the care and support provided to them.

AimsIn this study, the aim is to explore how adolescents with inflammatory bowel disease cope with the challenges posed by the illness through psychological adjustment, with the goal of providing insights for the implementation of targeted interventions.MethodsFrom June to August 2023, semi-structured interviews were conducted with patients. Data were analyzed using the Colaizzi seven-step method.ResultsThe psychological adaptation process for adolescents with IBD can be categorized into five main themes: 1) Denial phase: Disbelief in the reality of the disease; 2) Despair Phase：Struggling with the negative emotions brought about by the disease; 3) Rebuilding Phase: Reshaping of cognitive perspective; 4) Adaptation phase: Proactive behavioral response; and 5) Growth phase: Strengthening of psychological resilience.ConclusionHealthcare staff should place emphasis on the patients' positive experiences, foster connections between patients and their individual selves, families, and society, thereby strengthening their psychological adaptability.

ObjectivesQuality of life (QoL) is a significant health outcome for the older adults, especially during the COVID-19 pandemic. The demand for health care from older adults who use home care services often increases sharply due to a lack of healthy behaviors, which harms their QoL to various degrees. Thus, this study aimed to examine the predictors of the QoL of disabled older adults using home care services during the COVID-19 pandemic.MethodsA cross-sectional survey study was conducted. A total of 214 older adults were collected from five home care support centers in the central region of Taiwan from October 1, 2021, to July 8, 2022.ResultsStepwise multiple regression analysis showed that the health promotion of healthy behavior (11.9%), financial status (8.6%), activities of daily living (4.5%), community care services (3.5%), and could explain 28.5% of the variance in predicting the overall QoL.DiscussionMaintaining health-promoting behaviors, having a better financial status, engaging in suitable activities of daily life level, and receiving daycare services could effectively improve the QoL.