Chronic Illness最新文献

ObjectivesMany factors affect caregiver burden. Limited studies exist on the effect of social support and fatigue on family caregivers. This study aims to explore the impact of fatigue and social support on the burden experienced by family caregivers of palliative care patients.MethodsThe study was conducted with 80 family caregivers. Data were collected using the Piper Fatigue Scale, the Burden Interview, and the Multidimensional Scale of Perceived Social Support. Regression analysis was used to evaluate the data.ResultsThe regression analysis revealed that higher scores on the MSPSS were significantly associated with lower Burden Interview scores (p < 0.05). Conversely, higher PFS scores were significantly correlated with increased Burden Interview scores (p < 0.05).DiscussionBoth fatigue and social support play a critical role in shaping the caregiving burden experienced by family caregivers. Interventions aimed at reducing caregiver fatigue and enhancing social support may help alleviate this burden.

ObjectiveThis study aimed to evaluate the psychometric properties of the Persian version of the TSQM-14 in patients with hypertension in IranMethodsThis cross-sectional study was conducted among hypertensive patients referred to primary healthcare centers in Kerman City between January and February 2021. Cronbach's alpha and total-item correlation were used to evaluate internal consistency, while the Intraclass Correlation Coefficient (ICC) was employed to assess test-retest reliability. Construct validity was examined using structural equation modeling (SEM), known-groups validity, and convergent validity.ResultsA total of 319 participants took part in the study, with a mean age of 56.7 years (SD = 13.0), and 57.7% (n = 184) were female. The Cronbach's alpha and ICC values of the TSQM-14 for the composite scales were 0.83 and 0.91, respectively, indicating good reliability. The SEM indices for TSQM-14 demonstrated adequate model fit, with χ² = 118.9 (P ≤ 0.001), CFI = 0.96, RMSEA = 0.07, TLI = 0.95, and NFI = 0.91. The mean (standard deviation (SD)) scores of the composite scale for patients in the uncontrolled group (systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg) and the controlled group were 50.2 (SD = 6.6) and 47.6 (SD = 6.1), respectively (P = 0.021). Additionally, the Spearman correlation coefficient between the TSQM-14 scale and the MMAS-8 was 0.30 (P < 0.001), demonstrating a weak but significant correlation.ConclusionsThis study demonstrated that the Persian version of the TSQM-14 has acceptable reliability, as well as construct and convergent validity, for assessing treatment satisfaction among hypertensive patients.

ObjectiveThis study investigated how patients managed their chronic diseases, focusing on burden of treatment, within the primary care level in Mendoza Province, Argentina.MethodThe study used a mixed-methods approach, including a qualitative component with a purposive sampling of patients with diabetes, hypertension, or depression using primary care services, and a quantitative component with secondary analysis of databases from public and social security. Ten focus group sessions were conducted at primary healthcare centers in urban and rural areas. The Burden of Treatment theory was used to frame the analysis.ResultsThe study found that accessing care was difficult due to appointment difficulties and long waiting times, and obtaining medication and laboratory tests at secondary centers was also problematic. Non-emergency hospital care required primary care referrals, and users in rural areas faced access problems. Financial constraints were significant, with co-payments in social security sector, transportation costs, and lost work revenue. Strategies employed included networking, emergency service use, careful planning, and taking loans.ConclusionThis study underscores the complex implications of chronic disease management in a subnational healthcare system and provides insights for policymakers and healthcare providers.

ObjectivesThe purpose of this study was to assess the extent of diuretic nonadherence and to understand the reasons for diuretic nonadherence among patients with a 90-day heart failure hospital readmission.MethodsThis study utilized a convergent parallel mixed-method design. The extent and reasons for medication nonadherence were measured using the Domains of Subjective Extent of Nonadherence scale. Semi-structured interviews were used to understand patients' reasons for nonadherence. Descriptive and regression tests were used to analyze quantitative data. Thematic analysis was used for qualitative data analysis. Meta-inferences were developed from merged data.ResultsEighty-two adults participated in the study. The merged data indicated that 61% of participants were diuretic nonadherent. The analysis of merged data revealed 3 meta-inferences: (1) Diuretic nonadherence may not be entirely unintentional or intentional; (2) Fearing a loss of dignity contributes to diuretic nonadherence; and (3) Diuretic nonadherence is an act of self-determination.DiscussionIn this study, diuretic nonadherence was a complex mix of unintentional and intentional reasons, a strategy to protect against dignity loss, and an effort to gain control over diuretic effects. A need for dignity and self-determination may be important drivers of nonadherence and should be considered by clinicians and researchers.

ObjectivesThis review aims to identify the content of family-based interventions that are commonly used for primary caregivers of people diagnosed with chronic illness. In addition, the psychological-related outcome measures of the FAMIs will be examined.MethodsPRISMA was adopted for the review process. We searched CINAHL, Scopus, and Web of Science databases for studies that implemented a family-based intervention for family caregivers of patients with chronic illness. We reviewed articles published between January 2000 and January 2021. Two independent reviewers, multiple researcher triangulation, and peer review were employed to ensure the validity and reliability of the data.ResultsWe included 11 studies in this systematic literature review. In total, seven themes emerged under the content of family-based intervention consisting of family elements, skills, information, activities, positive psychology, recovery, and roles and responsibility. The psychological related outcome measures of the intervention include recovery, patient care management, skills improvement, emotional management, family relationships, and self-functioning.DiscussionThe aspect of family functioning may help the family caregivers to empower themselves and build up their inner strength to face unexpected situations. The results highlighted the importance of the involvement of the experts in family therapy in helping family caregivers. Cultural implications were also highlighted.

Background and PurposeThere is inconsistency and lack of conceptual clarity regarding the concept of "recurrence" in diabetes-related foot ulcers. Therefore, the purpose of this concept analysis is to analyze the concept of recurrence-related to diabetes-related foot ulcer after the healing of a previous foot ulcer.MethodThe Rodger's evolutionary concept analysis method was employed to analyze the concept of recurrence in diabetes-related foot ulcers. Eight databases, including PubMed, EMBASE, CINAHL Plus with Full Text, MEDLINE with Full Text (EBSCO), Web of Science, Cochrane Library, PsychoINFO, and Scopus, were searched. Additionally, Google Scholar, bibliographies, and hand searching were conducted. The search spanned from inception through August 13, 2023, yielding 3290 studies. Among these, 3242 did not meet the inclusion criteria, leaving 46 articles that fulfilled the criteria.FindingsIn a majority of the studies (n = 20, 43%), diabetes-related foot ulcer recurrence occurred at the same site after the healing of previous foot ulcers. In contrast, in fourteen (20%) studies, the diabetes-related foot ulcer recurrence was described as not at the same site as the previous foot ulcer. In the other twelve (26%) studies, the attribute of recurrence was not identified.ConclusionsThe concept of recurrence-related to diabetes-related foot ulcer should be reserved for diabetes-related foot ulcers at the same site after the healing of previous foot ulcers.

ObjectivesThe 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.MethodsThe 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.Resultsand 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.ConclusionThe 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.

ObjectiveThe aim of the current study was to better understand if perceived parental distress moderates the effects of having a chronic illness and poor physical quality of life on psychological problems reported by emerging adults.MethodsParticipants consisted of 538 college-attending emerging adults (53.5% women; 46.5% men). Participants completed an online study that was composed of questions regarding chronic illness, the World Health Organization Quality of Life - Brief, the Adult Self-Report scale, and the Adult Behavior Checklist.ResultsIn both emerging adult women and men, endorsing a chronic illness is significantly associated with psychological problems. Psychological problems in both emerging adult women and men were significantly predicted by the three-way interaction between endorsing a chronic illness, physical quality of life, and perceived maternal distress. Specifically, increased perceived maternal distress was associated with higher psychological problems in both emerging adult women and men with chronic illnesses and low physical quality of life.DiscussionFor emerging adult women and men with a chronic illness, higher perceived maternal distress was associated with poorer psychological adjustment, while lower perceived maternal distress was associated with better psychological adjustment.

ObjectiveThe aim of this study was to assess and compare knowledge of the health consequences of heavy alcohol consumption among individuals with different substance use statuses.MethodsWe used a cross-sectional study design to analyze the Health Information National Trends Survey (HINTS) 5, Cycle 3 (2019). Participants were classified into four categories based on their substance use status: (a) nonsmoker and nondrinkers; (b) nonsmokers but drinkers; (c) smokers but nondrinkers; and (d) smokers and drinkers. Weighted logistic regression models were utilized to evaluate the association between knowledge of heavy alcohol consumption and health conditions by participants' substance use status.ResultsMore than 79% of participants were aware that drinking too much alcohol causes liver disease. However, less than 40% of them realized that heavy alcohol consumption also contributes to cancer. The odds of correctly identifying heavy alcohol consumption as a risk factor for diabetes were 3.00 times (95% confidence interval (CI): 1.29,7.00) higher among smokers but nondrinkers than smokers and alcohol drinkers. Education level was significantly associated with participants' awareness of risk factor (p < 0.01).DiscussionThere is an urgent need for targeted educational campaigns and interventions to increase understanding of the impact of heavy alcohol consumption on cancer risk.

ObjectivesTo 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.MethodsIn-depth interviews were conducted with 63 participants, including 31 PWPs and 32 partners. Interviews were transcribed and analyzed using constant comparative techniques.ResultsParticipants 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.DiscussionIn 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.