Chronic Illness最新文献

ObjectiveThis study evaluated the relationship between life events, perceived social support, and depressive features among people with diabetes.MethodsThis study was a cross-sectional design using convenience sampling. Questionnaires were distributed to targeted patients in primary health care services in the Nablus district.Questionnaires used wereThe Holmes-Rahe Stress Inventory Scale, The Beck Depression Inventory, and The Multidimensional Scale of Perceived Social Support.ResultsAbout 120 diabetic patients participated in this study. Findings revealed that higher diabetes mellitus prevalence was among older ages (39.2% are 60 years or older). More than half of the participants were smokers. Regarding life events, 53.3% of the patients have a 50% chance of developing major breakdowns in the next two years. Depression was found to be normal among 32.5% of participants, while 22.5% were moderately depressed. More patients had a disagreement that they could find social support from their friends than their family members.DiscussionPeople with diabetes are affected significantly by life events, depressive features, and perceived social support, hence, further attention is needed accompanied by frequent assessment for such factors for effective diabetes management.

ObjectiveThe 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.DesignCross-sectional qualitative study.MethodsFourteen 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.ResultsFour 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.ConclusionsParticipants 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.

ObjectiveTo analyze the published randomized controlled trials (RCTs) that investigated the effects of physical rehabilitation interventions provided directly (face to face) and by telerehabilitation on exercise performance, dyspnea, and health-related quality of life (HRQoL) in acute and post-acute COVID-19 patients.MethodsFor this systematic review and meta-analysis, different electronic databases were searched up to January 2023. Mean difference (MD), (standardized mean difference (SMD) were calculated.Results34 studies (2214 patients) met the study criteria. Physical interventions may improve aerobic capacity in acute COVID-19 (SMD 1.7; 95% CI 0.37, 2.8) and in post-acute COVID-19 participants (MD 0.4; 95% CI 0.1, 07) compared to usual care for acute and pos-acute COVID-19 patients, respectively. Physical interventions may also improve dyspnea in acute (SMD -1.4; 95% CI -0.8, -0.01) and in post-acute COVID-19 participants (MD -0.4; 95% CI -0.7, -0.2) compared to usual care. Physical interventions may result in an improvement in HRQoL (physical domain) (SMD 0.6; 95% CI 0.3) in post-acute COVID-19 participants compared to usual care in pos-acute COVID-19 patients.DiscussionThe results support that physical rehabilitation interventions improve aerobic capacity and dyspnea in acute and post-COVID-19 patients. Moreover, physical interventions improve physical domain in HRQoL.

ObjectivesThe COVID-19 pandemic has left many suffering from long COVID, an episodic and debilitating chronic condition affecting people's ability to work and manage medical expenses. Though the Biden Administration has committed to conducting research and building support programs to alleviate the strain on those affected, in practice, static eligibility criteria for unemployment and disability benefits, patchy insurance coverage, and insufficient paid leave programs have left many people vulnerable. Given the magnitude of long COVID and the dearth to date of large-scale studies about its financial consequences, a focused qualitative analysis of lived experiences is warranted to understand and highlight gaps in the policy landscape.MethodsWe conducted in-depth semi-structured interviews from 2020 to 2022 with 25 people with experience of long COVID living predominately in the Midwest.ResultsOur inductive analysis revealed ways people became financially exhausted by uncertain medical care costs and precarious employment that left them trying, often alone, to access benefits. People described both experiences with workplace benefits and attempts to access federal benefits to address unstable employment situations created by protracted and uncertain functional impairments.DiscussionWe explore pre- and post-pandemic era unemployment, disability, and insurance policies and offer recommendations for better supporting people with long COVID.

IntroductionDespite the effect of coronary artery disease on sexual function and the relation between sexual function and marital satisfaction, few studies have investigated the effect of treatment adherence on marital satisfaction. The present study aims to investigate the role of treatment adherence in predicting marital satisfaction among women with coronary artery disease.MethodologyIn this cross-sectional study, 385 women with coronary artery disease in Bushehr-Iran, 2021, were selected using a convenient sampling method. The data were collected using the demographic form, Seyed Fatemi medication adherence scale, female sexual function index, and evaluation and nurturing relationship issues, communication, and happiness marital satisfaction scale. The data was analyzed using univariate and multivariate logistic regression tests.ResultsThe mean (± standard deviation) age of the participants was 52.19 ± 12.15 years old. Considering the effect of demographic variables, treatment adherence (β = 0.164, P = 0.001) and sexual function (β = 0.156, P = 0.001) were positive predictors of marital satisfaction.ConclusionTreatment adherence was a positive predictor of marital satisfaction. Healthcare providers should pay attention to the family consequences of non-adherence to treatment. Moreover, when counseling patients to adhere to the treatment, they should mention the physical benefits as well as psychological and family outcomes in order to motivate patients to follow their treatment.

ObjectivesThis study aimed to identify patients at higher risk for regional disengagement from health services using the Patient-centered Relevance Index (P-RI).MethodsThis nationwide retrospective cohort study analyzed the relationship between the P-RI and individual patient characteristics, including medical conditions and healthcare utilization patterns. The National Health Insurance Service claims database was used to characterize healthcare utilization by 3,046,914 patients with DM from 2017 to 2020.ResultsAs compared to the mild condition group, all other groups had a lower P-RI. Significant differences were observed among the groups with P-RI lower by 16.5%, 14%, 13%, 0.4%, and 0.6% in the repeated inpatient treatment (β = -0.165, P < 0.001), complication (β = -0.141, P < 0.001), extended long-term care stay (β = -0.130, P < 0.001), comorbidity (β = -0.041, P < 0.001), and other (β = -0.058, P < 0.001) groups, respectively. Additionally, the P-RI was high among low-income and older patients with high acuity.DiscussionSouth Korea's healthcare delivery system is not regionally self-sufficient. A relatively low P-RI in the high income and younger groups indicates healthcare access inequity. Therefore, a continuous management system that ensures uniform healthcare access needs to be established.

ObjectivesSpinal cord injury (SCI) results in mild to severe functional limitations, decreasing a person's ability to perform activities of daily living. This study aims to identify the influence of SCI characteristics and self-efficacy on functional limitations, controlling for sociodemographic factors.MethodsParticipants for this cross-sectional descriptive study included 272 persons with SCI. The participants completed questionnaires on sociodemographic information, secondary physical conditions, self-efficacy, and functional limitations, using an online Qualtrics Survey. Multiple hierarchical regression analysis was performed to test the hypothesis.ResultsParticipants reported higher functional limitations on dressing the lower body and managing their bowels compared to other activities of daily living. The sociodemographics, injury characteristics, and self-efficacy collectively accounted for 66% variance in functional limitations. A higher level of secondary physical conditions and tetraplegia injury contributed to higher functional limitations. As hypothesized, greater self-efficacy significantly contributed to low functional limitations above and beyond sociodemographic and SCI-related variables.DiscussionFunctional limitations following SCI are a pervasive challange in persons with SCI. Early recognition and management of secondary conditions and implementation of psychological interventions to strengthen self-efficacy in performing activities and managing secondary complications could potentially enhance functional independence and, ultimately, quality of life in this population.

ObjectivesThe objectives of this study were to (i) develop a self-report instrument to measure adjustment to chronic illness, (ii) evaluate its core structure and (iii) study various psychometric properties in the development of this instrument.MethodThe entire process of developing and validating the instrument is conducted in different phases: item writing and content validation; exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to extract dimensions of the instrument; reliability and validity testing. A total of 1095 participants were included in the study. The EFA was run using IBM SPSS 23 and CFA was done by AMOS 21.ResultsThe Cronbach alpha of the chronic illness adjustment scale was found to be .70. The instrument correlates positively with illness perception and well-being which supports the notion that the chronic illness adjustment scale has satisfactory convergent validity.DiscussionThe multifaceted nature of the chronic illness adjustment scale can serve as a global indicator of adjustment to chronic illness, allowing various interventions to flow toward the healthcare arena.

BackgroundHypertension is the most common comorbidity in patients with cancer. We aimed to estimate the prevalence of hypertension by demographic characteristics and cancer type among hospitalized patients with cancer.MethodsHospitalized cancer patients were included using 2016-2018 National Inpatient Sample data. The independent variable was the presence of hypertension, which was further classified as primary, secondary, and other hypertension. Patient characteristics were grouped by age, sex, race/ethnicity, and the 12 most common cancer types. Multinomial logistic regression was used.ResultsAmong 638,670 hospitalized patients with cancer, 56.8% had hypertension. The predicted percentages of having any hypertension were higher with age, male gender, and black race. The predicted percentages of any hypertension were the highest in kidney cancer patients across all age and race/ethnicity groups. Uterine cancer was associated with the highest percentages of primary hypertension, followed by kidney cancer. Leukemia was associated with the highest percentages of secondary hypertension, followed by non-Hodgkin lymphoma.DiscussionKidney cancer patients had the highest predicted percentage of hypertension overall, while uterine cancer and leukemia had the highest percentages of primary and secondary hypertension, respectively. This study provides evidence for identifying cancer patients who need more attention for the prevention and management of hypertension.

ObjectiveThe current study aimed to better understand how parent-child relationships might moderate the effects of the presence and severity (as measured by physical quality of life) of a chronic illness on psychological problems in emerging adulthood.MethodsThe participants included 538 emerging adults (53.5% women) with a mean age of 19.04. The participants completed an online study including chronic illness questions, the World Health Organization Quality of Life-Brief, the Parental Environment Questionnaire, and the Adult Self-Report scale.ResultsEndorsing a health condition significantly associated with psychological problems in emerging adult men. The three-way interaction between endorsing a health condition, physical quality of life, and maternal parent-child relationship quality significantly predicted psychological problems in emerging adult men and women. Specifically, higher maternal relationship quality was associated with a weaker relation between psychological problems and having a health condition with a low physical quality of life.DiscussionThe emerging adults who reported the most psychological problems also reported having a health condition, low physical quality of life, and low maternal relationship quality, highlighting that the combination of these variables predicted the highest rate of psychological problems. A low maternal relationship quality contributes to poor psychological adjustment while a high maternal relationship quality contributes to good psychological adjustment.