当前位置： SCI文献检索 > ANNALS OF FAMILY MEDICINE期刊下所有文献 > Barriers to self-management and quality-of-life outcomes in seniors with multimorbidities.

Barriers to self-management and quality-of-life outcomes in seniors with multimorbidities.

Abstract：

PURPOSE:Persons with multiple chronic diseases must integrate self-management tasks for potentially interacting conditions to attain desired clinical outcomes. Our goal was to identify barriers to self-management that were associated with lower perceived health status and, secondarily, with lower reported physical functioning for a population of seniors with multimorbidities. METHODS:We conducted a cross-sectional telephone survey of 352 health maintenance organization members aged 65 years or older with, at a minimum, coexisting diagnoses of diabetes, depression, and osteoarthritis. Validated questions were based on previous qualitative interviews that had elicited potential barriers to the self-management process for persons with multimorbidities. We analyzed associations between morbidity burden, potential barriers to self-management, and the 2 outcomes using multivariate linear regression modeling. RESULTS:Our response rate was 47%. Sixty-six percent of respondents were female; 55% were aged 65 to 74 years, and 45% were aged 75 years or older. Fifty percent reported fair or poor health. On average they had 8.7 chronic diseases. In multivariate analysis, higher level of morbidity, lower level of physical functioning, less knowledge about medical conditions, less social activity, persistent depressive symptoms, greater financial constraints, and male sex were associated with lower perceived health status. Potential barriers to self-management significantly associated with lower levels of physical functioning were higher level of morbidity, greater financial constraints, greater number of compound effects of conditions, persistent depressive symptoms, higher level of patient-clinician communication, and lower income. CONCLUSIONS:In addition to morbidity burden, specific psychosocial factors are independently associated with lower reported health status and lower reported physical functioning in seniors with multimorbidities. Many factors are amenable to intervention to improve health outcomes.

journal_name

Ann Fam Med

journal_title

Annals of family medicine

authors

Bayliss EA,Ellis JL,Steiner JF

doi

10.1370/afm.722

subject

Has Abstract

pub_date

2007-09-01 00:00:00

pages

395-402

issue

eissn

1544-1709

issn

1544-1717

pii

5/5/395

journal_volume

pub_type

杂志文章

在线工具

Barriers to self-management and quality-of-life outcomes in seniors with multimorbidities.