Schoenberg Nancy E, Leach Corinne, Edwards William
Department of Behavioral Science, The University of Kentucky, College of Medicine, Lexington, KY 40536-0086, USA.
J Health Care Poor Underserved. 2009 Feb;20(1):134-51. doi: 10.1353/hpu.0.0115.
Nearly three quarters of older adults have multiple morbidities (MM). This study investigated which morbidities older adults prioritize, why, and how they accommodate these conditions, focusing on elders with two or more chronic conditions and low socioeconomic status. Methods. In-depth interviews were conducted with 41 older adults (most being African American women from the southeastern U.S., with two or more chronic illnesses). Results. Many participants reported worrying most about their heart disease, diabetes, and disability/mobility problems, and about their synergistic effects. Many worried that MMs might tip them into a downward spiral. Participants spent the most time and money on arthritis and diabetes. Few received help; when they did, relatives assisted with arthritis/mobility, diabetes, and effects of stroke. Discussion. Enhanced formal care coordination, increased use of technological innovations, and understanding elders' priorities are necessary to improve self-care/management and quality of life.
近四分之三的老年人患有多种疾病(MM)。本研究调查了老年人将哪些疾病列为优先事项、原因以及他们如何应对这些疾病,重点关注患有两种或更多慢性病且社会经济地位较低的老年人。方法。对41名老年人(大多数是来自美国东南部的非裔美国女性,患有两种或更多慢性病)进行了深入访谈。结果。许多参与者表示最担心自己的心脏病、糖尿病、残疾/行动问题以及它们的协同作用。许多人担心多种疾病可能会使他们陷入恶性循环。参与者在关节炎和糖尿病上花费的时间和金钱最多。很少有人得到帮助;当他们得到帮助时,亲属会协助处理关节炎/行动问题、糖尿病以及中风的影响。讨论。加强正式的护理协调、增加技术创新的应用以及了解老年人的优先事项对于改善自我护理/管理和生活质量是必要的。