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采用混合分析方法阐明英语和西班牙语老年患者的多种慢性疾病体验。

A mixed analysis approach to elucidate the multiple chronic condition experience of English- and Spanish-speaking older adults.

机构信息

Department of Health Science, College of Health Care Sciences, Nova Southeastern University, Fort Lauderdale, FL, USA,

Department of Psychiatry and Behavioral Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, USA,

出版信息

Clin Interv Aging. 2019 Feb 20;14:407-418. doi: 10.2147/CIA.S193215. eCollection 2019.

Abstract

BACKGROUND

Having multiple chronic conditions (MCCs) is the most common health condition in older adults. The management of each condition presents many challenges. A key factor in patients' ability to manage their own health care is their level of health literacy.

PURPOSE

The purpose of this mixed analysis study was to elucidate the experience of older adults living with MCCs and identify associations among the experiences to determine targets for future mobile health (mHealth) interventions focused on MCCs and health literacy.

PARTICIPANTS AND METHODS

Using the Abilities, Skills, and Knowledge Model as a framework, semi-structured interviews were completed with 25 older adults in English and Spanish. Interviews were analyzed using inductive thematic analysis and hierarchical cluster analysis.

RESULTS

The main themes from these results included 1) Reflections of chronic disease; 2) Emotional aspects of chronic disease; 3) Physical barriers to well-being; 4) Quality-of-care factors; and 5) Cognitive strategies for self-management. Qualitative results highlighted the importance of a multi-targeted approach to chronic disease self-management (CDSM). Cluster analysis identified associations within the qualitative data, revealing the importance of the subthemes related to coping with pain and the impact of the patient-provider relationship on treatment adherence.

CONCLUSION

Results support the utility of mHealth interventions to improve health literacy and promote CDSM.

摘要

背景

患有多种慢性疾病(MCC)是老年人最常见的健康状况。每种疾病的治疗都带来了许多挑战。患者管理自身健康的关键因素是他们的健康素养水平。

目的

本混合分析研究旨在阐明患有多种慢性疾病的老年人的体验,并确定这些体验之间的关联,以确定未来专注于多种慢性疾病和健康素养的移动健康(mHealth)干预的目标。

参与者和方法

使用能力、技能和知识模型作为框架,用英语和西班牙语对 25 名老年人进行了半结构化访谈。使用归纳主题分析和层次聚类分析对访谈进行了分析。

结果

这些结果的主要主题包括 1)慢性病的反思;2)慢性病的情绪方面;3)身体健康障碍;4)医疗质量因素;5)自我管理的认知策略。定性结果强调了针对慢性病自我管理(CDSM)的多目标方法的重要性。聚类分析揭示了定性数据中的关联,突出了与应对疼痛和患者与提供者关系对治疗依从性的影响相关的子主题的重要性。

结论

研究结果支持使用移动健康干预措施来提高健康素养和促进慢性病自我管理。

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