Bazzano A N, Monnette A M, Wharton M K, Price-Haywood E G, Nauman E, Dominick P, Glover C, Hu G, Shi L
Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
Department of Health Policy and Management, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
Patient Prefer Adherence. 2019 May 30;13:901-911. doi: 10.2147/PPA.S201072. eCollection 2019.
Management of diabetes may be uniquely challenging for older individuals with multiple chronic conditions. Health systems and policymakers have attempted to reduce barriers to chronic care management (CCM) through incentives to provide non-face-to-face care. This qualitative study aimed to investigate and present views on non-face-to-face care management held by elderly patients with diabetes and other chronic conditions in order to contribute to improved programming for this population. Semi-structured interviews were conducted with patients over the age of 64 who have been diagnosed with diabetes and at least one other chronic health condition. Interview recordings were transcribed and analyzed by experienced researchers using a thematic analytic approach, and an illustrative case study was developed. Thirty individuals participated in this study. Participants were drawn from three health systems in south Louisiana, an area with high rates of morbidity and mortality related to chronic diseases. We identified themes related to lived experiences with diabetes and other medical conditions, perception of personal health status, perceived value of non-face-to-face programs, and support needs for future programming. Additionally, we present one case study describing in detail an individual patient's experience with non-face-to-face CCM. Health systems should consider intentionally recruiting participants who would benefit most from non-face-to-face care, including higher-need, less self-sufficient patients with resource constraints, while continuing to offer in-person services. Future research should examine whether tailoring non-face-to-face programming and support to address unique barriers can further enhance diabetes care at the population level.
对于患有多种慢性病的老年人来说,糖尿病的管理可能具有独特的挑战性。卫生系统和政策制定者试图通过激励措施来减少慢性护理管理(CCM)的障碍,以提供非面对面护理。这项定性研究旨在调查并呈现患有糖尿病和其他慢性病的老年患者对非面对面护理管理的看法,以便为改善针对该人群的项目做出贡献。对64岁以上被诊断患有糖尿病和至少一种其他慢性健康状况的患者进行了半结构化访谈。访谈录音由经验丰富的研究人员使用主题分析方法进行转录和分析,并开展了一个案例研究。30人参与了这项研究。参与者来自路易斯安那州南部的三个卫生系统,该地区与慢性病相关的发病率和死亡率很高。我们确定了与糖尿病和其他疾病的生活经历、个人健康状况认知、非面对面项目的感知价值以及未来项目的支持需求相关的主题。此外,我们呈现了一个案例研究,详细描述了一名患者在非面对面CCM方面的经历。卫生系统应考虑有意招募那些将从非面对面护理中受益最大的参与者,包括需求较高、资源有限且自理能力较差的患者,同时继续提供面对面服务。未来的研究应探讨针对独特障碍量身定制非面对面项目和支持措施是否能在人群层面进一步改善糖尿病护理。