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老年人脑卒中特定自我管理方案的预适应。

The Pre-Adaptation of a Stroke-Specific Self-Management Program Among Older Adults.

机构信息

Department of Occupational Therapy, School of Health Professions, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.

Department of Orthopaedic Surgery, School of Medicine, Duke University, Durham, NC, USA.

出版信息

J Aging Health. 2023 Oct;35(9):632-642. doi: 10.1177/08982643231152520. Epub 2023 Jan 31.

Abstract

Managing multimorbidity as aging stroke patients is complex; standard self-management programs necessitate adaptations. We used visual analytics to examine complex relationships among aging stroke survivors' comorbidities. These findings informed pre-adaptation of a component of the Chronic Disease Self-Management Program. Secondary analysis of 2013-2014 Medicare claims with stroke as an index condition, hospital readmission within 90 days ( = 42,938), and 72 comorbidities. Visual analytics identified patient subgroups and co-occurring comorbidities. Guided by the framework for reporting adaptations and modifications to evidence-based interventions, an interdisciplinary team developed vignettes that highlighted multimorbidity to customize the self-management program. There were five significant subgroups ( = 6.19, < .001) of comorbidities such as obesity and cancer. We constructed 6 vignettes based on the 5 subgroups. Aging stroke patients often face substantial disease-management hurdles. We used visual analytics to inform pre-adaptation of a self-management program to fit the needs of older adult stroke survivors.

摘要

管理老年卒中患者的多种合并症较为复杂;标准的自我管理方案需要进行调整。我们使用可视化分析方法来研究老年卒中幸存者合并症之间的复杂关系。这些发现为预先调整慢性病自我管理方案的一个组成部分提供了信息。对 2013 年至 2014 年医疗保险索赔数据的二次分析,这些数据将卒中作为索引条件,90 天内的医院再入院(=42938)和 72 种合并症。可视化分析确定了患者亚组和同时发生的合并症。在基于报告适应和修改证据为基础的干预措施框架的指导下,一个跨学科团队制定了突出多重合并症的案例,以定制自我管理方案。有五个显著的合并症亚组(=6.19,<.001),例如肥胖和癌症。我们根据 5 个亚组构建了 6 个案例。老年卒中患者经常面临重大的疾病管理障碍。我们使用可视化分析来为自我管理方案的预调整提供信息,以满足老年卒中幸存者的需求。

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