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Lindsay, Sally. "Prioritizing Illness: Lessons in Self-Managing Multiple Chronic Diseases." Canadian Journal of Sociology 34, no. 4 (May 29, 2009): 983–1002. http://dx.doi.org/10.29173/cjs1776.
Повний текст джерелаАнотація:
Chronic disease management strategies are largely based on single disease models, yet patients often need to manage multiple conditions. This study uses the concepts of ‘chronic illness trajectory’ and ‘biographical disruption’ to examine how patients self-manage multiple chronic conditions and especially how they prioritize which condition(s) will receive the greatest attention. Fifty-three people with multiple chronic illnesses participated in one of 6 focus groups. The results suggest that people who were disrupted tended to be younger than 60, lived on their own, cared for other family members, or other barriers. Many participants anticipated subsequent illnesses given their age and prior experience with illness. In order to cope with their multiple illnesses most felt it was necessary to prioritize their ‘main’ illness. Their reasons for prioritizing a particular illness included: (1) the unpredictable nature of the disease; (2) the condition could not be controlled by tablets; and (3) the condition tended to set off the rest of their health problems. Social context played a key role in shaping patients’ biography and chronic illness trajectory.
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Davies, Sue. "Telehomecare for patients with multiple chronic illnesses." Primary Health Care 18, no. 7 (September 14, 2008): 31. http://dx.doi.org/10.7748/phc.18.7.31.s20.
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Heid, Allison R., Andrew R. Gerber, David S. Kim, Stefan Gillen, Seran Schug, and Rachel Pruchno. "Timing of onset and self-management of multiple chronic conditions: A qualitative examination taking a lifespan perspective." Chronic Illness 16, no. 3 (September 4, 2018): 173–89. http://dx.doi.org/10.1177/1742395318792066.
Повний текст джерелаАнотація:
Objectives Over two-thirds of older individuals live with multiple chronic conditions, yet chronic diseases are often studied in silos. Taking a lifespan approach to understanding the development of multiple chronic conditions in the older population helps to further elucidate opportunities for targeted interventions that address the complexities of multiple chronic conditions. Methods Semi-structured interviews were conducted with 38 older adults (age 64+) diagnosed with at least two chronic health conditions. Content analysis was used to build understanding of how older adults discuss the timing of diagnoses and subsequent self-management of multiple chronic conditions. Results Findings highlight the complex process by which illnesses unfold in the context of individuals’ lives and the subsequent engagement and/or disengagement in self-management behaviors. Two primary themes were evident regarding timing of illnesses: illnesses were experienced within the context of social life events and/or health events, and illnesses were not predominantly seen as connected to one another by patients. Self-management behaviors were described in response to onset of each illness. Discussion Findings provide insight into how older adults understand their experience of multiple chronic conditions and change in self-management behaviors over time. In order for practitioners to ignite behavioral changes, a person’s history and life experiences must be considered.
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Divo, Miguel J., Carlos H. Martinez, and David M. Mannino. "Ageing and the epidemiology of multimorbidity." European Respiratory Journal 44, no. 4 (August 19, 2014): 1055–68. http://dx.doi.org/10.1183/09031936.00059814.
Повний текст джерелаАнотація:
The world’s population is ageing and an important part of this demographic shift is the development of chronic illness. In short, a person who does not die of acute illnesses, such as infections, and survives with chronic illnesses is more likely to develop additional chronic illnesses. Chronic respiratory diseases are an important component of these diseases associated with ageing. This article reviews the relationship between ageing and chronic respiratory disease, and also how certain chronic diseases cluster with others, either on the basis of underlying risk factors, complication of the primary disease or other factors, such as an increased state of inflammation. While death is inevitable, disabling chronic illnesses are not. Better understanding of how individuals can age healthily without the development of multiple chronic illnesses should lead to an improved global quality of life.
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Heid, Allison R., Rachel Pruchno, and Maureen Wilson-Genderson. "Illness Representations of Multiple Chronic Conditions and Self-Management Behaviors in Older Adults: A Pilot Study." International Journal of Aging and Human Development 87, no. 1 (May 8, 2018): 90–106. http://dx.doi.org/10.1177/0091415018771327.
Повний текст джерелаАнотація:
This article explores the intraindividual variability in illness representations of people with multiple chronic conditions and examines how representations of hypertension and arthritis are associated with self-management. Intraclass correlations determined the proportion of within-person variability in illness representations including Timeline, Consequences, Personal Control, and Timeline—Cyclical for 25 adults aged 64 and older. Within-person consistency across illnesses was present for Timeline and Timeline—Cyclical, but variability across illnesses in Personal Control and Consequences. Correlations revealed associations of diet, exercise, and sleep with illness representations of people with arthritis and hypertension. Representations of hypertension (Personal Control, Timeline–Cyclical, and Consequences) were associated with adherence to a reduced fat diet, walking, and total sleep time. Representations of arthritis were not associated with health behaviors. Findings demonstrate that clinical practice must consider the illness representations patients have about each of their chronic illnesses to begin to sustain positive self-management behaviors.
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Newacheck, Paul W., and Jeffrey J. Stoddard. "Prevalence and impact of multiple childhood chronic illnesses." Journal of Pediatrics 124, no. 1 (January 1994): 40–48. http://dx.doi.org/10.1016/s0022-3476(94)70252-7.
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Scruggs, Brenda. "Chronic Health Care." Home Health Care Management & Practice 22, no. 1 (December 2009): 43–48. http://dx.doi.org/10.1177/1084822309340299.
Повний текст джерелаАнотація:
The traditional acute health care model works well for acute injuries and illnesses but is unlikely to achieve good outcomes in managing chronic health care conditions. Positive outcomes in chronic illness management requires multiple referrals from the primary care provider for a multidisciplinary team, relinquished control by the health care providers as they coach the patient into the active role of self-care life skills and daily management of their health, and active learning, participation, and accountability of the patient.
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Wolock, Elizabeth R., Alexander H. Queen, Gabriela M. Rodríguez, and John R. Weisz. "Chronic Illness and Internalizing Symptomatology in a Transdiagnostic Clinical Sample of Youth." Journal of Pediatric Psychology 45, no. 6 (May 9, 2020): 633–42. http://dx.doi.org/10.1093/jpepsy/jsaa028.
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Abstract Objective In research with community samples, children with chronic physical illnesses have shown elevated anxiety and depressive symptoms, compared to healthy peers. Less is known about whether physical illnesses are associated with elevated internalizing symptoms even among children referred for mental health treatment—a pattern that would indicate distinctive treatment needs among physically ill children receiving mental health care. We investigated the relationship between chronic physical illness and internalizing symptomatology among children enrolling in outpatient mental health treatment. Method A total of 262 treatment-seeking children ages 7–15 and their caregivers completed a demographic questionnaire, Child Behavior Checklist, and Youth Self-Report during a pre-treatment assessment. Physical illnesses were identified through caregiver report. Results There was no overall association between the presence/absence of chronic physical illness and parent- or child-reported symptoms. However, number of chronic physical illnesses was related to parent- and child-reported affective symptoms. Children with two or more chronic physical illnesses had more severe depressive symptoms than those with fewer physical illnesses. Conclusion Having multiple chronic illnesses may elevate children’s risk of depression symptomatology, even in comparison to other children seeking mental health care. This suggests a need to identify factors that may exacerbate depression symptoms in physically ill children who are initiating therapy and to determine whether different or more intensive services may be helpful for this group. The findings suggest the potential utility of screening for depression in youth with chronic physical illnesses, as well as addressing mental and physical health concerns during treatment.
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Khalil, Hanan, Tatyana A. Shamliyan, and Maria Middleton. "Interventions for Community-Dwelling Patients with Multiple Chronic Illnesses." American Journal of Medicine 130, no. 2 (February 2017): 148–52. http://dx.doi.org/10.1016/j.amjmed.2016.10.015.
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Jowsey, Tanisha, Laurann Yen, Robert Wells, and Stephen Leeder. "National Health and Hospital Reform Commission final report and patient-centred suggestions for reform." Australian Journal of Primary Health 17, no. 2 (2011): 162. http://dx.doi.org/10.1071/py10033.
Повний текст джерелаАнотація:
The final report of the National Health and Hospital Reform Commission (NHHRC) called for a strengthened consumer voice and empowerment. This has salience for the development of health policy concerning chronic illnesses. This paper compares the recommendations for chronic illness care made in the NHHRC final report with suggestions made by people with chronic illness and family carers of people with chronic illness in a recent Australian study. Sixty-six participants were interviewed in a qualitative research project of the Serious and Continuing Illness Policy and Practice Study (SCIPPS). Participants were people with type II diabetes mellitus, chronic obstructive pulmonary disease or chronic heart failure. Family carers were also interviewed. Content analysis was undertaken and participants’ recommendations for improving care were compared with those proposed in the NHHRC final report. Many suggestions from the participants of the SCIPPS qualitative research project appeared in the NHHRC final report, including the need to improve care coordination, health literacy and the experience of Indigenous Australians. The research project also identified important issues of family carers, immigrants and people with multiple illnesses, which were not addressed in the NHHRC final report. More specific attention is needed in health reform to improve the experience of family carers, Indigenous peoples, immigrants to Australia and people with multiple illnesses. To align more closely with their needs, health reform must be explicitly informed by the voices of people with chronic illness and their family carers. The NHHRC recommendations must be supplemented with proposals that address the needs of these people for support and the problems associated with poor care coordination.
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Katon, Wayne J. "Collaborative Care: Evidence-Based Models that Improve Primary Care Depressive Outcomes." CNS Spectrums 14, S14 (December 2009): 10–13. http://dx.doi.org/10.1017/s1092852900024652.
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The 2001 Institute of Medicine Report “Crossing the Quality Chasm,” summarized the current care of chronic illness in the United States by emphasizing “Between the health care we have and the health care we could have lies not just a gap, but a chasm.” Across multiple chronic illnesses within primary and specialty care systems, this summary statement illustrates that clinicians and other health professionals are not adequately providing patients guideline levels of treatment–levels that can lower the risk for complications of those illnesses.
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Nicolson, Garth L., Robert Settineri, and Rita R. Ellithorpe. "Neurodegenerative and Fatiguing Illnesses, Infections and Mitochondrial Dysfunction: Use of Natural Supplements to Improve Mitochondrial Function." Functional Foods in Health and Disease 4, no. 1 (January 25, 2014): 23. http://dx.doi.org/10.31989/ffhd.v4i1.26.
Повний текст джерелаАнотація:
Background: Many chronic diseases and illnesses are associated with one or more chronic infections, dysfunction of mitochondria and reduced production of ATP. This results in fatigue and other symptoms that occur in most if not all chronic conditions and diseases.Methods: This is a review of the published literature on chronic infections in neurodegenerative diseases and fatiguing illnesses that are also typified by mitochondrial dysfunction. This contribution also reviews the use of natural supplements to enhance mitochondrial function and reduce the effects of chronic infections to improve overall function in various chronic illnesses.Results: Mitochondrial function can be enhanced by the use of various natural supplements, notably Lipid Replacement Therapy (LRT) using glyerolphospholipids and other mitochondrial supplements. In various chronic illnesses that are characterized by the presence of chronic infections, such as intracellular bacteria (Mycoplasma, Borrelia, Chlamydia and other infections) and viruses, LRT has proven useful in multiple clinical trials. For example, in clinical studies on chronic fatigue syndrome, fibromyalgia syndrome and other chronic fatiguing illnesses where a large majority of patients have chronic infections, LRT significantly reduced fatigue by 35-43% in different clinical trials and increased mitochondrial function. In clinical trials on patients with multiple intracellular bacterial infections and intractable fatigue LRT plus other mitochondrial supplements significantly decreased fatigue and improved mood and cognition.Conclusions: LRT formulations designed to improve mitochondrial function appear to be useful as non-toxic dietary supplements for reducing fatigue and restoring mitochondrial and other cellular membrane functions in patients with chronic illnesses and multiple chronic infections.Key words: Neurodegenerative and fatiguing illnesses, infections and mitochondrial dysfunction, ATP, Lipid Replacement Therapy (LRT)
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Huitson, Kelly. "Chronic illness and resilience in the veterinary industry." Veterinary Nurse 13, no. 3 (April 2, 2022): 114–18. http://dx.doi.org/10.12968/vetn.2022.13.3.114.
Повний текст джерелаАнотація:
Chronic illnesses affect approximately 26 million people in the UK, with 10 million people having multiple conditions. The effect of often ‘invisible illnesses’ can be debilitating in their symptoms, compounded by the associated stigma, fear and anxiety the individuals suffer. This article looks at a small selection of chronic illnesses and their effects, as well as how to help colleagues or staff, and ensure consideration is given to all the team, no matter how ‘healthy’ they appear.
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Huitson, Kelly. "Chronic illness and resilience in the veterinary industry." Veterinary Nurse 13, no. 3 (April 2, 2022): 114–18. http://dx.doi.org/10.12968/vetn.2022.13.3.114.
Повний текст джерелаАнотація:
Chronic illnesses affect approximately 26 million people in the UK, with 10 million people having multiple conditions. The effect of often ‘invisible illnesses’ can be debilitating in their symptoms, compounded by the associated stigma, fear and anxiety the individuals suffer. This article looks at a small selection of chronic illnesses and their effects, as well as how to help colleagues or staff, and ensure consideration is given to all the team, no matter how ‘healthy’ they appear.
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Smagina, I. V., Yu N. Ignatova, S. A. Yelchaninova, and A. S. Fedyanin. "Multiple sclerosis prevalence and risk factors among the Altai Region population." Bulletin of Siberian Medicine 10, no. 2 (April 28, 2011): 39–43. http://dx.doi.org/10.20538/1682-0363-2011-2-39-43.
Повний текст джерелаАнотація:
In Altai Region, Russian Federation, multiple sclerosis (MS) prevalence is found in 39,9 cases of 100000 with wide variation in certain areas of the territory and ethnic corridor widening. Genotypes HLA-DRBI (13/15, 15/15, 15/3, 3/other) are associated with MS risk factors; recent illnesses (before 15 years old), such as chickenpox, rubella, herpes, chronic tonsillitis, and also head trauma before the illness debut are not associated with MS hazard.
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Torossian, Maral, and Cynthia Jacelon. "CHRONIC ILLNESSES AND FATIGUE IN OLDER INDIVIDUALS: A LITERATURE REVIEW." Innovation in Aging 3, Supplement_1 (November 2019): S319. http://dx.doi.org/10.1093/geroni/igz038.1164.
Повний текст джерелаАнотація:
Abstract In the United states, 60% of adults have one chronic disease and 40% have at least two chronic diseases. Fatigue is a commonly reported symptom in individuals with chronic illnesses, the prevalence of which ranges between 40-74%. It is associated with multiple risk factors and has a tremendous impact on quality of life, social functioning, mood, motivation and cognition. Despite its high prevalence, the relationship between fatigue and chronic illness has not been well explored. Accordingly, the focus of this synthesis of literature is to explore fatigue-associated factors and their relation to chronic disease. The databases searched were CINAHL, PubMed, PsychInfo and Web of Science, where the following keywords were used: “Chronic disease” OR “Chronic illness” OR “Chronic conditions”, “Fatigue”, “Elderly” OR “Older adults” OR “Seniors” OR “Geriatrics”. The synthesis resulted in four themes: understanding the concept of fatigue, factors related to fatigue, activity and fatigue, and self-management of fatigue. There were some inconsistencies in the findings among research studies which were addressed, in addition to the strengths and weaknesses of some of the fatigue measurement scales used. This literature review integrates findings about fatigue in chronic illnesses in various aspects, in the population of individuals who are of 65 age or older. The four emerged themes are of value to individuals with similar characteristics as the selected population, as well as to health care providers and researchers who may address the inconsistent findings and provide a strong evidence for best practice.
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Bosire, Edna N., Emily Mendenhall, and Lesley Jo Weaver. "Comorbid Suffering: Breast Cancer Survivors in South Africa." Qualitative Health Research 30, no. 6 (March 24, 2020): 917–26. http://dx.doi.org/10.1177/1049732320911365.
Повний текст джерелаАнотація:
Cycles of chronic illness are unpredictable, especially when multiple conditions are involved, and that instability can transform “normal” everyday life for individuals and their families. This article employs a theory of “comorbid suffering” to interpret how multiple concurrent diagnoses produce webs of remarkable suffering. We collected 50 life stories from breast cancer survivors enrolled in the South Africa Breast Cancer Study. We present three women’s narratives who grapple with comorbid suffering and illness-related work, which arise interpersonally when comorbid illnesses affects social interactions. We found that women strive to create a balance between living with comorbid suffering and continuously performing routine activities amid treatment. Discrimination and isolation were underpinned by women’s fear of being rejected by their families or how their illnesses created social distance between family members and the wider community. This study therefore illustrates how comorbid suffering requires intensive family commitments amid and beyond illness.
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Harrison, Emily. "Multimorbidity in family medicine clerkship." University of Western Ontario Medical Journal 84, no. 2 (March 3, 2016): 5–7. http://dx.doi.org/10.5206/uwomj.v84i2.4272.
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PURPOSE: To document senior medical students’ experiences in caring for patients with multiple chronic illnesses in family medicine clerkship and explore their attitudes towards the inclusion of this topic in existing curricula.
METHODS: A cohort of third-year medical students from the Schulich School of Medicine and Dentistry at the University of Western Ontario were surveyed following their core family medicine clerkship.
RESULTS: One hundred percent of students surveyed participated in the care of patients with multiple chronic illnesses during their family medicine clerkship. However, only 28% percent reported receiving formal teaching on this topic while 89.5% felt that multimorbidity should be taught at the clerkship level. The majority of students surveyed felt comfortable caring for this patient population.
CONCLUSION: Patients with multiple chronic illnesses are common in family practice. All third-year medical students encountered patients with multimorbidity during their family medicine clerkship. This study contributes to a growing body of literature that suggests the need for a shift in medical education and health care delivery in order to better serve an increasingly complex patient population.
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Vickers, Margaret H. "Sick Organizations, Rabid Managerialism: Work-Life Narratives from People with Invisible Chronic Illness." Public Voices 4, no. 1 (January 26, 2017): 59. http://dx.doi.org/10.22140/pv.335.
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This article explores the problematic nature of work-life for people with ''invisible" chronic illness, especially given the recent rise of managerialism in modern organizations. Recent Heideggenian, phenomenological, exploratory research has uncovered work-life narratives from people who are "sick" (but who "appear'' well) and who are trying to survive in organizations that are "sick", demonstratingunreasonable expectations, unsupportive cultures-"rabid" managerialism. The argument commences with some comment about the perilous uncertainty characterizing life and work with "Invisible" chronic illness (ICI) which is briefly defined as an ongoing illness that cannot be seen" by others in the work-place. Illnesses such as HIV, cancer, epilepsy and multiple sclerosis constitute examples.
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CLARKE, LAURA HURD, and ERICA BENNETT. "‘You learn to live with all the things that are wrong with you’: gender and the experience of multiple chronic conditions in later life." Ageing and Society 33, no. 2 (January 12, 2012): 342–60. http://dx.doi.org/10.1017/s0144686x11001243.
Повний текст джерелаАнотація:
ABSTRACTThis article examines how older adults experience the physical and social realities of having multiple chronic conditions in later life. Drawing on data from in-depth interviews with 16 men and 19 women aged 73+ who had between three and 14 chronic conditions, we address the following research questions: (a) What is it like to have multiple chronic conditions in later life? (b) How do older men and women ‘learn to live’ with the physical and social realities of multiple morbidities? (c) How are older adults’ experiences of illness influenced by age and gender norms? Our participants experienced their physical symptoms and the concomitant limitations to their activities to be a source of personal disruption. However, they normalised their illnesses and made social comparisons in order to achieve a sense of biographical flow in distinctly gendered ways. Forthright in their frustration over their loss of autonomy and physicality but resigned and stoic, the men's stories reflected masculine norms of control, invulnerability, physical prowess, self-reliance and toughness. The women were dismayed by their bodies’ altered appearances and concerned about how their illnesses might affect their significant others, thereby responding to feminine norms of selflessness, sensitivity to others and nurturance. We discuss the findings in relation to the competing concepts of biographical disruption and biographical flow, as well as successful ageing discourses.
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Bresnahan, James J., Zachary A. Winthrop, Rabia Salman, and Salman Majeed. "Alagille Syndrome: A Case Report Highlighting Dysmorphic Facies, Chronic Illness, and Depression." Case Reports in Psychiatry 2016 (2016): 1–5. http://dx.doi.org/10.1155/2016/1657691.
Повний текст джерелаАнотація:
Alagille syndrome is a rare multisystem disorder affecting the liver, heart, vertebrae, eyes, and face. Alagille syndrome shares multiple phenotypic variants of other congenital or chronic childhood illnesses such as DiGeorge syndrome, Down syndrome, spina bifida, type 1 diabetes mellitus, and cystic fibrosis. All of these chronic illnesses have well-established links to psychiatric conditions. There are few community resources for Alagille patients, as it is an extremely rare condition. Despite the overlap with other chronic childhood illnesses, the psychiatric manifestations of Alagille syndrome have not been previously discussed in literature. The current study is a case report of a twelve-year-old female hospitalized in our pediatric psychiatric hospital for suicidal ideation with intent and plan. The patient had major depressive disorder, anxiety, other specified feeding and eating disorder, and attention-deficit/hyperactive disorder.
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Kayser, Jay, and Jacqui Smith. "Loneliness Before and During the Covid-19 Pandemic: Associations with Chronic Illnesses and Relationship Quality." Innovation in Aging 5, Supplement_1 (December 1, 2021): 739. http://dx.doi.org/10.1093/geroni/igab046.2747.
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Abstract While self-reported loneliness generally declines after age 65, the likelihood of experiencing chronic illnesses increases. During the Covid-19 pandemic, social isolation measures have changed the social context of many people. We address three research questions: 1) What is the predictive strength of chronic illnesses, relationship quality, and their interaction on loneliness? 2) Has Covid-19 altered experienced loneliness relative to pre-pandemic? 3) Was loneliness during Covid-19 associated with the number of prior chronic illnesses in 2016? To answer these questions, we have analyzed data from participants in the Health and Retirement Study (HRS) included in the early 2020 release who also completed the 2016 wave (N = 1106). On average, in 2016, these participants were age 74.64 (SD = 6.66) and reported 2.57 (SD = 1.39) chronic illnesses. In 2016, unadjusted multiple regression models revealed that chronic illnesses (β = .38) and relationship quality (β = -.41) were associated with loneliness (R2 = .28). When covariates were added, these values were attenuated but remained statistically significant. In 2020 during the pandemic, 8% of these participants reported they often felt lonely and 26% reported feeling lonelier since the start of the Covid-19 pandemic. People who had more chronic illnesses in 2016 reported feeling lonelier in 2020 as did people whose relationships were poorer quality (p < .05). Further analyses with final data from HRS are needed to confirm these trends. These findings highlight the importance of having longitudinal information to identify individuals at high risk and most likely to benefit from interventions.
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Schorr, Emily M., Daniel Kurz, Kyle C. Rossi, Margaret Zhang, Anusha K. Yeshokumar, Nathalie Jette, and Mandip S. Dhamoon. "Depression readmission risk is elevated in multiple sclerosis compared to other chronic illnesses." Multiple Sclerosis Journal 28, no. 1 (November 17, 2021): 139–48. http://dx.doi.org/10.1177/13524585211051316.
Повний текст джерелаАнотація:
Objective: Assess readmissions for depression or suicide attempt (SA) after MS admission versus other chronic inflammatory illnesses. Methods: This retrospective cohort study identified MS, asthma, rheumatoid arthritis (RA), depression, and SA in the 2013 National Readmissions Database by International Classification of Diseases codes. Index admissions (MS, n = 7698; asthma, n = 93,590; RA, n = 3685) and depression or SA readmission rates were analyzed. Hazard ratios (HRs) estimated 1-year depression/SA readmission hazard, comparing MS to asthma or RA, adjusting for age, sex, psychiatric comorbidity, substance abuse, tobacco use, income, and index hospitalization characteristics. Results: MS had more baseline depression (24.7%) versus asthma (15.6%) and RA (14.6%). Ninety-day depression readmission rate was higher in MS (0.5%) than asthma (0.3%) and RA (0.03%). Depression readmission HR was higher after MS admission versus asthma (HR = 1.37, 95% confidence interval (CI) = 1.00–1.86, p = 0.0485) and RA (HR = 4.68, 95% CI = 1.60–13.62, p = 0.0047). HR was not different for SA readmission across groups. Depression readmission HR was more than double in MS patients with psychiatric disease or substance abuse versus RA or asthma patients with either comorbidity. Conclusion: Depression readmission risk after MS hospitalization was elevated versus asthma/RA. Substance use and baseline psychiatric comorbidity were more strongly associated with depression readmission in MS patients.
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Chadi, Nicholas, Elli Weisbaum, Catherine Malboeuf-Hurtubise, Sara Ahola Kohut, Christine Viner, Miriam Kaufman, Jake Locke, and Dzung X. Vo. "Can the Mindful Awareness and Resilience Skills for Adolescents (MARS-A) Program Be Provided Online? Voices from the Youth." Children 5, no. 9 (August 28, 2018): 115. http://dx.doi.org/10.3390/children5090115.
Повний текст джерелаАнотація:
Mindfulness-based interventions (MBIs) have been shown to improve health and well-being in adolescents with chronic illnesses. Because they are most often delivered in person in a group setting, there are several barriers that limit access to MBIs for youth with limited mobility or who cannot access in-person MBIs in their communities. The objective of this study was to determine if eHealth is a viable platform to increase accessibility to MBIs for teens with chronic illnesses. This study reports the qualitative results of a mixed method randomized trial describing the experience of the Mindful Awareness and Resilience Skills for Adolescents (MARS-A) program, an eight-week MBI, delivered either in person or via eHealth. Participants were adolescents between the ages of 13 and 18 with a chronic illness recruited at a tertiary pediatric hospital in Toronto, Canada. Individual semi-structured post-participation audio-video interviews were conducted by a research assistant. A multiple-pass inductive process was used to review interview transcripts and interpret emergent themes from the participants’ lived experiences. Fifteen participants (8 online and 7 in person) completed post-participation interviews. Four distinct themes emerged from participants in both groups: Creation of a safe space, fostering peer support and connection, integration of mindfulness skills into daily life, and improved well-being through the application of mindfulness. Direct quotations representative of those four themes are reported. Results from this study suggest that eHealth delivery of an adapted MBI for adolescents with chronic illnesses may be an acceptable and feasible mode of delivery for MBIs in this population. EHealth should be considered in future studies of MBIs for adolescents with chronic illnesses as a promising avenue to increase access to MBIs for youth who might not be able to access in-person programs.
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Hassan, Raihan, Maryam Mohd Zulkifli, Imran Ahmad, and Siti Suhaila MohdYusoff. "Depression, Anxiety and Stress among Obese Patients with Chronic Illnesses: Prevalence and Associated Factors in North East Malaysia." Bangladesh Journal of Medical Science 18, no. 2 (March 25, 2019): 252–59. http://dx.doi.org/10.3329/bjms.v18i2.40694.
Повний текст джерелаАнотація:
Introduction: Concomitant obesity and chronic medical illness is a significant health problem in Malaysia and worldwide. The comorbid psychological impact in obese patients is associated with a social stigma and low self-esteem. The aim of this study was to determine the prevalence and the factors associated with depression, anxiety and stress in obese patients with chronic medical illnesses attending an outpatient clinic.
Methods: This was a cross-sectional study among obese patients with chronic medical illnesses presenting at the Universiti Sains Malaysia Hospital outpatient clinic. A total of 274 patients were involved. The 21-item Depression, Anxiety and Stress Scale questionnaire was used, and the results were evaluated using single and multiple logistic regression analyses.
Results: The prevalences of depression, anxiety and stress among the obese patients with chronic medical illnesses were 13.9%, 23.4% and 10.9%, respectively. Younger age [p=0.003, adjusted odds ratio (AOR),1.0; 95%confidence interval (CI),0.91–0.98], unemployed employment(p=0.013, AOR,3.7;95% CI,1.32–10.09) and smoking (p=0.022, AOR,3.2; 95% CI,1.18–8.55) were associated with depression. No formal education (p=0.011, AOR,5.7; 95%CI,1.49–21.89), high body mass index (p=0.029, AOR,1.1;95% CI,1.01–1.13) and family history of psychiatric illness (p=0.018, AOR,5.1; 95% CI,1.33–19.56) were associated with anxiety. Stress was strongly associated with females (p=0.004, AOR,5.0; 95% CI,1.70–15.13) and smoking(p=0.002, AOR,6.5; 95% CI,2.03–20.7).
Conclusion: Interestingly, younger age group was associated with depression. Current smokers, no education, family history of psychiatric illness and female sex were significantly associated with anxiety and stress. This notifies new emerging knowledge on factors associated with obese patients that would empower the development of effective preventive strategies for it.
Bangladesh Journal of Medical Science Vol.18(2) 2019 p.252-259
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Morey, Miriam C., Carola Ekelund, Megan Pearson, Gail Crowley, Matthew Peterson, Richard Sloane, Carl Pieper, Eleanor McConnell, and Hayden Bosworth. "Project LIFE: A Partnership to Increase Physical Activity in Elders with Multiple Chronic Illnesses." Journal of Aging and Physical Activity 14, no. 3 (July 2006): 324–43. http://dx.doi.org/10.1123/japa.14.3.324.
Повний текст джерелаАнотація:
The authors describe a medical center-based randomized trial aimed at determining the feasibility and effectiveness of partnering patients and primary-care providers with an exercise health counselor. Study participants included 165 veterans age 70 years and older. The primary end point was change in physical activity at 3 and 6 months comparing patients receiving high-intensity physical activity counseling, attention control counseling, and usual care after receiving standardized clinic-based counseling. We noted a significant Group × Time interaction (p= .041) for physical activity frequency and a similar effect for caloric expenditure (p= .054). Participants receiving high-intensity counseling and usual care increased physical activity over the short term, but those with usual care returned to baseline by the end of the study. The intervention was well received by practitioners and patients. We conclude that partnering primary-care providers with specialized exercise counselors for age- and health-appropriate physical activity counseling is effective.
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Hochhalter, Angela K., Juhee Song, Jennifer Rush, Lisa Sklar, and Alan Stevens. "Making the Most of Your Healthcare intervention for older adults with multiple chronic illnesses." Patient Education and Counseling 81, no. 2 (November 2010): 207–13. http://dx.doi.org/10.1016/j.pec.2010.01.018.
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Matura, Lea Ann, Susan Malone, Rosario Jaime-Lara, and Barbara Riegel. "A Systematic Review of Biological Mechanisms of Fatigue in Chronic Illness." Biological Research For Nursing 20, no. 4 (March 14, 2018): 410–21. http://dx.doi.org/10.1177/1099800418764326.
Повний текст джерелаАнотація:
Fatigue, a commonly reported symptom, is defined as an overwhelming, debilitating, and sustained sense of exhaustion that decreases the ability to function and carry out daily activities. To date, cancer researchers have been in the forefront in investigating the possible biological mechanisms of fatigue, identifying inflammation, dysregulation of the hypothalamic–pituitary–adrenal (HPA) axis, and activation of the autonomic nervous system. The purpose of this systematic review is to describe fatigue and what is known about the biological mechanisms described in cancer in five chronic, noninfectious illnesses: heart failure, multiple sclerosis, chronic kidney disease, rheumatoid arthritis, and chronic obstructive pulmonary disease. We searched PubMed and EMBASE using fatigue as a major Medical subject headings (MeSH) heading with each individual disease added as a search term followed by each biological mechanism. We included only primary research articles published in English between 1996 and 2016 describing studies conducted in adult humans. We identified 26 relevant articles. While there is some evidence that the biological mechanisms causing fatigue in cancer are also associated with fatigue in other chronic illnesses, more research is needed to explore inflammation, the HPA axis, and the autonomic nervous system, and other mechanisms in relation to fatigue in a variety of chronic illnesses.
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Cornell, John E., Jacqueline A. Pugh, John W. Williams, Jr, Lewis Kazis, Austin F. S. Lee, Michael L. Parchman, John Zeber, Thomas Pederson, Kelly A. Montgomery, and Polly Hitchcock Noël. "Multimorbidity Clusters: Clustering Binary Data From Multimorbidity Clusters: Clustering Binary Data From a Large Administrative Medical Database." Applied Multivariate Research 12, no. 3 (January 13, 2009): 163. http://dx.doi.org/10.22329/amr.v12i3.658.
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Our purpose in this article is to describe and illustrate the application of cluster analysis to identify clinically relevant multimorbidity groups. Multimorbidity is the co-occurrence of 2 or more illnesses within a single person, which raises the question whether consistent, clinically useful multimorbidity groups exist among sets of chronic illnesses. Our purpose in this article is to describe and illustrate the application of cluster analysis to identify clinically relevant multimorbidity groups. Application of cluster analysis involves a sequence of critical methodological and analytic decisions that influence the quality and meaning of the clusters produced. We illustrate the application of cluster analysis to identify multimorbidity clusters in a set of 45 chronic illnesses in primary care patients (N = 1,327,328), with 2 or more chronic conditions, served by the Veterans Health Administration. Six clinically useful multimorbidity clusters were identified: a Metabolic Cluster, an Obesity Cluster, a Liver Cluster, a Neurovascular Cluster, a Stress Cluster and a Dual Diagnosis Cluster. Cluster analysis appears to be a useful technique for identifying multiple disease clusters and patterns of multimorbidity.
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Joo, Jee Young, and Megan F. Liu. "The Experience of Chronic Illness Transitional Care: A Qualitative Systematic Review." Clinical Nursing Research 31, no. 2 (November 2, 2021): 163–73. http://dx.doi.org/10.1177/10547738211056166.
Повний текст джерелаАнотація:
This is a qualitative systematic review of recent qualitative studies of the experiences and perceptions of both individuals with chronic illness(es) and their caregivers regarding hospital-to-home transitions. Thematic synthesis was used to identify common themes from seven qualitative studies published from 2012 to 2021 and extracted from four electronic databases. This review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement. Quality appraisal was assessed and adequate methodological rigor was determined. A total of three barriers to transitional care (communication with multiple healthcare providers, self-management, and psychological stress) and two facilitators of transitional care (family caregiver support and nurse-provided patient-centered care) were identified. These findings can be used by nursing research and healthcare managers to reform transitional care practices for chronic illnesses and caregivers.
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Urowitz, Sara, Kevin Smith, Nour Alkazaz, Emma Apatu, Naa Kwarley Quartey, and David Wiljer. "Patient Accessible Electronic Health Records for the Chronically Ill: A Review of the Literature." Journal of Hospital Administration 1, no. 2 (September 9, 2012): 64. http://dx.doi.org/10.5430/jha.v1n2p64.
Повний текст джерелаАнотація:
Background: Consumers with chronic conditions account for approximately 70% of all healthcare spending. The Chronic Care Model is a healthcare paradigm whose purpose is the achievement of improved patient outcomes by facilitating the delivery of patient-centered, evidence-based care. We conducted a review of the literature to examine the role patient accessible electronic health records (PAEHR) may play in implementing and supporting the Chronic Care Model. Methods: A review of the literature was conducted using multiple databases (1950-2012). Publications included in the review were restricted to those using experimental or quasi-experimental methodology, English language and peer review. Results: Published results indicated that PAEHR facilitated improvements in health literacy and patient-provider communication, and that personalization of content was viewed favourably. Research on the use of PAEHR by some disease groups suggest improvements in clinical outcomes. Conclusions: The literature reviewed indicated that the patient experience for individuals with chronic illnesses could be enhanced through access to PAEHR. Improved satisfaction was noted for individuals with access to PAEHR with personalized content (e.g lab results etc). Use of PAEHR also improved patient-provider communication and increased personal knowledge and comprehension concerning individual condition and state of health. PAEHR for individuals living with chronic illnesses are an effective management technique that can help patients better manage the challenges of living with a chronic illness. These results indicate PAEHR have the potential to be a key component for actualizing the theoretical constructs of the Chronic Care Model by providing a platform for increased patient-provider collaboration.
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Jun, Hankyung, and Emma Aguila. "Private Insurance and Mental Health among Older Adults with Multiple Chronic Conditions: A Longitudinal Analysis by Race and Ethnicity." International Journal of Environmental Research and Public Health 18, no. 5 (March 5, 2021): 2615. http://dx.doi.org/10.3390/ijerph18052615.
Повний текст джерелаАнотація:
Older adults with multiple chronic conditions have a higher risk than those without multiple conditions of developing a mental health condition. Individuals with both physical and mental conditions face many substantial burdens. Many such individuals also belong to racial and ethnic minority groups. Private insurance coverage can reduce the risks of developing mental illnesses by increasing healthcare utilization and reducing psychological stress related to financial hardship. This study examines the association between private insurance and mental health (i.e., depressive symptoms and cognitive impairment) among older adults in the United States with multiple chronic conditions by race and ethnicity. We apply a multivariate logistic model with individual fixed-effects to 12 waves of the Health and Retirement Study. Among adults with multiple chronic conditions in late middle age nearing entry to Medicare and of all racial and ethnic groups, those without private insurance have a stronger probability of having depressive symptoms. Private insurance and Medicare can mediate the risk of cognitive impairment among non-Hispanic Whites with multiple chronic conditions and among Blacks regardless of the number of chronic conditions. Our study has implications for policies aiming to reduce disparities among individuals coping with multiple chronic conditions.
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Nicklett, Emily Joy, Robert Joseph Taylor, Ola Rostant, Kimson E. Johnson, and Linnea Evans. "Biopsychosocial Predictors of Fall Events Among Older African Americans." Research on Aging 39, no. 4 (March 13, 2017): 501–25. http://dx.doi.org/10.1177/0164027516651974.
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This study identifies risk and protective factors for falls among older, community-dwelling African Americans. Drawing upon the biopsychosocial perspective, we conducted a series of sex- and age-adjusted multinomial logistic regression analyses to identify the correlates of fall events among older African Americans. Our sample consisted of 1,442 community-dwelling African Americans aged 65 and older, participating in the 2010–2012 rounds of the Health and Retirement Study. Biophysical characteristics associated with greater relative risk of experiencing single and/or multiple falls included greater functional limitations, poorer self-rated health, poorer self-rated vision, chronic illnesses (high blood pressure, diabetes, cancer, lung disease, heart problems, stroke, and arthritis), greater chronic illness comorbidity, older age, and female sex. Physical activity was negatively associated with recurrent falls. Among the examined psychosocial characteristics, greater depressive symptoms were associated with greater relative risk of experiencing single and multiple fall events. Implications for clinicians and future studies are discussed.
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Fosarelli, Patricia D., Catherine DeAngelis, and E. David Mellits. "Health Services Use by Children Enrolled in a Hospital-Based Primary Care Clinic: A Longitudinal Perspective." Pediatrics 79, no. 2 (February 1, 1987): 196–202. http://dx.doi.org/10.1542/peds.79.2.196.
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The use of a hospital-based primary care clinic for health maintenance and illness care and use of the emergency room were monitored for 3 years for 293 children who had been enrolled in the clinic as infants. Infrequent users of one facet of care were infrequent users of other facets of care, and they remained so for all 3 years. The same trends were noted for frequent users. Children who used the clinic for health maintenance infrequently were more likely to have registered in the clinic after 2 months of age and to demonstrate consistently infrequent use throughout the 3 years. Children who used the clinic for illness care infrequently were more likely to have at least two siblings and to demonstrate consistently infrequent use. Children who used the emergency room infrequently were likely to have been consistently infrequent users for emergencies and illness throughout the 3 years. Conversely, those who used the clinic frequently for health maintenance were more likely to have registered before 1 month of age, to have multiple chronic conditions, and to demonstrate consistently frequent use for maintenance throughout the 3 years. Frequent users for illness came were more likely to have none or one sibling, multiple chronic conditions, and to demonstrate consistently frequent use for illnesses. Finally, children who used the emergency room frequently were likely to have multiple chronic conditions and to demonstrate sustained frequent use throughout the 3 years. These results suggest that patterns of use are established as early as the first year of life.
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Furuyashiki, Tomoyuki, Satoshi Akiyama, and Shiho Kitaoka. "Roles of multiple lipid mediators in stress and depression." International Immunology 31, no. 9 (February 27, 2019): 579–87. http://dx.doi.org/10.1093/intimm/dxz023.
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AbstractProlonged or excessive stress may induce emotional and cognitive disturbances, and is a risk factor for mental illnesses. Using rodent chronic stress models of depression, roles of multiple lipid mediators related to inflammation have been revealed in chronic stress-induced emotional alterations. Prostaglandin (PG) E2, an arachidonic acid (AA)-derived lipid mediator, and its receptor subtype EP1 mediate depression-like behavior induced by repeated social defeat stress through attenuating prefrontal dopaminergic activity. Repeated social defeat stress activates microglia through innate immune receptors, and induces PGE2 synthesis through cyclooxygenase-1, a prostaglandin synthase enriched in microglia. PGD2, another AA-derived lipid mediator, has been implicated in depression induced by chronic stress, although either pro-depressive or anti-depressive actions have been reported. Chronic stress up-regulates hippocampal expression of 5-lipoxygenase, hence synthesis of cysteinyl leukotrienes, thereby inducing depression through their receptors. Consistent with beneficial effects of n-3 fatty acids in the diet of depressive patients, resolvins—a novel class of pro-resolving lipid mediators—in the brain attenuate neuroinflammation-associated depression. These findings in animal models of depression offer lipid mediators and related molecules as novel therapeutic targets for treating depression. To translate these findings into clinics, translational biomarkers to visualize lipid mediator profiles in depressive patients need to be established.
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Shaw, Ryan J., Dori M. Steinberg, Jonathan Bonnet, Farhad Modarai, Aaron George, Traven Cunningham, Markedia Mason, et al. "Mobile health devices: will patients actually use them?" Journal of the American Medical Informatics Association 23, no. 3 (January 17, 2016): 462–66. http://dx.doi.org/10.1093/jamia/ocv186.
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Although mobile health (mHealth) devices offer a unique opportunity to capture patient health data remotely, it is unclear whether patients will consistently use multiple devices simultaneously and/or if chronic disease affects adherence. Three healthy and three chronically ill participants were recruited to provide data on 11 health indicators via four devices and a diet app. The healthy participants averaged overall weekly use of 76%, compared to 16% for those with chronic illnesses. Device adherence declined across all participants during the study. Patients with chronic illnesses, with arguably the most to benefit from advanced (or increased) monitoring, may be less likely to adopt and use these devices compared to healthy individuals. Results suggest device fatigue may be a significant problem. Use of mobile technologies may have the potential to transform care delivery across populations and within individuals over time. However, devices may need to be tailored to meet the specific patient needs.
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Bolton, Rendelle E., Gemmae M. Fix, Carol VanDeusen Lukas, A. Rani Elwy, and Barbara G. Bokhour. "Biopsychosocial benefits of movement-based complementary and integrative health therapies for patients with chronic conditions." Chronic Illness 16, no. 1 (June 18, 2018): 41–54. http://dx.doi.org/10.1177/1742395318782377.
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Objectives Complementary and integrative health practices are growing in popularity, including use of movement-based therapies such as yoga, tai-chi, and qigong. Movement-based therapies are beneficial for a range of health conditions and are used more frequently by individuals with chronic illness. Yet little is known about how patients with chronic conditions characterize the health benefits of movement-based therapies. Methods We conducted focus groups with 31 patients enrolled in yoga and qigong programs for chronic conditions at two VA medical centers. Transcripts were analyzed using conventional content analysis with codes developed inductively from the data. Participants’ descriptions of health benefits were then mapped to Engel’s biopsychosocial model. Results Participants described improvements in all biopsychosocial realms, including improved physical and mental health, reduced opiate and psychotropic use, enhanced emotional well-being, and better social relationships. Changes were attributed to physical improvements, development of coping skills, and increased self-awareness. Discussion Patients with chronic illnesses in our sample reported multiple benefits from participation in movement-based therapies, including in physical, mental, and social health realms. Providers treating patients with complex comorbidities may consider referrals to movement-based therapy programs to address multiple concerns simultaneously, particularly among patients seeking alternatives to medication or adjunctive to an opiate reduction strategy.
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Gallagher, Lisa M., and Francois Bethoux. "Therapeutic use of the Arts for Patients with Multiple Sclerosis." US Endocrinology 13, no. 02 (2017): 82. http://dx.doi.org/10.17925/use.2017.13.02.82.
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People with multiple sclerosis (MS) face a wide variety of physical, emotional, and social challenges. A multidisciplinary comprehensive care approach is recommended for the management of MS and its consequences, and non-traditional treatments are increasingly considered by patients and health care providers, particularly for the promotion of wellness in the context of this chronic disease. Previous research has demonstrated the benefits of the therapeutic arts (art therapy, dance and movement therapy, and music therapy) in addressing some of the physiological, psychological, cognitive, social, and spiritual needs of patients facing a variety of chronic illnesses. Our review of the literature suggests that therapeutic art can be beneficial to individuals with MS, particularly in promoting self-efficacy, emotional well-being, and motor control. However, the body of evidence is limited, and further research is needed regarding the outcomes and mechanism of action of therapeutic arts in MS to better understand their role in the management of the consequences of the disease.
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Gallagher, Lisa M., and Francois Bethoux. "Therapeutic use of the Arts for Patients with Multiple Sclerosis." US Neurology 13, no. 02 (2017): 82. http://dx.doi.org/10.17925/usn.2017.13.02.82.
Повний текст джерелаАнотація:
People with multiple sclerosis (MS) face a wide variety of physical, emotional, and social challenges. A multidisciplinary comprehensive care approach is recommended for the management of MS and its consequences, and non-traditional treatments are increasingly considered by patients and health care providers, particularly for the promotion of wellness in the context of this chronic disease. Previous research has demonstrated the benefits of the therapeutic arts (art therapy, dance and movement therapy, and music therapy) in addressing some of the physiological, psychological, cognitive, social, and spiritual needs of patients facing a variety of chronic illnesses. Our review of the literature suggests that therapeutic art can be beneficial to individuals with MS, particularly in promoting self-efficacy, emotional well-being, and motor control. However, the body of evidence is limited, and further research is needed regarding the outcomes and mechanism of action of therapeutic arts in MS to better understand their role in the management of the consequences of the disease.
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López-Larrosa, Silvia. "Quality of Life, Treatment Adherence, and Locus of Control: Multiple Family Groups for Chronic Medical Illnesses." Family Process 52, no. 4 (June 27, 2013): 685–96. http://dx.doi.org/10.1111/famp.12034.
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SINNAKARUPPAN, INDRANI. "Development of a coping scale for use with chronic illnesses, especially multiple sclerosis - a pilot study." International Journal of Rehabilitation Research 23, no. 1 (September 2000): 155–61. http://dx.doi.org/10.1097/00004356-200023030-00003.
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Corlateanu, Alexandru, Serghei Covantev, Irina Caraivanova, Vlada Bodrug, Victor Botnaru, Joseph Varon, and Nikolaos Siafakas. "Alpha-1 Antitrypsin Deficiency and Chronic Obstructive Pulmonary Disease: Between Overlaps, Phenotypes and Illnesses." Current Respiratory Medicine Reviews 15, no. 2 (December 10, 2019): 147–55. http://dx.doi.org/10.2174/1573398x15666190617143122.
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Alpha-1 antitrypsin deficiency (AATD) or alpha-1 antitrypsin proteinase inhibitor (α1-Pi) deficiency, is a genetic disorder leading to a higher risk of pulmonary, hepatic and other organrelated diseases. The spectrum of diseases associated with AATD is large and includes pulmonary conditions (COPD, asthma, asthma-COPD overlap syndrome, bronchiectasis, etc.) as well as extrapulmonary (liver diseases, systemic vasculitis, rheumatoid arthritis, panniculitis, multiple sclerosis, peripheral neuropathy). We present a review of AATD focusing on its connection to other conditions.
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Monsen, Karen A., Diane E. Holland, Ping W. Fung-Houger, and Catherine E. Vanderboom. "Seeing the Whole Person: Feasibility of Using the Omaha System to Describe Strengths of Older Adults With Chronic Illness." Research and Theory for Nursing Practice 28, no. 4 (2014): 299–315. http://dx.doi.org/10.1891/1541-6577.28.4.299.
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A promising strategy for enhancing care and self-management of chronic illness is an integrative, whole-person approach that recognizes and values well-being. Assessment tools are needed that will enable health care professionals to perceive patients as whole persons, with strengths as well as problems. The purpose of this study was to examine the feasibility of using a standardized terminology (theOmaha System) to describe strengths of older adults with chronic illness. The Omaha System assessment currently consists of identifying signs/symptoms for 42 health concepts. Researchers mapped self-reported strengths phrases to Omaha System concepts using existing narratives of 32 older adults with 12–15 comorbid conditions. Results demonstrated the feasibility of describing strengths of patients with chronic illness. Exploratory analysis showed that there were 0–9 strengths per patient, with unique strengths profiles for 30 of 32 patients. Given that older adults with multiple chronic illnesses also have strengths that can be classified and quantified using the Omaha System, there is potential to use the Omaha System as a whole-person assessment tool that enables perception of both problems and strengths. Further research is needed to enhance the Omaha System to formally represent strengths-based as well as a problem-focused perspectives.
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Meszaros, Katalin, та Attila Patocs. "Glucocorticoids Influencing Wnt/β-Catenin Pathway; Multiple Sites, Heterogeneous Effects". Molecules 25, № 7 (25 березня 2020): 1489. http://dx.doi.org/10.3390/molecules25071489.
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Glucocorticoid hormones are vital; their accurate operation is a necessity at all ages and in all life situations. Glucocorticoids regulate diverse physiological processes and they use many signaling pathways to fulfill their effect. As the operation of these hormones affects many organs, the excess of glucocorticoids is actually detrimental to the whole human body. The endogenous glucocorticoid excess is a relatively rare condition, but a significant proportion of adult people uses glucocorticoid medication for the treatment of chronic illnesses, therefore they are exposed to the side effects of long-term glucocorticoid treatment. Our review summarizes the adverse effects of glucocorticoid excess affecting bones, adipose tissue, brain and skin, focusing on those effects which involve the Wnt/β-catenin pathway.
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Rodrigues, Myanca, Joshua Wiener, Saverio Stranges, Bridget Ryan, and Kelly Anderson. "S86. THE RISK OF PHYSICAL HEALTH MULTIMORBIDITY IN PATIENTS WITH PSYCHOSIS: SYSTEMATIC REVIEW AND META-ANALYSIS." Schizophrenia Bulletin 46, Supplement_1 (April 2020): S67. http://dx.doi.org/10.1093/schbul/sbaa031.152.
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Abstract Background Patients with psychotic disorders have a reduced life expectancy compared to those without psychosis, and this is primarily due to differences in physical illnesses. We aimed to assess the risk of developing multimorbidity or multiple chronic physical health conditions, and quantify its prevalence among this clinical population. Methods We identified studies through MEDLINE, EMBASE and PsycINFO from 1990 to September 2019, and reference scanning of included studies. Quantitative studies were included if proportions of 2+ and/or 3+ chronic physical health conditions were evaluated for patients with psychosis. Findings from all studies were descriptively summarized, and estimates for risk and prevalence of multimorbidity were meta-analyzed using random effects models. Results Fourteen studies were included, eight of which were meta-analyzed to determine the risk of developing 2+ chronic conditions for patients with psychosis. The pooled meta-analytic estimate suggests that persons with psychosis have an increased risk of developing multimorbidity than those without psychotic disorders (Risk ratio, RR=1.69, 95% CI 1.37, 2.08). All studies employed different operational definitions of multimorbidity, with respect to both the number and types of included chronic conditions. Evidence from included studies suggests gender and age as potential risk factors for developing multiple chronic conditions. Discussion Patients with psychosis are 69% more likely to develop multimorbidity than those without psychotic disorders. Clinicians responsible for the management of patients with psychosis should assess their risk for somatic illnesses. Future research examining multimorbidity should employ consistent definitions to better enable cross-study comparisons.
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Morrison, Tessalyn, Sylvia Madaras, Charlotte Larson, and Rebecca Harrison. "Personal Agency and Community Resilience: Narratives of Women Navigating Health Care With Chronic Lyme Disease." Qualitative Health Research 31, no. 14 (November 12, 2021): 2706–14. http://dx.doi.org/10.1177/10497323211044463.
Повний текст джерелаАнотація:
Chronic Lyme disease can manifest as a debilitating illness with symptoms that change over time. With its varied presentation, timeline variation, diagnostic difficulty, and lack of definitive treatment, clinical recognition of chronic Lyme disease remains controversial. At the same time, patients face challenges in finding a provider who is supportive and knowledgeable about diagnosing and treating Lyme. We examined the ways the medical system may have affected the lived experiences of chronic Lyme patients. In this article, we communicate the personal, health care, and community illness experiences of 14 women navigating the medical system with chronic Lyme disease through a qualitative community-based participatory research study using interviews and narrative reflection in a rural community setting. The women were interviewed by a researcher living with chronic Lyme disease and the transcripts were analyzed for themes. All participants described navigating multiple allopathic and nonallopathic care modalities to find satisfactory care. They struggled with physical and emotional burdens of chronic, nonlinear illness, as well as disbelief and discrimination by medical providers. Their lives followed patterns of illness and wellness, trust and mistrust of medical treatment, and community connection and disengagement. They learned to become their own advocates to seek affirmative care. They are aware of the controversial nature of their illness, and many have channeled their frustrations into caring for one another through their Lyme community. Women living with controversial diagnoses like chronic Lyme disease experience increased challenges navigating the medical system to find satisfactory care and thus create communities with each other for mutual aid and support. In understanding these challenges, the medical community can improve care for people living with contested chronic illnesses.
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Melvin, Diane, and Lorraine Sherr. "Women and children living with HIV infection." Psychiatric Bulletin 21, no. 8 (August 1997): 472–76. http://dx.doi.org/10.1192/pb.21.8.472.
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HIV infection is a relatively new disease affecting families (Pizzo & Wilfert, 1994). As with other chronic and life-threatening illnesses, families are faced with many changes and losses as well as much uncertainty about the future (Eiser, 1990). Unlike most other conditions, however, there can be extra stigma-related stresses, such as fear and secrecy, which can compound existing burdens of illness and coping (Richmond & Ross, 1995). As further knowledge of the full impact on HIV on families evolves, there is a need to consider the effects of multiple loss and changes on the mental health and adjustment of the children as well as their parents (Melvin & Sherr, 1995; Reidy, 1995).
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Jason, Kendra, and Christy L. Erving. "The Intersecting Consequences of Race-Gender Health Disparities on Workforce Engagement for Older Workers: An Examination of Physical and Mental Health." Social Currents 9, no. 1 (December 5, 2021): 45–69. http://dx.doi.org/10.1177/23294965211053835.
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The dramatic growth of older adults’ labor participation over the past 25 years, including women and people of color, is reshaping the American labor force. The current study contributes new knowledge concerning why individuals over age 50 years may be working longer despite negative impacts of deteriorating physical and mental health associated with aging. Inquiries regarding who continues to work and why can be answered, in part, by addressing how workforce engagement and health are shaped by notable social inequities along the dimensions of age, race, and gender. Guided by cumulative advantage/disadvantage and intersectionality frameworks, we examine whether having multiple chronic conditions (MCC)—two or more physical conditions—and depression affect workforce participation. Using multinomial logistic regression models, we analyze the 2014–2016 waves of the Health and Retirement Study ( N = 4250). Findings reveal that having multiple chronic illnesses increase the likelihood of labor force exit, especially among workers who also have depression. We also discover intersectional nuances which illuminate complex race-gender dynamics related to health and work processes in later life. We conclude with recommendations for workplace policy that promote the retention of older workers with chronic illness and depression and aim to decrease disparities in older workers’ work engagement.
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Kuehl, D. R. "Heavy Emergency Department Users in a State Medicaid Population Have Multiple Chronic Illnesses and Unstable Primary Care." Academic Emergency Medicine 13, no. 5Supplement 1 (May 1, 2006): S105. http://dx.doi.org/10.1197/j.aem.2006.03.258.
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Bell, Megan F., Donna M. Bayliss, Rebecca Glauert, and Jeneva L. Ohan. "Developmental vulnerabilities in children of chronically ill parents: a population-based linked data study." Journal of Epidemiology and Community Health 73, no. 5 (February 21, 2019): 393–400. http://dx.doi.org/10.1136/jech-2018-210992.
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BackgroundCurrently, there is mixed evidence regarding the effects on children when a parent is chronically ill. Research has also primarily been conducted with adolescent samples. This study investigated developmental vulnerabilities in young children of parents with chronic illness.MethodsThis study used linked administrative data. The study population included children born in Western Australia during 2003–2004 (n=19 071; mean age 5.5 years). The outcome measure was a score in the bottom 25% on any of the five developmental domains (physical, social, emotional, communicative and cognitive) of the Australian Early Development Census (2009 collection). Parental chronic illnesses were identified from hospital and cancer registry records, during the period from 1 year prior to the child’s birth and until the end of 2009.ResultsHigher odds of developmental vulnerabilities in physical, social, emotional and communication domains were observed for daughters of chronically ill mothers. Sons of chronically ill mothers had increased odds of language and cognitive difficulties. Risk level increased with each additional year of exposure to maternal chronic illness. Results also indicated increased odds of developmental vulnerabilities for children of mothers experiencing multiple compared with single chronic conditions; however, results were not statistically significant (all p>0.05). No association between fathers’ chronic illness and children’s developmental outcomes was found.ConclusionsMaternal chronic illness is associated with an increased risk of poor developmental outcomes for children, particularly daughters. Healthcare services have an important role to play in linking families into appropriate family-centred services to best support the needs of chronically ill mothers.