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1
Stenberg, Nicola, and Penny J. Furness. "Living Well With a Long-Term Condition." Qualitative Health Research 27, no. 4 (July 9, 2016): 547–58. http://dx.doi.org/10.1177/1049732316628834.
Анотація:
The outcomes of self-management interventions are commonly assessed using quantitative measurement tools, and few studies ask people with long-term conditions to explain, in their own words, what aspects of the intervention they valued. In this Grounded Theory study, a Health Trainers service in the north of England was evaluated based on interviews with eight service-users. Open, focused, and theoretical coding led to the development of a preliminary model explaining participants’ experiences and perceived impact of the service. The model reflects the findings that living well with a long-term condition encompassed social connectedness, changed identities, acceptance, and self-care. Health trainers performed four related roles that were perceived to contribute to these outcomes: conceptualizer, connector, coach, and champion. The evaluation contributes a grounded theoretical understanding of a personalized self-management intervention that emphasizes the benefits of a holistic approach to enable cognitive, behavioral, emotional, and social adjustments.
2
Ambrosio, Leire, Kelly Hislop-Lennie, Nestor Serrano-Fuentes, Corine Driessens, and Mari Carmen Portillo. "Psychometric properties of the living with long term conditions scale in an English-speaking population living with long term conditions in the UK." BMJ Open 14, no. 1 (January 2024): e077978. http://dx.doi.org/10.1136/bmjopen-2023-077978.
Анотація:
ObjectiveTo present the psychometric properties of the living with long-term condition (LwLTCs) scale in an English-speaking population of people with different LTCs.DesignAn observational and cross-sectional study, with retest was conducted. Psychometric properties including feasibility, internal consistency, confirmatory factor analysis, reproducibility and content validity were tested.SettingThe study took place across the UK via primary care surgeries and voluntary organisations, between December 2021 and June 2022.ParticipantsThe study included 577 patients living with different LTCs, as chronic obstructive pulmonary disease, arthritis, chronic heart failure, Parkinson’s disease, chronic kidney disease and type 2 diabetes mellitus. Inclusion criteria included: (a) having been diagnosed with one or more of the conditions; (b) being able to read, understand and answer written questionnaires; (c) being fluent in English and (d) being able to provide written informed consent. Patients were involved in the design and pilot study of the scale.ResultsA total sample of 577 people with an age range of 37–97 years (98±9.65) were recruited. Internal consistency of the total 26-item LwLTCs scale score was excellent (ordinal alpha=0.90) but confirmatory factor analysis showed better fit indices (Normed Fit Index=0.96; standardised root mean square residual=0.051; Goodness of Fit Index=0.98) for a 20-item LwLTCs scale.ConclusionsA shorter version of the LwLTCs scale, with just 20 items and with excellent psychometric properties, is recommended. Having a short scale is key when considering the implementation of the scale in clinical practice to develop person-centred pathways and more comprehensive care plans.
3
Swallow, Veronica. "Special Issue on Children, Young People, and Families Living With Long-Term Conditions." Journal of Pediatric Nursing 30, no. 1 (January 2015): 1–3. http://dx.doi.org/10.1016/j.pedn.2014.10.015.
4
Owen, Natalie, Leanne Dew, Stuart Logan, Simon Denegri, and Lucy C. Chappell. "Research policy for people with multiple long-term conditions and their carers." Journal of Multimorbidity and Comorbidity 12 (January 2022): 263355652211044. http://dx.doi.org/10.1177/26335565221104407.
Анотація:
People with multiple long-term conditions (MLTC) are a growing population, not only in the United Kingdom but internationally. Health and care systems need to adapt to rise to this challenge. Policymakers need to better understand how medical education and training, and service configuration and delivery should change to meet the needs of people with MLTC and their carers. A series of workshops with people with MLTC and carers across the life-course identified areas of unmet need including the impact of stigma; poorly coordinated care designed around single conditions; inadequate communication and consultations that focus on clinical outcomes rather than patient-oriented goals and imperfectly integrate mental and physical wellbeing. Research which embeds the patient voice at its centre, from inception to implementation, can provide the evidence to drive the change to patient-centred, coordinated care. This should not only improve the lives of people living with MLTC and their carers but also create a health and care system which is more effective and efficient. The challenge of MLTC needs to be bought to the fore and it will require joint effort by policymakers, practitioners, systems leaders, educators, the third sector and those living with MLTC to design a health and care system from the perspective of patients and carers, and provide practitioners with the skills and tools needed to provide the highest quality care.
5
Corchon, Silvia, Carmen Rodríguez-Blázquez, Alfonso Meneses, Marta Aranda-Gallardo, Lorena López, Maria Eugenia Ursúa, Maria Victoria Navarta-Sanchez, Mari Carmen Portillo, and Leire Ambrosio. "The Determinants of Living with Long-Term Conditions: An International Cross-Sectional Study." International Journal of Environmental Research and Public Health 18, no. 19 (October 2, 2021): 10381. http://dx.doi.org/10.3390/ijerph181910381.
Анотація:
It is essential that healthcare and social professionals understand the daily lives of people with chronic diseases, and the variables that influence them. The aim of this study was to identify the determinants influencing the process of living with long-term conditions. To investigate this, an observational, international, cross-sectional study was carried out. A consecutive sample of 1788 Spanish-speaking population living with chronic obstructive pulmonary disease, chronic heart failure and type 2 diabetes mellitus were included. Descriptive statistics and multiple linear regression models were performed. The linear regression models identified that social support (β = 0.39, p < 0.001) and the satisfaction with life (β = 0.37, p < 0.001) were the main determinants in the process of living with a long-term condition (49% of the variance). Age (β = −0.08, p = 0.01) and disease duration (β = 0.07, p = 0.01) were determinants only in the chronic heart failure subgroup, and country was significant in the chronic obstructive pulmonary disease subgroup (β = −0.15, p = 0.002). Satisfaction with life and social support were key determinants influencing the process of living with long-term conditions. As such, those aspects should be included in the design of interventions focused on the achievement of a positive living in people with long-term conditions.
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Lunt, Catherine, Christopher Dowrick, and Mari Lloyd-Williams. "The role of day care in supporting older people living with long-term conditions." Current Opinion in Supportive and Palliative Care 12, no. 4 (December 2018): 510–15. http://dx.doi.org/10.1097/spc.0000000000000391.
7
Toze, Michael, Kelly Sisson, Thomas George, and Mo Ray. "Support for people with long-term neurological conditions in rural English communities." British Journal of Community Nursing 24, no. 5 (May 2, 2019): 212–15. http://dx.doi.org/10.12968/bjcn.2019.24.5.212.
Анотація:
Almost one-fifth of the population in England lives in rural areas. Compared to urban populations, the rural population is older and faces greater difficulties in accessing medical services. At the same time, healthcare teams in rural areas face particular challenges in recruiting and retaining staff, travelling between patients and keeping specialised knowledge up-to-date. Drawing upon a recent health needs assessment for people living with long-term neurological conditions in a rural English county, as well as a broader review of the literature, this paper considers the challenges of rurality and discusses potential solutions. Technological and community-based responses have often been suggested as responses to challenges of rurality. However, there is likely to be a need for up-front investment of resources and careful consideration of individual and community needs before these solutions can be applied to rural neurological care.
8
REILLY, SIOBHAN, JANE HUGHES, and DAVID CHALLIS. "Case management for long-term conditions: implementation and processes." Ageing and Society 30, no. 1 (September 24, 2009): 125–55. http://dx.doi.org/10.1017/s0144686x09990183.
Анотація:
ABSTRACTThis paper presents a structured literature review that focused on comprehensive case management by nurses for adults with long-term conditions living in the community. The emphases of the review are the implementation of case-management approaches, including its roles, core tasks and components, and the coverage and quality of the reported implementation data. Twenty-nine studies were included: the majority were concerned with case management for frail older people, and others focused on people with multiple chronic diseases, high-cost patients, or those at high risk of hospital admissions. All the studies reported that case managers undertook the core tasks of assessment, care planning and the implementation of the care plan, but there was more variation in who carried out case finding, monitoring, review and case closure. Few studies provided adequate implementation information. On the basis of the reviewed evidence, three issues were identified as key to the coherent and sustainable implementation of case management for people with long-term conditions: fidelity to the core elements of case management; size of caseload; and case-management practice, incorporating matters relating to the continuity of care, the intensity and breadth of involvement, and control over resources. It is recommended that future evaluations of case-management interventions include a comprehensive process component or, at the very least, that interventions should be more fully described.
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Ambrosio, Leire, Jacqui Morris, Eric Compton, and Mari Carmen Portillo. "Physical activity and mental health experiences of people living with long term conditions during COVID-19 pandemic: A qualitative study." PLOS ONE 18, no. 7 (July 10, 2023): e0285785. http://dx.doi.org/10.1371/journal.pone.0285785.
Анотація:
Introduction Regular physical activity is a strategy that is effective in the physical management of long term conditions. The COVID-19 pandemic, led to disruption of physical activity routines for many people with long term conditions. It is important, to understand the experiences of people with long term conditions regarding physical activity during COVID-19 to enable future identification of strategies to mitigate the impact of restrictions on health. Objective To explore perceptions and experiences of people with long term conditions of the impact of the UK Government physical distancing restrictions on their physical activity participation during the COVID-19 pandemic. Methods A qualitative study, with in depth videoconference semi-structured interviews were conducted between January and April 2022, with 26 adults living with at least one long term condition in the UK. Data were managed in analytical matrices within Excel and data analysis was conducted using thematic analysis. Results Two main themes were developed, explaining how participants managed their physical activity during COVID19 lockdowns, and based on those experiences, what they considered should be in place should another lockdown occur:1) COVID-19 and physical activity: Losses, opportunities and adapting to new formats; and 2) Micro, meso, and macro contexts: creating the right conditions for physical activity support in future pandemics. Conclusions This study provides information on how people with long term conditions managed their condition during the COVID-19 pandemic and generates new understanding of how physical activity routines changed. These findings will be used to inform stakeholder engagement meetings with individuals with long term conditions and local, regional, and national policy makers, to co-produce recommendations that will help people living with long term conditions remain active during and after COVID-19 and other pandemics.
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Harvey, Clare Lynette, Jonathan Sibley, Janine Palmer, Andrew Phillips, Eileen Willis, Robert Marshall, Shona Thompson, Susanne Ward, Rachel Forrest, and Maria Pearson. "Development, implementation and evaluation of nurse-led integrated, person-centred care with long-term conditions." Journal of Integrated Care 25, no. 3 (July 3, 2017): 186–95. http://dx.doi.org/10.1108/jica-01-2017-0003.
Анотація:
Purpose The purpose of this paper is to outline a conceptual plan for innovative, integrated care designed for people living with long-term conditions (LTCs). Design/methodology/approach The conceptual plan delivers a partnership between the health system, the person with LTCs (chronic), their family, and the community. The partnership aims to support people at home with access to effective treatment, consistent with the New Zealand Government Health Strategy. This concept of people-owned care is provided by nurses with advanced practice skills, who coordinate care across services, locations and multiple LTCs. Findings With the global increase in numbers of people with multiple chronic conditions, health services are challenged to deliver good outcomes and experience. This model aims to demonstrate the effective use of healthcare resources by supporting people living with a chronic condition, to increase their self-efficacy and resilience in accordance with personal, cultural and social circumstance. The aim is to have a model of care that is replicable and transferable across a range of health services. Social implications People living with chronic conditions can be empowered to manage their health and well-being, whilst having access to nurse-led care appropriate to individual needs. Originality/value Although there are examples of case management and nurse-led coordination, this model is novel in that it combines a liaison nursing role that works in partnership with patients, whilst ensuring that care across a number of primary and secondary care services is truly integrated and not simply interfaced.
11
Robinson, Patricia. "Long-term conditions and severe acute respiratory syndrome SARS-CoV-2 (COVID-19)." British Journal of Community Nursing 25, no. 5 (May 2, 2020): 247–51. http://dx.doi.org/10.12968/bjcn.2020.25.5.247.
Анотація:
Observation of infection trends through the course of the ongoing COVID-19 pandemic has indicated that those with certain pre-existing chronic conditions, such as hypertension, chronic obstructive pulmonary disease and obesity, are particularly likely to develop severe infection and experience disastrous sequelae, including near-fatal pneumonia. This article aims to outline how SARS-CoV-2 affects people and to consider why individuals living with long-term conditions are at increased risk from infection caused by this virus. A summary of available clinical guidelines with recommendations is presented, to provide community nurses with the up-to-date information required for protecting individuals living with a number of long-term conditions. Additionally, special measures required are outlined, so that community nurses may reflect on how to best provide nursing care for individuals living with long-term conditions and understand protection measures for individuals at increased risk from severe COVID-19.
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Abualfaraj, Raed, Blanaid Daly, Fraser McDonald, and Sasha Scambler. "Cleft lip and palate in context: Learning from, and adding to, the sociological literature on long-term conditions." Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine 22, no. 4 (February 27, 2017): 372–88. http://dx.doi.org/10.1177/1363459317693409.
Анотація:
Cleft lip and palate is a common congenital anomaly affecting males and females. While there is psychological research on cleft lip and palate, there is relatively little research exploring the social context of cleft lip and palate and the experiences of living with the condition on a daily basis. Drawing on common themes emerging from sociological work which have explored the experiences of people living with long-term conditions (uncertainty, social relations, self-esteem and self-image and biomedical concerns), we argue that these themes can be used to help elucidate the experiences of people living with cleft lip and palate. Within this framework, the findings of a qualitative study exploring the experiences of people living with cleft lip and palate are presented. The results suggest that all four themes can be found within the accounts of people living with cleft lip and palate, and there are many commonalities between the experiences of these people and those living with other long-term conditions. Conversely there are interesting areas of divergence. Unlike most long-term conditions, cleft lip and palate is not degenerative and treatment means symptoms will reduce over time. This is reflected in narratives around ‘normality’ as the endpoint of the care pathway. In addition, prenatal diagnosis means that the vast majority of participants within this study were born into, and grew up within, the care pathway. This has implications for the way in which cleft lip and palate is understood and the provision of information, relationships with members of the care team over time and the temporal and contextualised impact of cleft lip and palate on social relations and the self.
13
Ambrosio, Leire, James Faulkner, Jacqui H. Morris, Beth Stuart, Danielle Lambrick, Eric Compton, and Mari Carmen Portillo. "Physical activity and mental health in individuals with multimorbidity during COVID-19: an explanatory sequential mixed-method study." BMJ Open 14, no. 4 (April 2024): e079852. http://dx.doi.org/10.1136/bmjopen-2023-079852.
Анотація:
ObjectiveTo understand the physical activity and mental health of individuals living with long-term conditions during the COVID-19 pandemic.DesignA sequential explanatory mixed-methods study with two phases: phase 1: quantitative survey and phase 2: qualitative follow-up interviews.SettingFor the quantitative phase, an online survey was launched in March 2021, using Microsoft Forms. For the qualitative phase, in-depth semistructured interviews were conducted via online.Participants368 adults over 18 years old living in the UK with at least one long-term condition completed the survey. Interviews were conducted in a subsample of participants from the previous quantitative phase, with 26 people. Data were analysed using thematic analysis.ResultsResponses from the survey showed that people with one long-term condition were significantly more physically active and spent less time sitting, than those with two or more conditions, presenting with significantly higher well-being (p<0.0001), and lower levels of anxiety (p<0.01), and depression (p<0.0001). Interviews found that people developed a range of strategies to cope with the impact of changeability and the consequences of their long-term condition on their physical activity.ConclusionsThe number of long-term conditions influenced physical activity and how people coped with their condition during COVID-19. Findings will inform policy developments in preparation for future pandemics to support and remain people to remain physically active and mental health.
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Gardiner, L., G. Dibben, H. Young, S. Singh, R. S. Taylor, and P. Collaborative Group. "An overview of systematic reviews of exercise-based interventions for people living with long-term conditions." Physiotherapy 123 (June 2024): e12-e13. http://dx.doi.org/10.1016/j.physio.2024.04.016.
15
Tyukin, O. A., and I. E. Lukyanova. "The problem of maintaining the quality of life of older people living in self-isolation." Сибирский научный медицинский журнал 41, no. 1 (March 5, 2021): 124–29. http://dx.doi.org/10.18699/ssmj20210113.
Анотація:
This article describes the main issues and problems that arise in the process of implementing long-term home care and maintaining the quality of life of elderly people who are in conditions of forced self-isolation. The aim of the work is to identify factors that have a negative impact on the provision of a decent quality of life by long-term home care professionals for the elderly in conditions of self-isolation. The research material was official statistics and the results of scientific research by Russian scientists. The main research methods used were the method of theoretical scientific analysis, the method of systematization, interpretation, and the method of generalization of the activities of medical and social services that provide long-term care for the elderly at home. The analysis showed that the forced self-isolation of the elderly, caused by the presence of acute respiratory viral infections, leads to a number of negative consequences, which together can worsen both the physical and mental state of a person, which ultimately will lead to a decrease in the quality of life. The result of this study was to identify such problems that exist in the practice of long-term care for older people who are in conditions of forced self-isolation, such as: the problem of quality control of services, imperfection of methods and technologies used to work with older people to ensure a decent quality of life in conditions of forced self-isolation and limited social contacts. Based on the results of the study, some measures have been proposed that will resolve the existing problems in a relatively short time.
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Wilkinson, Amanda, Lucy Bowen, Elias Gustavsson, Simon Håkansson, Nicole Littleton, James McCormick, Michelle Thompson, and Hilda Mulligan. "Maintenance and Development of Social Connection by People with Long-term Conditions: A Qualitative Study." International Journal of Environmental Research and Public Health 16, no. 11 (May 28, 2019): 1875. http://dx.doi.org/10.3390/ijerph16111875.
Анотація:
Social connection is important for people’s health and well-being. Social isolation arising from a lack of meaningful connection with others can result in deterioration of well-being with negative consequences for health. For people living with multiple long-term conditions, the building and maintaining of social connection may be challenging. The aim of this study was to explore with people with long-term conditions how they perceive they maintain and develop social connections. We undertook semi-structured interviews with seventeen adults, and analyzed the data for themes. Themes were “Meaningful connection”, “Wherewithal for social connection” and “Impact of a major change in life course”. The findings suggest that social connection is valued, and facilitates meaningful ways to reciprocate support with others, thus enabling access to knowledge and resources for better health and well-being. However, people with long-term conditions can experience challenges to developing and maintaining social connectedness after a major change in life course. We suggest that healthcare providers are well placed to facilitate ways for people with long-term conditions to socially connect with others in their neighbourhood and community, and that this in particular be attended to after a major life change.
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Taylor, Eleanor M., Noelle Robertson, Courtney J. Lightfoot, Alice C. Smith, and Ceri R. Jones. "Nature-Based Interventions for Psychological Wellbeing in Long-Term Conditions: A Systematic Review." International Journal of Environmental Research and Public Health 19, no. 6 (March 9, 2022): 3214. http://dx.doi.org/10.3390/ijerph19063214.
Анотація:
Background: With the global burden of disease increasing, particularly in relation to often preventable chronic diseases, researchers and clinicians are keen to identify interventions that can mitigate ill health and enhance the psychological wellbeing of people living with long-term conditions (LTCs). It is long established that engagement with nature can support human health and wellbeing, and in recent years, nature-based interventions (NBIs) have been advanced as of potential benefit. This review thus sought to systematically appraise published evidence of the application of NBIs to address psychological wellbeing for those living with LTCs. Methods: A systematic search of three databases, PsycINFO, MEDLINE and SCOPUS, was undertaken, and the BestBETs quality assessment checklist was used to appraise methodological quality of elicited studies. Results: Of 913 studies identified, 13 studies (12 using quantitative methods, one qualitative) were used. Included papers reported use of a variety of psychological outcomes alongside more circumscribed physiological outcomes. Quality appraisal showed modest robustness, some methodological weaknesses and a dominance of application in developed countries, yet synthesis of studies suggested that reported psychological and physiological outcomes present a strong argument for NBIs having a promising and positive impact on psychological wellbeing. Conclusions: NBIs have positive psychological and physiological impacts on people with LTCs, suggesting they may be a suitable addition to current maintenance treatment. Future research should focus on minimising study bias and increasing the potential for cross-cultural applications.
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Murphy, Fiona, and Gobnait Byrne. "Promoting kidney health in people with type 2 diabetes: part 1." British Journal of Nursing 32, no. 18 (October 12, 2023): 874–80. http://dx.doi.org/10.12968/bjon.2023.32.18.874.
Анотація:
The incidence of chronic kidney disease is increasing internationally with risk factors for the condition being the same as those for type 2 diabetes. It is important therefore for nurses to use primary, secondary and tertiary prevention to minimise the incidence of chronic kidney disease when caring for individuals with type 2 diabetes. This article is the first of a two-part series on the interrelationship between these long-term conditions. This article, part 1, addresses the significance of primary prevention in promoting kidney health in adults living with type 2 diabetes, while part 2 will discuss the use of secondary and tertiary prevention relevant to these long-term conditions.
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Murphy, Fiona, and Gobnait Byrne. "Promoting kidney health in people with type 2 diabetes: part 2." British Journal of Nursing 32, no. 20 (November 9, 2023): 964–71. http://dx.doi.org/10.12968/bjon.2023.32.20.964.
Анотація:
The incidence of chronic kidney disease is increasing internationally with many risk factors for chronic kidney disease also being risk factors for type 2 diabetes. Nurses should use primary, secondary and tertiary prevention to minimise the incidence of chronic kidney disease when caring for individuals with type 2 diabetes. This article is the second in a two-part series on the interrelationship between these long-term conditions. Part 1 addressed the significance of using primary prevention to promote kidney health in adults living with type 2 diabetes; part 2 will discuss the use of secondary and tertiary prevention relevant to these long-term conditions.
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Ibragimova, N. M. "MECHANISMS AND TOOLS FOR DEVELOPING A LONG-TERM STRATEGY TO IMPROVE THE LIVING STANDARDS OF PEOPLE IN THE CONTEXT OF STRUCTURAL TRANSFORMATIONS AND ECONOMIC MODERNIZATION." Journal of Science and Innovative Development 3, no. 1 (February 26, 2020): 14–23. http://dx.doi.org/10.36522/2181-9637-2020-1-2.
Анотація:
The article deals with the basic principles of a long-term strategy for improving the living standards of the population and substantiates the requirements to ensure the living conditions and human capital development in the context of long-term modernization of the Uzbekistan economy and adjustment to international standards (Sustainable development goals). The study offers tools and mechanisms for developing a long-term strategy to improve living standards, including a program-targeted approach, an interactive system of targeted forecasting (monitoring) of indicators of living standards, and a social road map that presents a management plan and potential development directions, optimal ways to achieve the goal. It puts forward social and economic methods of analysis, development, and improvement of the living standards that allow to determine the main trends, positive and negative implications of social risks, provide an opportunity to analyze the current situation in the social sphere, form various scenarios and options for strategic planning of living standards in relation to strategic goals.
21
Gao, Wenfeng, Wenji Xie, Wenqin Xie, Changcheng Jiang, Zhenming Kang, and Naizhen Liu. "Psychophysiological effects of residential options on older people living in long-term nursing house." STEMedicine 3, no. 4 (September 4, 2022): e145. http://dx.doi.org/10.37175/stemedicine.v3i4.145.
Анотація:
Background: Nursing home is critical for the elderly.
Methods: To investigate the effects of decision-making process in terms of choosing room type and roommates on cognitive and psychosocial conditions of the elderly, 174 eligible participants were randomly assigned into three groups. In the first two groups, participants were randomly assigned to single-person rooms (Group SPR, n = 58) and multi-person rooms (2–4 persons per room, Group MPR, n = 58), and the third group of participants were allowed to voluntarily choose to live in single-person room or with preferred roommates (Group VPR, n = 58).
Results: Participants who voluntarily choose room type and roommates (Group VPR) showed the least deterioration of cognitive function, psychosocial, and physical health, with Group MPR showing less deterioration than Group SPR. Allowing elderly people to voluntarily choose room type and roommate is better for preserving their cognitive, psychological, and physical health.
Conclusions: Voluntary choice of room type and roommates is beneficial to the cognitive, psychological, and physical health of elderly people.
22
Young, Hannah M. L., Thomas Yates, Paddy C. Dempsey, Louisa Y. Herring, Joseph Henson, Jack Sargeant, Ffion Curtis, et al. "Physical activity and sedentary behaviour interventions for people living with both frailty and multiple long-term conditions: a scoping review protocol." BMJ Open 12, no. 5 (May 2022): e061104. http://dx.doi.org/10.1136/bmjopen-2022-061104.
Анотація:
IntroductionThe number of people living with multiple long-term conditions (MLTCs) is predicted to rise. Within this population, those also living with frailty are particularly vulnerable to poor outcomes, including decreased function. Increased physical activity, including exercise, has the potential to improve function in those living with both MLTCs and frailty but, to date, the focus has remained on older people and may not reflect outcomes for the growing number of younger people living with MLTCs and frailty. For those with higher burdens of frailty and MLTCs, physical activity may be challenging. Tailoring physical activity in response to symptoms and periods of ill-health, involving family and reducing sedentary behaviour may be important in this population. How the tailoring of interventions has been approached within existing studies is currently unclear. This scoping review aims to map the available evidence regarding these interventions in people living with both frailty and MLTCs.Methods and analysisWe will use a six-stage process: (1) identifying the research questions; (2) identifying relevant studies (via database searches); (3) selecting studies; (4) charting the data; (5) collating and summarising and (6) stakeholder consultation. Studies will be critically appraised using the Mixed Methods Appraisal Tool.Ethics and disseminationAll data in this project will be gathered through database searches. Stakeholder consultation will be undertaken with an established patient and public involvement group. We will disseminate our findings via social media, publication and engagement meetings.
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Reeve, Joanne, and Lucy Cooper. "Rethinking how we understand individual healthcare needs for people living with long-term conditions: a qualitative study." Health & Social Care in the Community 24, no. 1 (December 3, 2014): 27–38. http://dx.doi.org/10.1111/hsc.12175.
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Hampson, Natalie, Lorraine King, Linda-Mary Eriksson, and Hannah Smee. "The effects of relaxation training on depression and anxiety in people living with long-term neurological conditions." Disability and Rehabilitation 42, no. 15 (January 17, 2019): 2100–2105. http://dx.doi.org/10.1080/09638288.2018.1554009.
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Reid, Hamish, Ashley Jane Ridout, Simone Annabella Tomaz, Paul Kelly, and Natasha Jones. "Benefits outweigh the risks: a consensus statement on the risks of physical activity for people living with long-term conditions." British Journal of Sports Medicine 56, no. 8 (October 14, 2021): 427–38. http://dx.doi.org/10.1136/bjsports-2021-104281.
Анотація:
IntroductionThe benefits of physical activity for people living with long-term conditions (LTCs) are well established. However, the risks of physical activity are less well documented. The fear of exacerbating symptoms and causing adverse events is a persuasive barrier to physical activity in this population.This work aimed to agree clear statements for use by healthcare professionals about medical risks of physical activity for people living with LTCs through expert consensus. These statements addressed the following questions: (1) Is increasing physical activity safe for people living with one or more LTC? (2) Are the symptoms and clinical syndromes associated with common LTCs aggravated in the short or long term by increasing physical activity levels? (3) What specific risks should healthcare professionals consider when advising symptomatic people with one or more LTCs to increase their physical activity levels?MethodsStatements were developed in a multistage process, guided by the Appraisal of Guidelines for Research and Evaluation tool. A patient and clinician involvement process, a rapid literature review and a steering group workshop informed the development of draft symptom and syndrome-based statements. We then tested and refined the draft statements and supporting evidence using a three-stage modified online Delphi study, incorporating a multidisciplinary expert panel with a broad range of clinical specialties.ResultsTwenty-eight experts completed the Delphi process. All statements achieved consensus with a final agreement between 88.5%–96.5%. Five ‘impact statements’ conclude that (1) for people living with LTCs, the benefits of physical activity far outweigh the risks, (2) despite the risks being very low, perceived risk is high, (3) person-centred conversations are essential for addressing perceived risk, (4) everybody has their own starting point and (5) people should stop and seek medical attention if they experience a dramatic increase in symptoms. In addition, eight symptom/syndrome-based statements discuss specific risks for musculoskeletal pain, fatigue, shortness of breath, cardiac chest pain, palpitations, dysglycaemia, cognitive impairment and falls and frailty.ConclusionClear, consistent messaging on risk across healthcare will improve people living with LTCs confidence to be physically active. Addressing the fear of adverse events on an individual level will help healthcare professionals affect meaningful behavioural change in day-to-day practice. Evidence does not support routine preparticipation medical clearance for people with stable LTCs if they build up gradually from their current level. The need for medical guidance, as opposed to clearance, should be determined by individuals with specific concerns about active symptoms. As part of a system-wide approach, consistent messaging from healthcare professionals around risk will also help reduce cross-sector barriers to engagement for this population.
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Marín-Maicas, Patricia, Silvia Corchón, Leire Ambrosio, and Mari Carmen Portillo. "Living with Long Term Conditions from the Perspective of Family Caregivers. A Scoping Review and Narrative Synthesis." International Journal of Environmental Research and Public Health 18, no. 14 (July 8, 2021): 7294. http://dx.doi.org/10.3390/ijerph18147294.
Анотація:
(1) Background: When living with one or more long term conditions (LTCs), both the patient and the family experience the impact of the condition at different levels. The family’s needs and perceptions should be considered in the process of caring for people with LTCs. The aim of this review is to understand “the process of living with LTCs” from a family perspective. (2) Methods: A scoping review and narrative synthesis were conducted using a systematic methodology in MEDLINE, CINAHL, Web of Science and PsycINFO, in English and Spanish, including evidence from 2018. (3) Results: A total of 28 articles were included in the review. Acceptance, coping, self-management, integration, and adjustment were key attributes in the process of living with LTCs from the perspective of family caregivers that interrelated in a dynamic way through different mechanisms: being aware of the changing situation, personal networks, information and education, personal conditions, attitude to life and communication. (4) Conclusions: The five attributes that comprise living with LTCs from the perspective of the family caregiver are closely connected of to those of patients living with LTCs; however, self-management and integration have a different meaning and application.
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Brown, Richard, Lynne Coventry, Elizabeth Sillence, John Blythe, Simone Stumpf, Jon Bird, and Abigail C. Durrant. "Collecting and sharing self-generated health and lifestyle data: Understanding barriers for people living with long-term health conditions – a survey study." DIGITAL HEALTH 8 (January 2022): 205520762210844. http://dx.doi.org/10.1177/20552076221084458.
Анотація:
Background The growing popularity of collecting self-generated health and lifestyle data presents a valuable opportunity to develop our understanding of long-term health conditions and improve care. Barriers remain to the effective sharing of health and lifestyle data by those living with long-term health conditions which include beliefs around concepts of Trust, Identity, Privacy and Security, experiences of stigma, perceptions of risk and information sensitivity. Method We surveyed 250 UK adults who reported living with a range of long-term health conditions. We recorded data to assess self-reported behaviours, experiences, attitudes and motivations relevant to sharing self-generated health and lifestyle data. We also asked participants about their beliefs about Trust, Identity, Privacy and Security, stigma, and perceptions of risk and information sensitivity regarding their health and lifestyle data. Results Three-quarters of our sample reported recording information about their health and lifestyle on a daily basis. However, two-thirds reported never or rarely sharing this information with others. Trust, Identity, Privacy and Security concerns were considered to be ‘very important’ by those with long-term health conditions when deciding whether or not to share self-generated health and lifestyle data with others, with security concerns considered most important. Of those living with a long-term health condition, 58% reported experiencing stigma associated with their condition. The greatest perceived risk from sharing with others was the potential for future harm to their social relationships. Conclusions Our findings suggest that, in order for health professionals and researchers to benefit from the increased prevalence of self-generated health and lifestyle data, more can be done to address security concerns and to understand perceived risks associated with data sharing. Digital platforms aimed at facilitating the sharing of self-generated health and lifestyle data may look to highlight security features, enable users to control the sharing of certain information types, and emphasise the practical benefits to users of sharing health and lifestyle data with others.
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Biosca, Olga, Enrico Bellazzecca, Cam Donaldson, Ahalya Bala, Marta Mojarrieta, Gregory White, Neil McHugh, Rachel Baker, and Jonathan Morduch. "Living on low-incomes with multiple long-term health conditions: A new method to explore the complex interaction between finance and health." PLOS ONE 19, no. 6 (June 26, 2024): e0305827. http://dx.doi.org/10.1371/journal.pone.0305827.
Анотація:
People on low-incomes in the UK develop multiple long-term health conditions over 10 years earlier than affluent individuals. Financial diaries -new to public health- are used to explore the lived experiences of financially-vulnerable individuals, diagnosed with at least one long-term condition, living in two inner-city London Boroughs. Findings show that the health status of these individuals is a key barrier to work opportunities, undermining their income. Their precarious and uncertain financial situation, sometimes combined with housing issues, increased stress and anxiety which, in turn, contributed to further deteriorate participants’ health. Long-term health conditions limited the strategies to overcome moments of financial crisis and diarists frequently used credit to cope. Restrictions to access reliable services and timely support were connected to the progression of multiple long-term conditions. Models that integrate healthcare, public health, welfare and financial support are needed to slow down the progression from one to many long-term health conditions.
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Ali, Syed Mustafa, David A. Selby, Kazi Khalid, Katherine Dempsey, Elaine Mackey, Nicola Small, Sabine N. van der Veer, et al. "Engagement with consumer smartwatches for tracking symptoms of individuals living with multiple long-term conditions (multimorbidity): A longitudinal observational study." Journal of Multimorbidity and Comorbidity 11 (January 2021): 263355652110627. http://dx.doi.org/10.1177/26335565211062791.
Анотація:
Introduction People living with multiple long-term conditions (multimorbidity) (MLTC-M) experience an accumulating combination of different symptoms. It has been suggested that these symptoms can be tracked longitudinally using consumer technology, such as smartphones and wearable devices. Aim The aim of this study was to investigate longitudinal user engagement with a smartwatch application, collecting survey questions and active tasks over 90 days, in people living with MLTC-M. Methods ‘Watch Your Steps’ was a prospective observational study, administering multiple questions and active tasks over 90 days. Adults with more than one clinician-diagnosed long-term conditions were loaned Fossil® Sport smartwatches, pre-loaded with the study app. Around 20 questions were prompted per day. Daily completion rates were calculated to describe engagement patterns over time, and to explore how these varied by patient characteristics and question type. Results Fifty three people with MLTC-M took part in the study. Around half were male ( = 26; 49%) and the majority had a white ethnic background ( n = 45; 85%). About a third of participants engaged with the smartwatch app nearly every day. The overall completion rate of symptom questions was 45% inter-quartile range (IQR 23–67%) across all study participants. Older patients and those with greater MLTC-M were more engaged, although engagement was not significantly different between genders. Conclusion It was feasible for people living with MLTC-M to report multiple symptoms per day over 3 months. User engagement appeared as good as other mobile health studies that recruited people with single health conditions, despite the higher daily data entry burden.
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Pepper, Amy, and Karen Harrison Dening. "Dementia, comorbidity and multimorbidity." British Journal of Community Nursing 29, no. 7 (July 2, 2024): 321–25. http://dx.doi.org/10.12968/bjcn.2024.0053.
Анотація:
Many people living with dementia will also have multimorbidity comprising several other intercurrent, long-term and comorbid conditions. This article examines the relationship between such conditions in the context of dementia, giving an overview of the literature, including prevalence and some of the common conditions that can coexist with dementia. The theory and evidence-base will be tied together using a case study approach, to illustrate the complexity of managing comorbid conditions and multimorbidity alongside dementia, and explore some of the approaches that can be used by community nurses to support the overall health of people living with dementia that they work with.
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Brennan-Ing, Mark, Liz Seidel, Rebecca Erenrich, and Stephen E. Karpiak. "LONG-TERM EFFECTS OF CHILDHOOD SEXUAL ASSAULT AMONG OLDER PEOPLE WITH HIV." Innovation in Aging 3, Supplement_1 (November 2019): S549. http://dx.doi.org/10.1093/geroni/igz038.2022.
Анотація:
Abstract Research finds high rates of childhood sexual assault (CSA) among people with HIV (PWH). CSA is related to depression, post-traumatic stress disorder, substance abuse, and poor health. PWH age 50 and older account for the majority of this population in the U.S., but we have little information on the impact of CSA on these older adults. Data were obtained from the San Francisco arm of the Research on Older Adults with HIV 2.0 study (n=197). Fifty percent reported CSA. Cisgender women and transgender people were more likely to report CSA compared to other groups. PWH reporting CSA were more likely to meet the diagnostic criteria for PTSD (42% vs. 27%), and had higher mean PHQ-9 depression scores (9.3 vs. 6.8). Those reporting CSA had significantly more comorbid health conditions compared to their peers. Implications for using a trauma-informed care model with older adults living with HIV will be discussed.
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Sun, Juan Juan, and Haichao Wu. "LONG-TERM CARE NEEDS BY CHINESE ELDERLY AND POLICY PRIORITIES IN CHINA." Innovation in Aging 3, Supplement_1 (November 2019): S244. http://dx.doi.org/10.1093/geroni/igz038.916.
Анотація:
Abstract With the life expectancy in China continuing to increase, age-dependent chronic diseases are also likely to increase, as is the number of people with long-term care needs. This study evaluated the Long Term Care (LTC) needs of the Chinese older population and introduced related policy priorities. Using the 2014 and 2016 “China Longitudinal Aging Social Survey”, this study assessed the physical functions of older adults by measuring their ability to perform Activities of Daily Living independently, compared changes within the two years, and explored other related indicators including, Instrumental Activities of Daily Living, major chronic disease, and mental health conditions. The study also discussed the development of long-term care policies in China and highlighted the priorities of these policies.
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Bryngelson, Anna. "Long-term sickness absence and social exclusion." Scandinavian Journal of Public Health 37, no. 8 (September 2, 2009): 839–45. http://dx.doi.org/10.1177/1403494809346871.
Анотація:
Background: In previous research, ill-health and marginalization from the labour market have been pointed out as potential triggers for being marginalized from other spheres of society as well, e.g. economic, political and social, i.e. social exclusion. However, very few studies have examined the consequences of long-term sickness absence. Aim: The research question raised here is therefore to examine the relationship between long-term sickness absence (≥60 days) and social exclusion among individuals. Methods: The logistic regression analyses are based on longitudinal data (n = 3,144) from the Swedish Level of Living Survey linked to register data. Results: The results suggest that both women and men have higher odds of having no excess cash (‘‘cash margins’’) after their long-term sickness absence, compared with people with no such sickness absence. Women seem more likely to have no cash margins combined with being single/unmarried and having no close friends after long-term sickness absence, than do women without such sick-listing. The results indicate a slight mediating effect of employment status on the odds ratios for these economic and social conditions. Conclusions: The present study suggests that long-term sickness absence increases the risk of adverse economic and social conditions among individuals. That these conditions can be seen as indicators of social exclusion is more doubtful.
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Khunti, Kamlesh, Yogini V. Chudasama, Edward W. Gregg, Monika Kamkuemah, Shivani Misra, Jerry Suls, Nikhil S. Venkateshmurthy, and Jonathan Valabhji. "Diabetes and Multiple Long-term Conditions: A Review of Our Current Global Health Challenge." Diabetes Care 46, no. 12 (November 27, 2023): 2092–101. http://dx.doi.org/10.2337/dci23-0035.
Анотація:
Use of effective treatments and management programs is leading to longer survival of people with diabetes. This, in combination with obesity, is thus contributing to a rise in people living with more than one condition, known as multiple long-term conditions (MLTC or multimorbidity). MLTC is defined as the presence of two or more long-term conditions, with possible combinations of physical, infectious, or mental health conditions, where no one condition is considered as the index. These include a range of conditions such as cardiovascular diseases, cancer, chronic kidney disease, arthritis, depression, dementia, and severe mental health illnesses. MLTC has major implications for the individual such as poor quality of life, worse health outcomes, fragmented care, polypharmacy, poor treatment adherence, mortality, and a significant impact on health care services. MLTC is a challenge, where interventions for prevention and management are lacking a robust evidence base. The key research directions for diabetes and MLTC from a global perspective include system delivery and care coordination, lifestyle interventions and therapeutic interventions.
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Moreira, Debora, Rida Khan, and Paulo Marcelo Gondim Sales. "Neuropsychiatric sequelae of medication non-adherence in people living with HIV." AIMS Medical Science 10, no. 2 (2023): 162–73. http://dx.doi.org/10.3934/medsci.2023014.
Анотація:
<abstract> <p>Non-adherence to anti-retroviral therapy (cART) among people living with HIV/AIDS (PLWHA) is complex, multifactorial, and leads to increases in viral load, immunosuppression, and HIV burden related to direct CNS virulence and cART re-initiation (i.e., immune reconstitution syndrome). Among behavioral disturbances, which may become long-lasting without proper treatment, major depressive disorder, generalized anxiety disorder, schizophrenia, and bipolar spectrum disorders are frequent, as well as exacerbation of other premorbid underlying psychiatric conditions, such as post-traumatic stress disorder (PTSD) and substance use and related conditions, not to mention neurocognitive disorders that are encompassed under the umbrella term of HIV-Associated Neurocognitive Disorders (HAND). In this review, we summarized the neuropsychiatric sequelae of medication non-adherence in PLWHA by utilizing two clinical vignettes to illustrate how syndemic factors may interact and lead to unique presentations.</p> </abstract>
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Weich, S., P. Bebbington, D. Rai, S. Stranges, O. McBride, N. Spiers, H. Meltzer, and T. Brugha. "The population impact of common mental disorders and long-term physical conditions on disability and hospital admission." Psychological Medicine 43, no. 5 (August 21, 2012): 921–31. http://dx.doi.org/10.1017/s0033291712001705.
Анотація:
BackgroundLong-term physical conditions (LTCs) consume the largest share of healthcare budgets. Although common mental disorders (CMDs) and LTCs often co-occur, the potential impact of improved mental health treatment on severe disability and hospital admissions for physical health problems remains unknown.MethodA cross-sectional study of 7403 adults aged 16–95 years living in private households in England was performed. LTCs were ascertained by prompted self-report. CMDs were ascertained by structured clinical interview. Disability was assessed using questions about problems with activities of daily living. Population impact and potential preventive gain were estimated using population-attributable fraction (PAF), and conservative estimates were obtained using ‘treated non-cases’ as the reference group.ResultsOf the respondents, 20.7% reported at least one LTC. The prevalence of CMDs increased with the number of LTCs, but over two-thirds (71.2%) of CMD cases in people with LTCs were untreated. Statistically significant PAFs were found for CMDs and recent hospital admission [13.5%, 95% confidence intervals (CI) 6.6–20.0] and severe disability (31.3%, 95% CI 27.1–35.2) after adjusting for LTCs and other confounders. Only the latter remained significant when using the most conservative estimate of PAF (21.8%, 95% CI 14.0–28.9), and this was reduced only slightly when considering only participants with LTCs (18.5%, 95% CI 7.9–27.9).ConclusionsBetter treatments for CMDs in people with LTCs could achieve almost the same population health gain in terms of reducing severe disability as those targeted at the entire population. Interventions to reduce the prevalence of CMDs among people with LTCs should be part of routine medical care.
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Saunders, Catherine L., and Evangelos Gkousis. "Impact of telephone triage on access to primary care for people living with multiple long-term health conditions: rapid evaluation." Health and Social Care Delivery Research 10, no. 18 (June 2022): 1–48. http://dx.doi.org/10.3310/ucce5549.
Анотація:
Background Telephone triage is a service innovation in which every patient asking to see a general practitioner or other primary care professional calls the general practice and usually speaks to a receptionist first, who records a few details. The patient is then telephoned back by the general practitioner/primary care professional. At the end of this return telephone call with the general practitioner/primary care professional, either the issue is resolved or a face-to-face appointment is arranged. Before the COVID-19 pandemic, telephone triage was designed and used in the UK as a tool for managing demand and to help general practitioners organise their workload. During the first quarter of 2020, much of general practice moved to a remote (largely telephone) triage approach to reduce practice footfall and minimise the risk of COVID-19 contact for patients and staff. Ensuring equitable care for people living with multiple long-term health conditions (‘multimorbidity’) is a health policy priority. Objective We aimed to evaluate whether or not the increased use of telephone triage would affect access to primary care differently for people living with multimorbidity than for other patients. Methods We used data from the English GP Patient Survey to explore the inequalities impact of introducing telephone triage in 154 general practices in England between 2011 and 2017. We looked particularly at the time taken to see or speak to a general practitioner for people with multiple long-term health conditions compared with other patients before the COVID-19 pandemic. We also used data from Understanding Society, a nationally representative survey of households from the UK, to explore inequalities in access to primary care during the COVID-19 pandemic (between April and November 2020). Results Using data from before the COVID-19 pandemic, we found no evidence (p = 0.26) that the impact of a general practice moving to a telephone triage approach on the time taken to see or speak to a general practitioner was different for people with multimorbidity and for people without. During the COVID-19 pandemic, we found that people with multimorbidity were more likely than people with no long-term health conditions to have a problem for which they needed access to primary care. Among people who had a problem for which they would normally try to contact their general practitioner, there was no evidence of variation based on the number of conditions as to whether or not someone did try to contact their general practitioner; whether or not they were able to make an appointment; or whether they were offered a face-to-face, an online or an in-person appointment. Limitations Survey non-response, limitations of the specific survey measures of primary care access that were used, and being unable to fully explore the quality of the telephone triage and consultations were all limitations. Conclusions These results highlight that, although people with multimorbidity have a greater need for primary care than people without multimorbidity, the overall impact for patients of changing to a telephone triage approach is larger than the inequalities in primary care access that exist between groups of patients. Future work Future evaluations of service innovations and the ongoing changes in primary care access should consider the inequalities impact of their introduction, including for people with multimorbidity. Funding This project was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme and will be published in full in Health and Social Care Delivery Research; Vol. 10, No. 18. See the NIHR Journals Library website for further project information.
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Leather, Philip, and Sheila Mackintosh. "The Long Term Impact of Staying Put." Ageing and Society 13, no. 2 (June 1993): 193–211. http://dx.doi.org/10.1017/s0144686x00000854.
Анотація:
ABSTRACTStaying Put projects provide practical help to older home owners with the repair and improvement of their homes. A number of studies have examined the immediate impact of this help on the housing conditions experienced by older people and on their ability to remain living independently in the community, but the extent to which these benefits could last for a long period of time was not known. This paper describes the findings of a study which attempted to examine the longer-term impact of the Staying Put service. A sample of clients helped by Staying Put in the early 1980s were traced and interviewed in order to assess the impact of the assistance received and to examine their current and future housing and care needs. Although the study could not conclusively disentangle the impact of the Staying Put service from other factors influencing the ability of clients to live independently, it concluded that the help received was significant in improving housing conditions over a long period. The study made recommendations which aim to increase the effectiveness of Staying Put projects in the future, including the establishment of a target standard for the housing conditions of clients, the development of mechanisms for continuing contact with clients, and the provision of advice on moving on options where appropriate. More generally, however, the study concluded that more resources to fund services like Staying Put were required from government and from local and health authorities if they were to be more effective in helping clients to live independently.
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Oliver, David. "Preventing falls and falls-injuries in hospitals and long-term care facilities." Reviews in Clinical Gerontology 17, no. 2 (May 2007): 75–91. http://dx.doi.org/10.1017/s0959259808002451.
Анотація:
Falls are predominantly a problem of older people. In the UK, people over 65 currently account for around 60% of admissions and 70% of bed days in hospitals. There are approximately half a million older people in long-term care settings – many with frailty and multiple long-term conditions. The proportion of the population over 65 years is predicted to rise 25% by 2025, and that over 80 by 50%, with a similar increase in those with dependence for two or more activities of daily living. Despite policies to drive care to the community, it is likely that the proportion of older people in hospitals and care homes will therefore increase. Accidental falls are the commonest reported patient/resident safety incidents. Similar demographic trends can be seen in all developed nations, so that the growing problem of fall prevention in institutions is a global challenge. There has been far more focus in falls-prevention research on older people in ‘community’ settings, but falls are a pressing issue for hospitals and care homes, and a threat to the safety of patients and residents, even if a relatively small percentage of the population is in those settings at any one time.
40
Phillips, J., and P. Harris. "Helping people to help themselves: an eight-week mindfulness course for people living with a long-term inflammatory condition." Physiotherapy 105 (January 2019): e151-e152. http://dx.doi.org/10.1016/j.physio.2018.11.149.
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Porter, Tom, Bie Nio Ong, and Tom Sanders. "Living with multimorbidity? The lived experience of multiple chronic conditions in later life." Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine 24, no. 6 (March 21, 2019): 701–18. http://dx.doi.org/10.1177/1363459319834997.
Анотація:
Multimorbidity is defined biomedically as the co-existence of two or more long-term conditions in an individual. Globally, the number of people living with multiple conditions is increasing, posing stark challenges both to the clinical management of patients and the organisation of health systems. Qualitative literature has begun to address how concurrency affects the self-management of chronic conditions, and the concept of illness prioritisation predominates. In this article, we adopt a phenomenological lens to show how older people with multiple conditions experience illness. This UK study was qualitative and longitudinal in design. Sampling was purposive and drew upon an existing cohort study. In total, 15 older people living with multiple conditions took part in 27 in-depth interviews. The practical stages of analysis were guided by Constructivist Grounded Theory. We argue that the concept of multimorbidity as biomedically imagined has limited relevance to lived experience, while concurrency may also be erroneous. In response, we outline a lived experience of multiple chronic conditions in later life, which highlights differences between clinical and lay assumptions and makes the latter visible.
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Holland, Carol, Ian Garner, Jane Simpson, Fiona Eccles, Esperanza Navarro Pardo, Calum Marr, and Sandra Varey. "Impacts of COVID-19 lockdowns on frailty and wellbeing in older people and those living with long-term conditions." Advances in Clinical and Experimental Medicine 30, no. 11 (November 25, 2021): 1111–14. http://dx.doi.org/10.17219/acem/144135.
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Hirose, T., J. Hasegawa, S. Izawa, H. Enoki, Y. Suzuki, and M. Kuzuya. "P-161: Geriatric conditions that predict mortality and hospitalization in dependent older people living in long term care facilities." European Geriatric Medicine 6 (September 2015): S74—S75. http://dx.doi.org/10.1016/s1878-7649(15)30261-8.
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Rappe, Erja, Sirkka-Liisa Kivelä, and Hannu Rita. "Visiting Outdoor Green Environments Positively Impacts Self-rated Health among Older People in Long-term Care." HortTechnology 16, no. 1 (January 2006): 55–59. http://dx.doi.org/10.21273/horttech.16.1.0055.
Анотація:
The restorative effects of nature in enhancing human well-being are well documented. However, the effects of exposure to a green environment on health in institutional settings have not been adequately studied. Our study describes the relationship between the reported frequency of visits to an outdoor green environment and self-rated health, including hindrances experienced during outdoor visits among older people living in a nursing home. Forty-five women assessed their health and answered a questionnaire containing the Nottingham Health Profile (NHP) during an interview. A strong positive association was established between the reported frequency of visiting outdoors and self-rated health even when taking into account health-related distresses measured using the NHP (B = 0.235, P < 0.01). The main hindrances related to outdoor visits were lack of assistance and uncomfortable weather conditions. The results suggest that it might be possible to promote the well-being of older individuals living in nursing homes by providing them with opportunities to visit outdoor green environments. By increasing the accessibility and attractiveness of the outdoor environment, the frequency of outdoor visits could increase, resulting in better perceived health. Implementation of environmental interventions that facilitate year-round outdoor visits are recommended.
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Laki, Ildikó. "Disability Roles: Challenges Concerning the Education of People Living with Disabilities in Hungary." Practice and Theory in Systems of Education 12, no. 1 (February 1, 2017): 12–20. http://dx.doi.org/10.1515/ptse-2017-0002.
Анотація:
AbstractOne of the paths toward the social integration of people living with disabilities is to guarantee their participation in education and employment in the long term. The European Union emphasises the concept of lifelong learning to achieve the goals of improved education levels and the concomitant employability for this group. Although in the past few years there have been positive developments in the conditions of people living with disabilities in Hungary. Therefore, it remains one of the challenges of the Hungarian adult education system to bring about equal opportunities in participation for people living with disabilities. The main dilemma refers primarily to the provisioning of the wide array of learning aids required due to the diverse nature of possible disabilities and the establishment of a supportive and conducive learning environment.
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Hayanga, Brenda, Mai Stafford, and Laia Bécares. "Ethnic Inequalities in Healthcare Use and Care Quality among People with Multiple Long-Term Health Conditions Living in the United Kingdom: A Systematic Review and Narrative Synthesis." International Journal of Environmental Research and Public Health 18, no. 23 (November 29, 2021): 12599. http://dx.doi.org/10.3390/ijerph182312599.
Анотація:
Indicative evidence suggests that the prevalence of multiple long-term conditions (i.e., conditions that cannot be cured but can be managed with medication and other treatments) may be higher in people from minoritised ethnic groups when compared to people from the White majority population. Some studies also suggest that there are ethnic inequalities in healthcare use and care quality among people with multiple long-term conditions (MLTCs). The aims of this review are to (1) identify and describe the literature that reports on ethnicity and healthcare use and care quality among people with MLTCs in the UK and (2) examine how healthcare use and/or care quality for people with MLTCs compares across ethnic groups. We registered the protocol on PROSPERO (CRD42020220702). We searched the following databases up to December 2020: ASSIA, Cochrane Library, EMBASE, MEDLINE, PsycINFO, PubMed, ScienceDirect, Scopus, and Web of Science core collection. Reference lists of key articles were also hand-searched for relevant studies. The outcomes of interest were patterns of healthcare use and care quality among people with MLTCs for at least one minoritised ethnic group, compared to the White majority population in the UK. Two reviewers, L.B. and B.H., screened and extracted data from a random sample of studies (10%). B.H. independently screened and extracted data from the remaining studies. Of the 718 studies identified, 14 were eligible for inclusion. There was evidence indicating ethnic inequalities in disease management and emergency admissions among people with MLTCs in the five studies that counted more than two long-term conditions. Compared to their White counterparts, Black and Asian children and young people had higher rates of emergency admissions. Black and South Asian people were found to have suboptimal disease management compared to other ethnic groups. The findings suggest that for some minoritised ethnic group people with MLTCs there may be inadequate initiatives for managing health conditions and/or a need for enhanced strategies to reduce ethnic inequalities in healthcare. However, the few studies identified focused on a variety of conditions across different domains of healthcare use, and many of these studies used broad ethnic group categories. As such, further research focusing on MLTCs and using expanded ethnic categories in data collection is needed.
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Pires, Sandra Bartolomeu, Dorit Kunkel, Christopher Kipps, Nick Goodwin, and MC Portillo. "Integrated care for people and families living with Parkinson's, Huntington's and Multiple Sclerosis: A systematic review." International Journal of Integrated Care 23, S1 (December 28, 2023): 017. http://dx.doi.org/10.5334/ijic.icic23009.
Анотація:
People living with long term neurological conditions have complex needs that demand coordination of care across different health and social care sectors, however there is uncertainty in how to deliver integrated care and its impact on people.
Our research is focused on patients and caregivers living with long term neurological conditions, specifically with Parkinson’s disease (PD), Multiple Sclerosis (MS) and Huntington’s Disease (HD).
We developed the review questions and interpreted the results of the review with a patient and public involvement group composed of people with lived experience of long term conditions. The group identified three important problems with their care: fragmentation (services are not joined-up missing important needs), duplication (repetition of assessments) and lack of continuity (changes in staff and difficulty in knowing who to contact). These areas prompted us to identify the key characteristics of successful integrated care programmes in the literature and which benefits were brought to people.
We undertook a systematic review of the literature searching CINAHL, Cochrane, Embase, PsycINFO, Medline, Web of Science and Google Scholar of all published studies (from Jan 1, 2000 to Sep 30, 2021) testing multisectoral integrated care interventions in people living with PD, MS and HD. Articles published in English, Portuguese, Spanish and German were considered. We supplemented this with snowballing technique, hand and grey literature searches. Evidence was graded for strength (or certainty) for each outcome measure.
Our review identified 15 papers across 5 countries and a total of 2095 patients and caregivers were included. Analysis indicated that multisectoral integrated care programmes can improve people’s access to resources and patients’ mood (by reducing depression). UK studies indicated improvements in patients’ quality of life, although the international literature was inconclusive. To date, few programmes considered benefits for caregivers; studies that did, reported no differences or even a decline on caregivers’ outcomes. Evidence identified was inconsistent or limited regarding all other outcomes reported. Overall, the literature has a limited consideration of effects on people living with PD and MS, namely, needs being met and continuity of care; to date, no empirical research has focussed on people living with HD. Successful programmes for people with PD and MS were characterised by four facilitating factors:
• Expert knowledge
• Multi-sectoral care coordination
• Care continuity
• Person-centred approach
Hindering factors were related to logistics for care delivery, such as issues with data access and care transition between different providers.
To date, limited evidence exists to support the benefits of multisectoral integrate care programmes from the perspective of patients and caregivers. By focusing on metrics that do not reflect people’s experiences and how well people’s needs are being met, the true impact of these programmes is lost, and with it, the opportunity to advise policies for best service delivery in practice.
Future studies should investigate integrated care from the perspective of patients and caregivers, to measure impact at user-level. This is relevant across all conditions. Furthermore, more research is needed in vulnerable groups and people living with rare complex conditions such as HD.
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Rolewicz, Lucina, Eilís Keeble, Charlotte Paddison, and Sarah Scobie. "Are the needs of people with multiple long-term conditions being met? Evidence from the 2018 General Practice Patient Survey." BMJ Open 10, no. 11 (November 2020): e041569. http://dx.doi.org/10.1136/bmjopen-2020-041569.
Анотація:
ObjectivesTo investigate individual, practice and area level variation in patient-reported unmet need among those with long-term conditions, in the context of general practice (GP) appointments and support from community-based services in England.DesignCross-sectional study using data from 199 150 survey responses.SettingPrimary care and community-based services.ParticipantsRespondents to the 2018 English General Practice Patient Survey with at least one long-term condition.Primary and secondary outcome measuresThe primary outcomes were the levels of unmet need in GP and local services among patients with multiple long-term conditions. Secondary outcomes were the proportion of variation explained by practice and area-level factors.ResultsThere was no relationship between needs being fully met in patients’ last practice appointment and number of long-term conditions once sociodemographic characteristics and health status were taken into account (5+conditions−OR=1.04, 95% CI 0.99 to 1.09), but there was a relationship for having enough support from local services to manage conditions (5+conditions−OR=0.84, 95% CI 0.80 to 0.88). Patients with multimorbidity that were younger, non-white or frail were less likely to have their needs fully met, both in GP and from local services. Differences between practices and local authorities explained minimal variation in unmet need.ConclusionsLevels of unmet need are high, particularly for support from community services to manage multiple conditions. Patients who could be targeted for support include people who feel socially isolated, and those who have difficulties with their day-to-day living. Younger patients and certain ethnic groups with multimorbidity are also more likely to have unmet needs. Increased personalisation and coordination of care among these groups may help in addressing their needs.
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Ostrowski, Susan, and Peter S. Dixon. "Reading and Dementia." Perspectives of the ASHA Special Interest Groups 1, no. 15 (March 31, 2016): 26–36. http://dx.doi.org/10.1044/persp1.sig15.26.
Анотація:
The reading capacities of older adults living with dementia are difficult to assess and determine. In this paper, we discuss the challenges that conventional print present to people with dementia. We expand upon what it takes to produce highly readable material for this group of older adults and the conditions necessary to stimulate their preserved reading abilities. We elaborate on the benefits and applications of reading for many older adults, especially those living in long-term care facilities.
50
Nicholson, Caroline. "A new approach to older people's end of life care: Living and dying well." Open Access Government 37, no. 1 (January 6, 2023): 28–29. http://dx.doi.org/10.56367/oag-037-10492.
Анотація:
A new approach to older people's end of life care: Living and dying well Global ageing means that death is now most commonly an event of older age. For most older people, the nature of living and dying in later life will be frailty and multimorbidity (MM - the co-existence of two or more long-term conditions). Remodelling palliative and end of life care requires different ways of working, different partnerships and a sharing of power.