scholarly journals Cross-sectional survey of older patients’ views regarding multidisciplinary care for chronic conditions in general practice

2014 ◽  
Vol 20 (1) ◽  
pp. 27 ◽  
Author(s):  
Andrew Bonney ◽  
Christopher Magee ◽  
Russell Pearson
Keyword(s):  
Agency Theory ◽  
Continuity Of Care ◽  
Chronic Conditions ◽  
Older Patients ◽  
Practice Nurse ◽  
Systems Of Care ◽  
Multidisciplinary Care ◽  
Ageing Population ◽  
Cross Sectional Survey ◽  
Cross Sectional

The ageing population and increasing prevalence of chronic illness have contributed to the need for significant primary care reform, including increased use of multidisciplinary care and task substitution. This cross-sectional study explores conditions under which older patients would accept having health professionals other than their general practitioner (GP) involved in their care for chronic disease management (CDM). Ten practices were randomly sampled from a contiguous major city and inner regional area. Questionnaires were distributed to consecutive patients aged 60 years and over in each practice. Agency theory was used to inform analyses. Statistical analysis was undertaken using Wald’s test, growth modelling and linear regression, controlling for the clustered design. The response rate was 53% (n = 272). Most respondents (79%) had at least one chronic health condition. Respondents were more comfortable with GP than with practice nurse management in the CDM scenario (Wald’s test = 105.49, P < 0.001). Comfort with practice nurse CDM was positively associated with increased contact with their GP at the time of the visit (β = 0.41, P < 0.001), negatively associated with the number of the respondent’s chronic conditions (β = –0.13, P = 0.030) and not associated with the frequency of other health professional visits. Agency theory suggests that patients employ continuity of care to optimise factors important in CDM: information symmetry and goal alignment. Our findings are consistent with the theory and lend support to ensuring that interpersonal continuity of care is not lost in health care reform. Further research exploring patients’ acceptance of differing systems of care is required.

Continuity of care experiences: A national cross-sectional survey exploring the views and experiences of Australian students and academics

2021 ◽  
Author(s):  
Michelle Newton ◽  
Fiona Faulks ◽  
Carolyn Bailey ◽  
Jenny Davis ◽  
Monique Vermeulen ◽  
...  
Keyword(s):  
Continuity Of Care ◽  
Cross Sectional Survey ◽  
Cross Sectional

scholarly journals Older Patients’ Enthusiasm to Use Electronic Mail to Communicate With Their Physicians: Cross-Sectional Survey

2009 ◽  
Vol 11 (2) ◽  
pp. e18 ◽  
Author(s):  
Hardeep Singh ◽  
Sarah A Fox ◽  
Nancy J Petersen ◽  
Anila Shethia ◽  
Richard L Street
Keyword(s):  
Older Patients ◽  
Electronic Mail ◽  
Cross Sectional Survey ◽  
Cross Sectional

scholarly journals Prevalence of anxiety and depressive symptoms and impact on self-management among adults with chronic conditions in Chicago, Illinois, USA, during the COVID-19 pandemic: a cross-sectional survey

BMJ Open ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. e052495
Author(s):  
Rebecca M Lovett ◽  
Lauren Opsasnick ◽  
Andrea Russell ◽  
Esther Yoon ◽  
Sophia Weiner-Light ◽  
...  
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Chronic Conditions ◽  
Least Square ◽  
Self Management ◽  
Secondary Outcome ◽  
Measurement Information ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Patient Reported

ObjectivesTo examine the prevalence of mental health symptoms during the first surge of COVID-19 in the USA, and their associations with COVID-19-related emotional distress, health self-management and healthcare utilisation.DesignCross-sectional analysis of wave 3 (1–22 May 2020) survey data from the ongoing Chicago COVID-19 Comorbidities (C3) study.SettingSeven academic and community health centres in Chicago, Illinois.Participants565 adults aged 23–88 with one or more chronic conditions completing at least one prior C3 study wave.Primary and secondary outcome measuresClinically relevant anxiety and depressive symptoms as measured using Patient-Reported Outcomes Measurement Information System short forms. Self-reported emotional and health-related responses to COVID-19 were measured through a combination of single-item questions and validated measures.ResultsRates of anxiety and depressive symptoms were 14% (81/563) and 15% (84/563), respectively. Anxiety and depressive symptoms were then each separately associated with greater worry about contracting COVID-19 (relative risk (RR) 2.32, 95% CI 1.52 to 3.53; RR 1.67, 95% CI 1.10 to 2.54), greater stress (RR 4.93, 95% CI 3.20 to 7.59; RR 3.01, 95% CI 1.96 to 4.61) and loneliness (RR 3.82, 95% CI 2.21 to 6.60; RR 5.37, 95% CI 3.21 to 8.98), greater avoidance of the doctor (RR 1.62, 95% CI 1.06 to 2.49; RR 1.54, 95% CI 1.00 to 2.36) and difficulty managing health (least square means (LS Means) 6.09, 95% CI 5.25 to 6.92 vs 4.23, 95% CI 3.70 to 4.75; LS Means 5.85, 95% CI 5.04 to 6.65 vs 4.22, 95% CI 3.70 to 4.75) and medications (LS Means 3.71, 95% CI 2.98 to 4.43 vs 2.47, 95% CI 2.02 to 2.92) due to the pandemic.ConclusionsIdentifying and addressing mental health concerns may be an important factor to consider in COVID-19 prevention and management among high-risk medical populations.

scholarly journals Patients’ perception of communication at the interface between primary and secondary care: a cross-sectional survey in 34 countries

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Giacomo Scaioli ◽  
Willemijn L. A. Schäfer ◽  
Wienke G. W. Boerma ◽  
Peter Spreeuwenberg ◽  
Michael van den Berg ◽  
...  
Keyword(s):  
Primary Care ◽  
Continuity Of Care ◽  
Secondary Care ◽  
Multilevel Models ◽  
Medical Specialist ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Medical Specialists ◽  
Results Of Treatment ◽  
Personal Doctor

Abstract Background Poor communication between general practitioners (GPs) and medical specialists can lead to poorer quality, and continuity, of care. Our study aims to assess patients’ perceptions of communication at the interface between primary and secondary care in 34 countries. It will analyse, too, whether this communication is associated with the organisation of primary care within a country, and with the characteristics of GPs and their patients. Methods We conducted a cross-sectional survey among patients in 34 countries. Following a GP consultation, patients were asked two questions. Did they take to understand that their GP had informed medical specialists about their illness upon referral? And, secondly, did their GP know the results of the treatment by a medical specialist? We used multi-response logistic multilevel models to investigate the association of factors related to primary care, the GP, and the patient, with the patients’ perceptions of communication at the interface between primary and secondary care. Results In total, 61,931 patients completed the questionnaire. We found large differences between countries, in both the patients’ perceptions of information shared by GPs with medical specialists, and the patients’ perceptions of the GPs’ awareness of the results of treatment by medical specialists. Patients whose GPs stated that they ‘seldom or never’ send referral letters, also less frequently perceived that their GP communicated with their medical specialists about their illness. Patients with GPs indicating they ‘seldom or never’ receive feedback from medical specialists, indicated less frequently that their GP would know the results of treatment by a medical specialist. Moreover, patients with a personal doctor perceived higher rates of communication in both directions at the interface between primary and secondary care. Conclusion Generally, patients perceive there to be high rates of communication at the interface between primary and secondary care, but there are large differences between countries. Policies aimed at stimulating personal doctor arrangements could, potentially, enhance the continuity of care between primary and secondary care.

Community stroke education practices in New York State designated stroke centres

2019 ◽  
Vol 78 (8) ◽  
pp. 1012-1019
Author(s):  
Olajide Williams ◽  
Ellyn Leighton-Herrmann Quinn ◽  
Anna Colello ◽  
Crismely Perdomo ◽  
Ji Chong ◽  
...  
Keyword(s):  
New York ◽  
Best Practice ◽  
Systems Of Care ◽  
New York State ◽  
Cross Sectional Survey ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
York State ◽  
Stroke Education ◽  
Stroke Systems Of Care

Objective: Community stroke education is a regulated, integral component of stroke systems of care. However, little is known about the types of activities conducted by hospitals. This study was designed to examine the annual requirement for community stroke education among New York State’s 119 designated Primary Stroke Centres and identify areas for improvement that may have an implication on stroke outcomes. Design: Cross-sectional survey design Setting: All 119 New York State designated Primary Stroke Centres were invited to participate. Methods: Participating hospitals completed a 29-item online questionnaire assessing multiple domains related to community stroke education including hospital characteristics, allocated resources, implementation barriers, current community stroke education practices and willingness to adopt best practice guidelines. Data were analysed using univariate descriptive and chi-square statistics. Results: Eighty-eight percent of hospitals completed the survey (105/119). Respondents were mostly stroke coordinators and stroke directors. Stroke outreach education was conducted two to four times per year in 58% of the hospitals ( n = 69). Community stroke education included behavioural risk factor modification, the detection of stroke risk through screening and stroke preparedness education at health fairs. Although 95% of hospitals ( n = 98) reported using at least one best practice approach for these activities, evaluation was generally poor, with only about 23% ( n = 24) implementing outcome-specific assessments. Major barriers to stroke outreach were inadequate staffing, time constraints and lack of funding. Conclusion: Hospital-driven community stroke education efforts occur infrequently and are poorly evaluated. This component of stroke systems of care would benefit from guidelines from regulatory agencies, which currently do not exist.

scholarly journals Ethical issues in nursing home palliative care: a cross-national survey

2018 ◽  
Vol 10 (3) ◽  
pp. e29-e29 ◽  
Author(s):  
Deborah H. L. Muldrew ◽  
Sharon Kaasalainen ◽  
Dorry McLaughlin ◽  
Kevin Brazil
Keyword(s):  
Palliative Care ◽  
Nursing Homes ◽  
Ethical Issues ◽  
Survey Design ◽  
Family Values ◽  
Ageing Population ◽  
Policy Recommendations ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Uk

ObjectivesWith an increased dependency on nursing homes to provide care to the ageing population, it is likely that ethical issues will also increase. This study aimed to identify the type of ethical issues and level of associated distress experienced by nurses providing palliative care in nursing homes in the UK and Canada, and pilot the Ethical issues in Palliative Care for Nursing Homes (EPiCNH) instrument in Canada.MethodsA cross-sectional survey design was used. One hundred and twenty-three nurses located in 21 nursing homes across the UK and Canada completed the EPiCNH instrument.ResultsFrequent ethical issues include upholding resident autonomy, managing family distress, lack of staff communication and lack of time in both countries. Higher levels of distress resulted from poor communication, insufficient training, lack of time and family disagreements. Nurses in Canada experienced a greater frequency of ethical issues (p=0.022); however, there was no statistical difference in reported distress levels (p=0.53). The survey was positively rated for ease of completion, relevance and comprehensiveness.ConclusionsNurses’ reported comparable experiences of providing palliative care in UK and Canadian nursing homes. These findings have implications on the practice of care in nursing homes, including how care is organised as well as capacity of staff to care for residents at the end of life. Training staff to take account of patient and family values during decision-making may address many ethical issues, in line with global policy recommendations. The EPiCNH instrument has demonstrated international relevance and applicability.

School Nurse Perceptions of Nurse–Family Relationships in the Care of Elementary Students With Chronic Conditions

2017 ◽  
Vol 35 (2) ◽  
pp. 96-106 ◽  
Author(s):  
Camille Brown ◽  
Wendy S. Looman ◽  
Ann E. Garwick
Keyword(s):  
Elementary Students ◽  
Family Relationships ◽  
Chronic Conditions ◽  
Nursing Practice ◽  
Family Relationship ◽  
School Nurse ◽  
School Nurses ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Family Nursing

The purpose of this study was to explore school nurse perceptions of the nurse–family relationship in the care of elementary students with asthma and attention-deficit hyperactivity disorder (ADHD). A cross-sectional survey design was used to collect data from 97 school nurses in Minnesota. The Family Nursing Practice Scale measured nurses’ perceptions of their family nursing practice. Bivariate analyses were conducted to compare scores by factors at the community, school, nurse, and child levels. Results suggest that school nurses have positive appraisals of their family nursing practice, though scores were generally lower in the context of ADHD compared to asthma. Participants with a graduate degree reported greater skill in working with families, whereas novice nurses reported less confidence working with families and less comfort initiating family involvement in care. Results suggest that interventions at the nurse and school levels may support enhanced family nursing practice by nurses caring for students with chronic conditions.

scholarly journals Comparison of Mobile Health Technology Use for Self-Tracking Between Older Adults and the General Adult Population in Canada: Cross-Sectional Survey

10.2196/24718 ◽  
2020 ◽  
Vol 8 (11) ◽  
pp. e24718
Author(s):  
Mirou Jaana ◽  
Guy Paré
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Technology Use ◽  
Chronic Conditions ◽  
Mobile Apps ◽  
Adult Population ◽  
Smart Devices ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
General Adult Population

Background The burden of population aging and chronic conditions has been reported worldwide. Older adults, especially those with high needs, experience social isolation and have high rates of emergency visits and limited satisfaction with the care they receive. Mobile health (mHealth) technologies present opportunities to address these challenges. To date, limited information is available on Canadian older adults’ attitudes toward and use of mHealth technologies for self-tracking purposes—an area that is increasingly important and relevant during the COVID-19 era. Objective This study presents contributions to an underresearched area on older adults and mHealth technology use. The aim of this study was to compare older adults’ use of mHealth technologies to that of the general adult population in Canada and to investigate the factors that affect their use. Methods A cross-sectional survey on mHealth and digital self-tracking was conducted. A web-based questionnaire was administered to a national sample of 4109 Canadian residents who spoke either English or French. The survey instrument consisted of 3 sections assessing the following items: (1) demographic characteristics, health status, and comorbidities; (2) familiarity with and use of mHealth technologies (ie, mobile apps, consumer smart devices/wearables such as vital signs monitors, bathroom scales, fitness trackers, intelligent clothing); and (3) factors influencing the continued use of mHealth technologies. Results Significant differences were observed between the older adults and the general adult population in the use of smart technologies and internet (P<.001). Approximately 47.4% (323/682) of the older adults in the community reported using smartphones and 49.8% (340/682) indicated using digital tablets. Only 19.6% (91/463) of the older adults using smartphones/digital tablets reported downloading mobile apps, and 12.3% (47/383) of the older adults who heard of smart devices/wearables indicated using them. The majority of the mobile apps downloaded by older adults was health-related; interestingly, their use was sustained over a longer period of time (P=.007) by the older adults compared to that by the general population. Approximately 62.7% (428/682) of the older adults reported tracking their health measures, but the majority did so manually. Older adults with one or more chronic conditions were mostly nontrackers (odds ratio 0.439 and 0.431 for traditional trackers and digital trackers, respectively). No significant differences were observed between the older adults and the general adult population with regard to satisfaction with mHealth technologies and their intention to continue using them. Conclusions Leveraging mHealth technologies in partnership with health care providers and sharing of health/well-being data with health care professionals and family members remain very limited. A culture shift in the provision of care to older adults is deemed necessary to keep up with the development of mHealth technologies and the changing demographics and expectations of patients and their caregivers.

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