Managing Multiple Chronic Conditions during COVID-19 Among Patients with Social Health Risks.

Autor:	Tuzzio L; From the Kaiser Permanente Washington Research Institute, Seattle WA (LT, JDR, MFG); Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO (KSG, MD, RB, JLE, EAB); Center for an Informed Public, University of Washington, Seattle WA; Division of Research, Kaiser Permanente Northern California, Oakland, CA (RWG); Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO (EAB)., Gleason KS; From the Kaiser Permanente Washington Research Institute, Seattle WA (LT, JDR, MFG); Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO (KSG, MD, RB, JLE, EAB); Center for an Informed Public, University of Washington, Seattle WA; Division of Research, Kaiser Permanente Northern California, Oakland, CA (RWG); Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO (EAB)., Ralston JD; From the Kaiser Permanente Washington Research Institute, Seattle WA (LT, JDR, MFG); Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO (KSG, MD, RB, JLE, EAB); Center for an Informed Public, University of Washington, Seattle WA; Division of Research, Kaiser Permanente Northern California, Oakland, CA (RWG); Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO (EAB)., Drace M; From the Kaiser Permanente Washington Research Institute, Seattle WA (LT, JDR, MFG); Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO (KSG, MD, RB, JLE, EAB); Center for an Informed Public, University of Washington, Seattle WA; Division of Research, Kaiser Permanente Northern California, Oakland, CA (RWG); Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO (EAB)., Gray MF; From the Kaiser Permanente Washington Research Institute, Seattle WA (LT, JDR, MFG); Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO (KSG, MD, RB, JLE, EAB); Center for an Informed Public, University of Washington, Seattle WA; Division of Research, Kaiser Permanente Northern California, Oakland, CA (RWG); Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO (EAB)., Bedoy R; From the Kaiser Permanente Washington Research Institute, Seattle WA (LT, JDR, MFG); Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO (KSG, MD, RB, JLE, EAB); Center for an Informed Public, University of Washington, Seattle WA; Division of Research, Kaiser Permanente Northern California, Oakland, CA (RWG); Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO (EAB)., Ellis JL; From the Kaiser Permanente Washington Research Institute, Seattle WA (LT, JDR, MFG); Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO (KSG, MD, RB, JLE, EAB); Center for an Informed Public, University of Washington, Seattle WA; Division of Research, Kaiser Permanente Northern California, Oakland, CA (RWG); Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO (EAB)., Grant RW; From the Kaiser Permanente Washington Research Institute, Seattle WA (LT, JDR, MFG); Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO (KSG, MD, RB, JLE, EAB); Center for an Informed Public, University of Washington, Seattle WA; Division of Research, Kaiser Permanente Northern California, Oakland, CA (RWG); Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO (EAB)., Bayliss EA; From the Kaiser Permanente Washington Research Institute, Seattle WA (LT, JDR, MFG); Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO (KSG, MD, RB, JLE, EAB); Center for an Informed Public, University of Washington, Seattle WA; Division of Research, Kaiser Permanente Northern California, Oakland, CA (RWG); Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO (EAB). elizabeth.bayliss@kp.org., Jauregui L; From the Kaiser Permanente Washington Research Institute, Seattle WA (LT, JDR, MFG); Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO (KSG, MD, RB, JLE, EAB); Center for an Informed Public, University of Washington, Seattle WA; Division of Research, Kaiser Permanente Northern California, Oakland, CA (RWG); Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO (EAB). elizabeth.bayliss@kp.org., Bermet ZA; From the Kaiser Permanente Washington Research Institute, Seattle WA (LT, JDR, MFG); Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO (KSG, MD, RB, JLE, EAB); Center for an Informed Public, University of Washington, Seattle WA; Division of Research, Kaiser Permanente Northern California, Oakland, CA (RWG); Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO (EAB). elizabeth.bayliss@kp.org.
Jazyk:	angličtina
Zdroj:	Journal of the American Board of Family Medicine : JABFM [J Am Board Fam Med] 2024 Mar-Apr; Vol. 37 (2), pp. 172-179.
DOI:	10.3122/jabfm.2023.230053R2
Abstrakt:	Background: Optimal care for persons with multiple chronic conditions (MCC) requires primary and specialty care continuity, access to multiple providers, social risk assessment, and self-management support. The COVID-19 pandemic abruptly changed primary care delivery to increase reliance on telehealth and virtual care. We report on the experiences of individuals with MCC and their family caregivers on managing their health and receiving health care during the initial pandemic. Methods: Semistructured qualitative interviews with 30 patients (19 English speaking, 11 Spanish speaking) plus 9 accompanying care partners, who had 2+ primary care encounters between March 1, 2020, and November 30, 2020, 2+ chronic conditions, and 1 or more self-reported social risks. Questions focused on access to and experiences with care, roles for care partners, and self-management during the first 6 months of the pandemic. Results: Participants experienced substantial changes in care delivery. The most commonly reported changes were a shift to more virtual relative to in-person care and shifting roles for care partners. Changes fostered new perspectives on self-management and an appreciation of personal resilience and self-reliance. Virtual care was an acceptable complement to in-person care, though not a substitute for periodic in-person visits. It was more acceptable for English speakers and with a usual provider. Conclusion: New models of care delivery that recognize patient and family resilience and resourcefulness, emphasize provider continuity, and combine virtual and in-person care may support self-management for individuals with MCC and social needs. Competing Interests: Conflict of interest: None. (© Copyright 2024 by the American Board of Family Medicine.)
Databáze:	MEDLINE
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