Telephonic nurse case management for patients with diabetes and mental illnesses: a qualitative perspective
| Autor: | Chester H. Fox, June Carrington, Linda S. Kahn, Donald P. Bartlett, Michelle Kowalski, Urmi Desai, Heather Lyle |
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| Rok vydání: | 2010 |
| Předmět: |
Program evaluation
Adult Male medicine.medical_specialty MEDLINE Nurse's Role Cohort Studies Nursing medicine Humans Healthcare Disparities Qualitative Research Aged Remote Consultation Health Services Needs and Demand Medicaid managed care Primary Health Care business.industry Medicaid Health Policy Mental Disorders Perspective (graphical) General Medicine Middle Aged Mental illness medicine.disease United States Telephone Diabetes Mellitus Type 2 Family medicine Female business Case Management Cohort study Qualitative research Program Evaluation |
| Zdroj: | Chronic illness. 5(4) |
| ISSN: | 1745-9206 |
| Popis: | Objectives: Gold Choice, a partially capitated Medicaid managed care programme for individuals with a behavioural health diagnosis, implemented a telephonic nurse case management (TNCM) programme to improve diabetes self-management. We sought to identify issues faced by patients with co-morbid behavioural health diagnoses and diabetes as documented in the telephonic nurse case manager’s progress notes. We also explored the role of the TNCM in addressing members’ needs. Methods: We undertook a qualitative analysis of 853 de-identified progress notes from 539 Gold Choice members and conducted a semi-structured interview with the TNCM. Results: Seven major themes emerged reflecting the nurse’s perspectives on challenges faced by Gold Choice members and addressed by the TNCM: (1) Transience of the population. (2) Complex needs, involving not only medical and psychiatric conditions but also housing, transportation and survival. (3) Confusion regarding diabetes diagnosis. (4) Mistrust and suspicion. (5) Difficulties with medical care. (6) Need for diabetes self-management education/skills. (7) Marked appreciation that the TNCM would initiate contact and care about the patient. Discussion: Members with co-morbid behavioural health diagnoses and diabetes constitute a complex population with extensive needs. The TNCM’s role extends beyond diabetes care and entails social support as well as navigation of the healthcare and social service systems. |
| Databáze: | OpenAIRE |
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