Healthcare Task Difficulty Among Older Adults With Multimorbidity
| Autor: | Chad Boult, Bruce Leff, Cynthia S. Rand, Travonia Hughes, Jennifer L. Wolff, Qian Li Xue, Cynthia M. Boyd, Erin R. Giovannetti, Lisa Reider, Carlos O. Weiss |
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| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty Cross-sectional study Health Status MEDLINE Sample (statistics) Comorbidity Article Task (project management) Physical medicine and rehabilitation Cost of Illness Surveys and Questionnaires Health care Humans Medicine Multimorbidity Longitudinal Studies Geriatric Assessment Aged Aged 80 and over business.industry Public Health Environmental and Occupational Health medicine.disease Mental health United States Cross-Sectional Studies Mental Health Chronic Disease Female Self Report business |
| Zdroj: | Medical Care. 52:S118-S125 |
| ISSN: | 0025-7079 |
| DOI: | 10.1097/mlr.0b013e3182a977da |
| Popis: | Applying disease-specific guidelines to people with multimorbidity may result in complex regimens that impose treatment burden.To describe and validate a measure of healthcare task difficulty (HCTD) in a sample of older adults with multimorbidity.Cross-sectional and longitudinal secondary data analysis.Multimorbid adults aged 65 years or older from primary care clinics.We generated a scale (0-16) of self-reported difficulty with 8 HCTD and conducted factor analysis to assess its dimensionality and internal consistency. To assess predictive ability, cross-sectional associations of HCTD and number of chronic diseases, and conditions that add to health status complexity (falls, visual, and hearing impairment), patient activation, patient-reported quality of chronic illness care (Patient Assessment of Chronic Illness Care), mental and physical health (SF-36) were tested using statistical tests for trend (n=904). Longitudinal analyses of the effects of change in HCTD on changes in the outcomes were conducted among a subset (n=370) with ≥1 follow-up at 6 and/or 18 months. All models were adjusted for age, education, sex, race, and time.Greater HCTD was associated with worse mental and physical health [Cuzick test for trend (P0.05)], and patient-reported quality of chronic illness care (P0.05). In longitudinal analysis, increasing patient activation was associated with declining HCTD over time (P0.01). Increasing HCTD over time was associated with declining mental (P0.001) and physical health (P=0.001) and patient-reported quality of chronic illness care (P0.05).The findings of this study establish the construct validity of the HCTD scale. |
| Databáze: | OpenAIRE |
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