期刊
MEDICAL CARE
卷 52, 期 3, 页码 S118-S125出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MLR.0b013e3182a977da
关键词
multimorbidity; comorbidity; healthcare task difficulty; treatment burden
类别
资金
- AHRQ HHS [R01 HS014580-01A1, 1R21HS017650-01] Funding Source: Medline
- NCATS NIH HHS [UL1 TR001079] Funding Source: Medline
- NIA NIH HHS [T32 AG027668, K23 AG032910, 1K23AG032910] Funding Source: Medline
- NIMH NIH HHS [5K01MH82885-02, K01 MH082885] Funding Source: Medline
Background: Applying disease-specific guidelines to people with multimorbidity may result in complex regimens that impose treatment burden. Objectives: To describe and validate a measure of healthcare task difficulty (HCTD) in a sample of older adults with multimorbidity. Research Design: Cross-sectional and longitudinal secondary data analysis. Subjects: Multimorbid adults aged 65 years or older from primary care clinics. Measures: 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. Results: Greater HCTD was associated with worse mental and physical health [ Cuzick test for trend (P < 0.05)], and patient-reported quality of chronic illness care (P< 0.05). In longitudinal analysis, increasing patient activation was associated with declining HCTD over time (P< 0.01). Increasing HCTD over time was associated with declining mental (P < 0.001) and physical health (P = 0.001) and patient-reported quality of chronic illness care (P < 0.05). Conclusions: The findings of this study establish the construct validity of the HCTD scale.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据