Who participates in chronic disease self-management (CDSM) programs? Differences between participants and nonparticipants in a population of multimorbid older adults.
Who participates in chronic disease self-management (CDSM) programs? Differences between participants and nonparticipants in a population of multimorbid older adults.
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DOI：
10.1097/mlr.0b013e318268abe7
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发表时间：
2012-12
期刊：
影响因子：
3
通讯作者：
Boyd C
中科院分区：
文献类型：
--
作者：
Dattalo M;Giovannetti ER;Scharfstein D;Boult C;Wegener S;Wolff JL;Leff B;Frick KD;Reider L;Frey K;Noronha G;Boyd C
自我护理管理被认为是多病老年人护理的关键组成部分，但最有可能参与慢性病自我管理（CDSM）计划的人的特征以及如何最大限度地参与这些计划尚不清楚。在一个多病老年人样本中，确定与参加CDSM项目相关的个体因素。参与指导护理模式的配对群集随机对照试验的干预组的参与者被邀请参加六次CDSM课程。Logistic回归用于确定与出勤率独立相关的因素。所有受试者（N=241）均为65岁或以上，处于医疗保健利用的高风险中，并且不在家。CDSM参与者和非参与者可获得有关人口统计学、健康状况、健康活动和护理质量的基线信息。参与的定义是参加五次或五次以上的CDSM会议。被邀请参加CDSM课程的多发病老年人中有22.8%参加了五次或五次以上的课程。具有更好的身体健康（OR[95%CI] = 2.3[1.1-4.8]）和评价医生对患者激活的支持较差（OR[95%CI] = 2.8[1.3-6.0]）与出勤率独立相关。身体健康状况较好且对医生支持患者激活不满意的多发病老年人更有可能参加CDSM课程。
Self-care management is recognized as a key component of care for multi-morbid older adults, but the characteristics of those most likely to participate in Chronic Disease Self-Management (CDSM) programs and how to maximize participation in such programs are unknown. To identify individual factors associated with attending CDSM programs in a sample of multi-morbid older adults. Participants in the intervention arm of a matched-pair cluster-randomized controlled trial of the Guided Care model were invited to attend a six-session CDSM course. Logistic regression was used to identify factors independently associated with attendance. All subjects (N=241) were 65 years or older, were at high risk for health care utilization, and were not homebound. Baseline information on demographics, health status, health activities, and quality of care was available for CDSM participants and non-participants. Participation was defined as attendance at five or more CDSM sessions. 22.8% of multi-morbid older adults who were invited to CDSM courses participated in five or more sessions. Having better physical health (OR[95% CI] = 2.3[1.1–4.8]) and rating one’s physician poorly on support for patient activation (OR[95% CI] = 2.8[1.3–6.0]) were independently associated with attendance. Multi-morbid older adults who are in better physical health and who are dissatisfied with their physicians’ support for patient activation are more likely to participate in CDSM courses.