The meaning and significance of self-management among socioeconomically vulnerable older adults
The meaning and significance of self-management among socioeconomically vulnerable older adults
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DOI：
10.1093/geronb/63.5.s312
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发表时间：
2008-09-01
影响因子：
6.2
通讯作者：
Callahan, Christopher M.
中科院分区：
文献类型：
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作者：
Clark, Daniel O.;Frankel, Richard M.;Callahan, Christopher M.
目标.本研究的目的是描述和对比自我管理的社会经济脆弱和非脆弱的老年人的看法。我们采用了以身份认同理论为指导的深入的家庭访谈。分析包括审查录音带，创建和比较现场笔记，编码成绩单，并根据案件摘要确定主题。访谈在患者家中进行。参与者是23名收入等于或低于联邦贫困线200%的弱势老年人，没有私人保险，12名老年人有私人医疗保险。弱势群体的受教育程度和健康知识水平低于私人保险样本。保持看医生和服用处方药在很大程度上定义了脆弱样本的自我管理，但这只是私人保险集团指出的一些角色中的两个，他们表示健康促进是健康老龄化的关键。脆弱的受访者转述了一些健康老龄化的例子，也没有对健康老龄化的期望。相比之下，私人保险的受访者给出了例子，并期望长寿和健康地进入老年。更好地理解社会背景在老龄化预期中的作用，以及自我管理的意识和优先事项。可能导致自我管理支持的改善，从而改善慢性护理结果。
Objectives. The aim of this study was to describe and contrast perceptions of self-management among socioeconomically vulnerable and nonvulnerable older adults.Methods. We used in-depth, in-home interviews guided by identity theory. Analyses included reviewing audiotapes, creating and comparing field notes, coding transcripts, and identifying themes based on case summaries. Interviews took place in patients' homes. Participants were 23 vulnerable older adults with incomes at or below 200% of the federal poverty level and no private insurance and 12 older adults with private health insurance.Results. The vulnerable sample had lower educational attainment and lower health literacy than the privately insured sample. Keeping doctor visits and taking prescription medications largely defined self-management for the vulnerable sample but were just two of a number of roles noted by the privately insured group, who expressed health promotion as the key to healthy aging. The vulnerable interviewees relayed few examples of healthy aging and did not have expectations for healthful aging. In contrast, the privately insured interviewees gave examples and had expectations of living long and healthfully into old age.Discussion. Improved understanding of the role of social context in expectations regarding aging, and awareness of and priorities for self-management. could lead to improvements in self-management Support and thus chronic care outcomes.