Perceived challenges and priorities in co-morbidity management of older patients with Type 2 diabetes
Perceived challenges and priorities in co-morbidity management of older patients with Type 2 diabetes
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DOI：
10.1111/j.1464-5491.2011.03282.x
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发表时间：
2011-07-01
影响因子：
3.5
通讯作者：
Weinger, K.
中科院分区：
文献类型：
--
作者：
Beverly, E. A.;Wray, L. A.;Weinger, K.
Aims To Explore Older Patients' Perceived Impact of Chronic Co-morbid Conditions on Type 2 Diabetes Self-management.Methods我们采用目的抽样法选择32名精神警觉的社区居住成年人，年龄60岁或以上，诊断为2型糖尿病和至少一种其他慢性健康状况参加焦点小组。我们总结了每个焦点小组的讨论，并确定代码来描述的总体themes.Results我们进行了8个90分钟的焦点小组，每个小组由2至6名患者组成。出现了三个主题。(i)糖尿病并发症作为一个诱因：管理共病状况使健康成为老年患者生活中的一个重要焦点。大多数患者承认并发症对他们的糖尿病自我管理产生了积极影响，促使他们更加关注糖尿病，以减少这些并发症的进展。(ii)优先考虑健康状况：患者报告说，他们根据自己感觉到的严重性或重要性，对健康状况进行了优先排序，并有选择地关注这些状况的管理。此外，许多患者认为某些疾病比其他疾病更严重，并承认将另一种健康状况优先于糖尿病。(iii)情绪的影响，共病管理：患者描述的感觉沮丧，困惑，不知所措的反应冲突的治疗建议，特别是饮食，体力活动和药物治疗regiments.Conclusions并发症和共病可能有不同的影响，老年患者的糖尿病自我管理。解决并发症对糖尿病自我管理的影响可能会改善患者的结局;然而，在临床实践中利用这些信息的最有效方法需要进行检查。
Aims To explore older patients' perceived impact of chronic co-morbid conditions on Type 2 diabetes self-management.Methods We used purposive sampling to select 32 mentally alert community-dwelling adults, aged 60 years or older, diagnosed with Type 2 diabetes and at least one other chronic health condition to participate in focus groups. We summarized the discussions following each focus group and identified codes to describe the overarching themes.Results We conducted eight 90-min focus groups, each consisting of two to six patients. Three themes emerged. (i) Diabetes complications as a motivator: managing co-morbid conditions made health an important focal point in the lives of older patients. Most patients acknowledged the positive effect complications had on their diabetes self-management by motivating them to pay greater attention to their diabetes to diminish the progression of these complications. (ii) Prioritizing health conditions: patients reported prioritizing health conditions and selectively attending to the management of those conditions based on perceived severity or importance. Further, many patients perceived some conditions as more serious than others and admitted to prioritizing another health condition over their diabetes. (iii) Emotional impact of co-morbidity management: patients described feeling frustrated, confused, and overwhelmed in response to conflicting treatment recommendations, particularly for diet, physical activity and medication regimens.Conclusions Complications and co-morbidities may have differential impacts on the diabetes self-management of older patients. Addressing the perceived impact of co-morbidity on diabetes self-management may improve patients' outcomes; however, the most effective method of utilizing this information in clinical practice needs to be examined.