Descriptions of barriers to self-care by persons with comorbid chronic diseases.
Descriptions of barriers to self-care by persons with comorbid chronic diseases.
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DOI：
10.1370/afm.4
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发表时间：
2003-05-01
影响因子：
4.4
通讯作者：
Main, Deborah S
中科院分区：
文献类型：
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作者：
Bayliss, Elizabeth A;Steiner, John F;Main, Deborah S
背景：慢性疾病通常是合并症，而不是孤立的疾病。慢性病的成功管理取决于充分的自我护理。然而，鲜为人知的是，共病慢性conditions.OBJECTIVE：我们的目标是确定共病慢性病患者的自我保健的感知障碍。方法：我们进行了半结构化的个人访谈与16名成年人从4个城市家庭的做法在CaReNet的实践为基础的研究网络谁自我报告的存在2个或更多的常见慢性医疗条件。使用自由列表技术，参与者被要求：“请列出你能想到的所有影响你照顾自己医疗条件的能力的事情。回答分析潜在的障碍自我care.RESULTS：参与者的反应显示自我保健的障碍，包括身体限制，缺乏知识，财政限制，物流获得护理，需要社会和情感的支持，加重一个条件的症状或治疗的另一个，多个问题的药物，和压倒性的影响占主导地位的个人条件。这些障碍中有许多直接相关的comorbidity.CONCLUSIONS：患有慢性疾病的人经历了广泛的自我保健的障碍，包括几个具体涉及到有多种医疗条件。自我管理干预措施可能需要解决慢性病之间的相互作用以及护理个别疾病所需的技能。
BACKGROUND: Chronic medical conditions often occur in combination, as comorbidities, rather than as isolated conditions. Successful management of chronic conditions depends on adequate self-care. However, little is known about the self-care strategies of patients with comorbid chronic conditions.OBJECTIVE: Our objective was to identify perceived barriers to self-care among patients with comorbid chronic diseases.METHODS: We conducted semistructured personal interviews with 16 adults from 4 urban family practices in the CaReNet practice-based research network who self-reported the presence of 2 or more common chronic medical conditions. Using a free-listing technique, participants were asked, "Please list everything you can think of that affects your ability to care for your medical conditions." Responses were analyzed for potential barriers to self-care.RESULTS: Participants' responses revealed barriers to self-care, including physical limitations, lack of knowledge, financial constraints, logistics of obtaining care, a need for social and emotional support, aggravation of one condition by symptoms of or treatment of another, multiple problems with medications, and overwhelming effects of dominant individual conditions. Many of these barriers were directly related to having comorbidities.CONCLUSIONS: Persons with comorbid chronic diseases experience a wide range of barriers to self-care, including several that are specifically related to having multiple medical conditions. Self-management interventions may need to address interactions between chronic conditions as well as skills necessary to care for individual diseases.