WRIISC as a Model of Care for Chronic Multisymptom Illness
WIISC 作为慢性多症状疾病的护理模式
基本信息
- 批准号:9759669
- 负责人:
- 金额:--
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2016
- 资助国家:美国
- 起止时间:2016-03-01 至 2020-12-31
- 项目状态:已结题
- 来源:
- 关键词:AddressAdherenceBeliefCaringChronicChronic DiseaseClinicClinicalClinical assessmentsCoinCollaborationsCommunicationCompetenceCross-Sectional StudiesDiabetes MellitusEnvironmental HealthEvaluationFutureGulf WarHealthImpairmentIndividualInjuryInstitute of Medicine (U.S.)InterventionInterviewLeadLung diseasesMeasuresMedicalOutcomePatient-Centered CarePatient-Focused OutcomesPatientsPersian GulfPhysical activityPopulationPrimary Care PhysicianPrimary Health CareProspective StudiesProviderQuestionnairesRecommendationReportingScienceSelf ManagementSymptomsSystemTimeVeteransWarWorkbiomedical referral centerchronic care modelclinical encounterdesigndisabilityeffective therapyexperiencehealth administrationhealth care service utilizationillness perceptionsimprovedinnovationmedical specialtiesmultidisciplinaryprospectivesatisfactiontreatment planning
项目摘要
DESCRIPTION (provided by applicant):
Gulf War Veterans (GWVs) with Chronic Multi-Symptom Illness (CMI) are twice as likely to be dissatisfied with Veterans Health Administration (VHA) care as Veterans without CMI. This suggests the need to identify the critical components of effective patient-centered care for these Veterans. The challenges of treating CMI likely center on the fact that there is continuing debate about the cause(s) of CMI. Disagreement, or non-concordance, between patients' and providers' understanding of illness (illness perceptions) are related to dissatisfaction with care n other populations. Beyond satisfaction with care, illness perceptions are thought to be the key determinant of outcomes for patients with CMI. Illness perceptions account for 33% of the variability in disability for GWVs with CMI. What is not known is how providers should address illness perceptions. Treatments that have sought to change GWVs with CMI "maladaptive" illness perceptions have generally suffered from poor adherence or low efficacy. An innovative approach is to assume patients are experts of their experience and providers are medical experts and that both are needed to improve care. Thus providers need to work with patients to develop individualized aligned illness perceptions. Among patients with other chronic illnesses (e.g., diabetes), patients who have concordant illness perceptions with their providers are more satisfied and have better health outcomes. This is because when patients and providers understand the illness in the same way together they create effective treatment plans to which patients want to adhere. The War Related Illness and Injury Study Center (WRIISC) is a specialized clinic for deployed Veterans with CMI. WRIISC providers seek to collaborate with a patient to align illness perceptions. Over 97% of Veterans seen at the WRIISC are satisfied with their care, yet it is not known if this satisfaction is due to concordant illness perceptions or ifthis satisfaction may ultimately improve adherence to recommendations for future utilization and self-management, and lower disability. If concordant illness perceptions were found to improve health outcomes for GWVs with CMI, this approach could be disseminated to VHA providers through existing collaborations between WRIISC and environmental health and post- deployment integrated care initiative clinical champions at each facility, to improve care for all GWVs with CMI. This application proposes an observational prospective study to examine the relationship between degree of concordance in illness perceptions between GWVs with CMI and providers and health outcomes. Clinical encounters of 100 GWVs with CMI seen at the WRIISCs, and 100 GWVs with CMI seen by a VHA Primary Care Physician will be audio recorded. Patients' perceived concordance of illness perceptions will be measured with an observer rating system and by using the Illness Concordance Questionnaire. Health outcomes will be measured one week, three months and one year after the encounter. Qualitative interviews will be conducted with 30 of the GWVs with CMI. The aims are to determine the relationship between degree of concordance in illness perceptions between GWVs with CMI and providers and improvements in outcomes over time. The second aim is to compare the extent of illness perception elicitation and various outcomes at WRIISCs and usual VA primary care. Finally, identify the communication strategies providers used to elicit GWVs' illness perceptions and generate concordance in illness perceptions.
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
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Peter J. Bayley其他文献
Estimating survival in data-driven phenotypes of mental health symptoms and peripheral biomarkers: a prospective study
估计心理健康症状和外周生物标志物的数据驱动表型的生存率:一项前瞻性研究
- DOI:
10.1016/j.bbih.2024.100815 - 发表时间:
2024 - 期刊:
- 影响因子:0
- 作者:
Santiago Allende;Peter J. Bayley - 通讯作者:
Peter J. Bayley
Peter J. Bayley的其他文献
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Feasibility of At Home Telehealth Yoga for Treating Chronic Pain
在家远程保健瑜伽治疗慢性疼痛的可行性
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10184910 - 财政年份:2019
- 资助金额:
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Feasibility of At Home Telehealth Yoga for Treating Chronic Pain
在家远程保健瑜伽治疗慢性疼痛的可行性
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Feasibility of At Home Telehealth Yoga for Treating Chronic Pain
在家远程保健瑜伽治疗慢性疼痛的可行性
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10212246 - 财政年份:2019
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- 批准号:
8860046 - 财政年份:2015
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