Psychological aspects of serious illness: Chronic conditions, fatal diseases, and clinical care.

1996 ◽  
Keyword(s):  
Chronic Conditions ◽  
Clinical Care ◽  
Psychological Aspects ◽  
Serious Illness

scholarly journals Innovative Strategies to Facilitate Patient-Centered Research in Multiple Chronic Conditions

2021 ◽  
Vol 10 (10) ◽  
pp. 2112
Author(s):  
Tullika Garg ◽  
Courtney A. Polenick ◽  
Nancy Schoenborn ◽  
Jane Jih ◽  
Alexandra Hajduk ◽  
...  
Keyword(s):  
Chronic Conditions ◽  
Clinical Care ◽  
Intervention Development ◽  
Healthcare Services ◽  
Multiple Chronic Conditions ◽  
Patient Centered ◽  
Older Americans ◽  
Innovative Strategies ◽  
Department Of Health ◽  
Innovative Methods

Multiple chronic conditions (MCC) are one of today’s most pressing healthcare concerns, affecting 25% of all Americans and 75% of older Americans. Clinical care for individuals with MCC is often complex, condition-centric, and poorly coordinated across multiple specialties and healthcare services. There is an urgent need for innovative patient-centered research and intervention development to address the unique needs of the growing population of individuals with MCC. In this commentary, we describe innovative methods and strategies to conduct patient-centered MCC research guided by the goals and objectives in the Department of Health and Human Services MCC Strategic Framework. We describe methods to (1) increase the external validity of trials for individuals with MCC; (2) study MCC epidemiology; (3) engage clinicians, communities, and patients into MCC research; and (4) address health equity to eliminate disparities.

scholarly journals Onset of Multiple Chronic Conditions and Depressive Symptoms: A Life Events Perspective

2017 ◽  
Vol 1 (2) ◽  
Author(s):  
Maureen Wilson-Genderson ◽  
Allison R Heid ◽  
Rachel Pruchno
Keyword(s):  
Heart Disease ◽  
Depressive Symptoms ◽  
Pulmonary Disease ◽  
Chronic Conditions ◽  
Clinical Care ◽  
Psychological Impact ◽  
Multiple Chronic Conditions ◽  
Care Providers ◽  
The Subject ◽  
Independent Effects

Abstract Background While the association between depressive symptoms and chronic illness has been the subject of many studies, little is known about whether depressive symptoms differ as a function of the illnesses people have as they transition to living with multiple chronic conditions. Methods Self-reports of five diagnosed chronic conditions (arthritis, diabetes, heart disease, hypertension, and pulmonary disease) and depressive symptoms were provided by 3,396 people participating in three waves of the ORANJ BOWLSM research panel. Longitudinal multilevel modeling was used to examine the effects that transitioning to having a diagnosis of multiple chronic conditions has on depressive symptoms. Results Between 2006 and 2014, controlling for age, gender, income, race, and a lifetime diagnosis of depression, people who transitioned to having a diagnosis of multiple chronic conditions had significantly higher levels of depressive symptoms than people who did not make this transition. The diagnosis of arthritis, diabetes, heart disease, and pulmonary disease, but not hypertension had independent effects, increasing depressive symptoms. Conclusions Having a diagnosis of multiple chronic conditions leads to increases in depressive symptoms, but not all illnesses have the same effect. Findings highlight the need for clinicians to be aware of mental health risks in patients diagnosed with multiple chronic conditions, particularly those with a diagnosis of arthritis, diabetes, heart disease, and pulmonary disease. Clinical care providers should take account of these findings, encouraging psychosocial supports for older adults who develop multiple chronic conditions to minimize the negative psychological impact of illness diagnosis.

scholarly journals The centrality of disclosure decisions to the illness experience for youth with chronic conditions: A qualitative study

2020 ◽  
pp. 135910532096224
Author(s):  
Roberta Lynn Woodgate ◽  
Pauline Tennent ◽  
Sarah Barriage ◽  
Nicole Legras
Keyword(s):  
Chronic Illness ◽  
Qualitative Study ◽  
Chronic Conditions ◽  
Clinical Care ◽  
Constructivist Grounded Theory ◽  
Illness Experience ◽  
Healthcare Decision ◽  
Categorical Approach ◽  
Healthcare Decision Making ◽  
Disclosure Decisions

The aim of this paper is to illuminate findings of disclosure experiences for youth living with chronic illness using a non-categorical approach. The findings were derived from a larger qualitative study framed by social constructivist grounded theory that sought to understand youth’s involvement in healthcare decision-making in the context of chronic illness. Fifty-four youth participated in the study, ranging from 9 to 24 years. Three main themes representing the youth’s perspectives and experiences of disclosing chronic illness were identified: (1) disclosure is central to the illness experience; (2) spectrum of disclosure; and (3) navigating others’ reactions to disclosure. The findings reinforce that more emphasis on decisions related to disclosing illness in research and clinical care for youth with chronic conditions is warranted.

The serious illness care program.

2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 12-12 ◽  
Author(s):  
Rachelle Bernacki ◽  
Susan Block
Keyword(s):  
End Of Life ◽  
Controlled Trial ◽  
Clinical Care ◽  
Care Program ◽  
Depression Score ◽  
Serious Illness ◽  
Clinician Training ◽  
The Mean ◽  
Surprise Question ◽  
The Impact

12 Background: Conversations between patients and clinicians about end-of-life care allow patients to prepare and plan for the end of life and are associated with improved outcomes. Objective: To determine the impact of a structured, seven-item conversation guide on anxiety and depression in patients with an estimated prognosis under a year. Methods: A cluster, randomized controlled trial enrolled 81 clinicians and 272 patients (goal of 400 patients) at Dana Farber Cancer Institute. The intervention (integrated into regular clinical care by oncologists) consisted of a system to identify patients and trigger clinician discussions using the checklist, clinician training, and documentation template in the electronic medical record. Adult patients were identified by oncologists using the “surprise” question. Surveys measured key outcomes before and after administration of the checklist (for patients) and after training (for oncologists). Results: 1,299 patients were identified using the surprise question. Of patients contacted, 332 agreed to participate and 254 declined. To date, 62 conversations are complete with a median length of 20 minutes (range: 8-70 min). The mean anxiety level using the GAD-7 score for the participants with complete data prior to the checklist conversation was 4.0 and post-conversation 3.1 (p=0.04). The mean depression score using the PHQ-9 prior to the checklist conversation was 6.3 and post-conversation 5.7 (p=0.2). 51% of patients found the discussion ‘very’ or ‘extremely’ helpful; 21% found the discussion ‘somewhat’ helpful; and 14% ‘slightly’ or ‘not at all’ helpful. The majority of clinicians found the guide simple (79%) and easy to use (78%); 81% reported they would continue its use after the trial. Conclusions: These preliminary data demonstrate that use of the guide is feasible, acceptable to patients and clinicians, and does not lead to increased anxiety or depression. There is a trend towards a significant reduction in anxiety in patients who had the discussion with their oncologists. The Serious Illness Care Program is an acceptable intervention to support clinicians in conducting conversations about end-of-life values and goals with patients, allowing them to articulate their wishes about future medical care. Clinical trial information: NCT01786811.

scholarly journals Person-centred care in complementary medicine for individuals with chronic conditions in Australia

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
H Foley ◽  
A Steel ◽  
J Adams
Keyword(s):  
Public Health ◽  
Complementary Medicine ◽  
Health Systems ◽  
Chronic Conditions ◽  
Clinical Care ◽  
Medical Doctors ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Public Health Burden ◽  
Public Health Systems

Abstract Background Increasing chronic condition diagnoses burden public health systems, individuals and communities. The duration and complexity of chronic conditions require ongoing, multifaceted care - such as person-centred care (PCC) - to address the individual needs and quality of life for patients. Many patients with chronic conditions seek additional care outside mainstream medicine, often consulting complementary medicine (CM) practitioners. This study examines the extent of PCC being experienced by patients with chronic conditions who consult CM practitioners. Methods Cross-sectional survey (n = 191), conducted nationally, November 2018 to March 2019, in clinics of the five CM professions most commonly consulted by individuals with chronic conditions in Australia (massage, chiropractic, osteopathy, acupuncture, naturopathy). Participants with chronic conditions (n = 153) were surveyed about experiences of PCC during CM consultation, and regarding consultation with medical doctors, using four validated measures. Results During consultation with CM practitioners, patient perceptions of PCC were consistently high. Ratings of PCC were consistently higher for consultations with any CM practitioners (summary mean 3.33) than consultations with medical doctors (summary mean 2.95). The highest mean scores for PCC were reported by patients of naturopaths (summary mean 4.04). Variations in perceived PCC for different items between professions indicate nuance in the experience of consultation across different CM professions. Conclusions This study indicates PCC is characteristic of CM consultation, which may reflect CM philosophies such as holism. CM practitioners may present an existing resource of PCC. Further attention should be given to CM professions regarding the potential to address unmet needs of individuals with chronic conditions, and subsequently to better manage the public health burden associated with chronic conditions. Key messages Person-centred care appears to be a consistent characteristic of complementary medicine clinical care for individuals with chronic conditions. Due to rising rates of chronic conditions and the associated burden on public health systems, complementary medicine professions should be considered as a resource to optimise chronic illness care.

Development and validation of the palliative care preferences scale (PCPS).

2018 ◽  
Vol 36 (34_suppl) ◽  
pp. 151-151
Author(s):  
Laura M Perry ◽  
Adina S Kazan ◽  
James Louis Rogers ◽  
Michael Hoerger
Keyword(s):  
Palliative Care ◽  
Internal Consistency ◽  
Convergent Validity ◽  
Factor Model ◽  
Clinical Care ◽  
Reliability And Validity ◽  
Internal Consistency Reliability ◽  
Care Utilization ◽  
Future Research ◽  
Serious Illness

151 Background: Research has not thoroughly examined patient-level factors such as perceptions that could contribute to underutilization of palliative care, which may be due in part to a lack of existing measures for this purpose. Therefore, this investigation aimed to develop and validate a 9-item measure called the Palliative Care Preferences Scale (PCPS-9), which was comprised of three subscales: emotional, cognitive, and behavioral. Methods: Data were collected in three separate online studies of individuals with cancer (study 1: N = 633; study 2: N = 462) or one of the following non-cancer serious illnesses: COPD, heart failure, or kidney failure (study 3: N = 248). Analyses assessed various psychometric properties of the scale in cancer and non-cancer patients, including internal consistency reliability, confirmatory factor analyses (CFAs), multigroup CFAs, and convergent validity associations with related constructs. Results: Across all three studies, results supported the internal consistency reliability for the total scale (αs from 0.76 to 0.83) and subscales: emotional (αs from 0.83 to 0.84), cognitive (αs from 0.60 to 0.77), behavioral (αs from 0.87 to 0.91). CFAs supported the three-factor model of the PCPS-9 (CFI ≥ 0.97, NNFI ≥ 0.96, RMSEA ≤ 0.07, SRMR ≤ 0.04), and a multigroup CFA supported the generalizability of its factor structure across cancer and non-cancer serious illness subgroups (ΔCFIs ≤ 0.006, ΔRMSEA ≤ 0.003). Finally, convergent validity analyses in studies 2 and 3 found that the PCPS-9 was significantly associated with related constructs, including a separate measure of palliative care preferences ( ps < 0.001) and a measure of palliative care knowledge ( ps < 0.001). Conclusions: Findings support the overall reliability and validity of the PCPS-9 in cancer and non-cancer serious illness samples and have implications for increasing palliative care utilization via clinical care and future research efforts.

scholarly journals The Art and Science of Group Visits in Lifestyle Medicine

2017 ◽  
Vol 11 (5) ◽  
pp. 408-413 ◽  
Author(s):  
Elizabeth Pegg Frates ◽  
Elizabeth C. Morris ◽  
Deepa Sannidhi ◽  
Wayne S. Dysinger
Keyword(s):  
Chronic Conditions ◽  
Clinical Care ◽  
Group Session ◽  
Group Support ◽  
Lifestyle Medicine ◽  
Shared Medical Appointments ◽  
Coaching Education ◽  
Group Visits ◽  
Group Coaching ◽  
Healthy Habits

Lifestyle medicine group sessions present a promising approach to clinical care. Based on decades of work in shared medical appointments and group visits for diabetes and other chronic conditions, a lifestyle medicine group session has the potential to provide a fresh and rewarding way of interacting with patients that fuels the practitioner and feeds patients’ needs to spend time with the lifestyle medicine practitioner, connect with him or her, connect with others, learn the latest recommendations regarding healthy habits, practice these behaviors, and discuss their obstacles, motivations, and strategies for healthy living. The lifestyle medicine group session discussed in this article is a combination of group coaching, education, and group support.

Clinical Care Strategies That Support Parents of Children With Complex Chronic Conditions

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Jori F. Bogetz ◽  
Anna Revette ◽  
Danielle D. DeCourcey
Keyword(s):  
Chronic Conditions ◽  
Clinical Care ◽  
Complex Chronic Conditions
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