NDLI: Barriers to self-management and quality-of-life outcomes in seniors with multimorbidities.

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Barriers to self-management and quality-of-life outcomes in seniors with multimorbidities.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Bayliss, Elizabeth A. Ellis, Jennifer L. Steiner, John F.
Spatial Coverage	United States
Description	Country affiliation: United States Author Affiliation: Bayliss EA ( Kaiser Permanente Clinical Research Unit, Denver, Colo 80237-8066, USA. Elizabeth.Bayliss@kp.org)
Abstract	PURPOSE: Persons with multiple chronic diseases must integrate self-management tasks for potentially interacting conditions to attain desired clinical outcomes. Our goal was to identify barriers to self-management that were associated with lower perceived health status and, secondarily, with lower reported physical functioning for a population of seniors with multimorbidities. METHODS: We conducted a cross-sectional telephone survey of 352 health maintenance organization members aged 65 years or older with, at a minimum, coexisting diagnoses of diabetes, depression, and osteoarthritis. Validated questions were based on previous qualitative interviews that had elicited potential barriers to the self-management process for persons with multimorbidities. We analyzed associations between morbidity burden, potential barriers to self-management, and the 2 outcomes using multivariate linear regression modeling. RESULTS: Our response rate was 47%. Sixty-six percent of respondents were female; 55% were aged 65 to 74 years, and 45% were aged 75 years or older. Fifty percent reported fair or poor health. On average they had 8.7 chronic diseases. In multivariate analysis, higher level of morbidity, lower level of physical functioning, less knowledge about medical conditions, less social activity, persistent depressive symptoms, greater financial constraints, and male sex were associated with lower perceived health status. Potential barriers to self-management significantly associated with lower levels of physical functioning were higher level of morbidity, greater financial constraints, greater number of compound effects of conditions, persistent depressive symptoms, higher level of patient-clinician communication, and lower income. CONCLUSIONS: In addition to morbidity burden, specific psychosocial factors are independently associated with lower reported health status and lower reported physical functioning in seniors with multimorbidities. Many factors are amenable to intervention to improve health outcomes.
File Format	HTM / HTML
ISSN	15441709
e-ISSN	15441717
Journal	The Annals of Family Medicine
Issue Number	5
Volume Number	5
Language	English
Publisher	Annals of Family Medicine Inc
Publisher Date	2007-09-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Family Medicine Statistics & Numerical Data Health Status Quality Of Life Comorbidity Cross-sectional Studies Depression Epidemiology Diabetes Mellitus Health Knowledge, Attitudes, Practice Health Surveys Linear Models Multivariate Analysis Osteoarthritis Qualitative Research Sex Distribution Socioeconomic Factors Research Support, N.i.h., Extramural Research Support, U.s. Gov't, P.h.s.
Content Type	Text
Resource Type	Article
Subject	Family Practice

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