自理
长期护理
门诊护理
医学
多级模型
家庭医学
心理学
医疗保健
慢性病
计算机科学
经济增长
机器学习
经济
作者
Paolo Iovino,Karen S. Lyons,Maddalena De Maria,Ercole Vellone,Davide Ausili,Christopher S. Lee,Bárbara Riegel,Maria Matarese
标识
DOI:10.1016/j.ijnurstu.2020.103574
摘要
Multiple chronic conditions (MCC) are highly prevalent worldwide, especially among older populations. Patient self-care and care partner (or caregiver) contributions to self-care are recommended to reduce the impact of MCC and improve patients' outcomes. To describe patient self-care and care partner contributions to self-care and to identify determinants of patient self-care and care partner contributions to self-care at the patient and care partner level. Multicentre cross-sectional study. Outpatient and community settings in Italy. A sample of 340 patients with MCC and care partner dyads was recruited between 2017 and 2018. We measured patient's self-care and care partner contributions to self-care in dyads using the Self-care of Chronic Illness Inventory and the Caregiver Contribution to Self-care of Chronic Illness Inventory. To control for dyadic interdependence, we performed a multilevel modelling analysis. Patients' and care partners' mean ages were 76.65 (± 7.27) and 54.32 (± 15.25), respectively. Most care partners were female and adult children or grandchildren. The most prevalent chronic conditions in patients were diabetes (74%) and heart failure (34%). Patients and care partners reported higher levels of self-care monitoring than self-care maintenance and management behaviours. Important patient clinical determinants of self-care included cognitive status, number of medications and type of chronic condition. Care partner determinants of self-care contributions included age, gender, education, perceived income, care partner burden, caregiving hours per week and the presence of a secondary care partner. Our findings support the importance of taking a dyadic approach when focusing on patients with MCC and their care partners. More dyadic longitudinal research is recommended to reveal the modifiable determinants of self-care and the complex relationships between patients and care partners in the context of MCC.
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