Life Interrupted: The Impact of Complex Chronic Disease from the Perspective of Hospitalized Patients

Kuluski, Kerry; Bensimon, Cécile M.; Alvaro, Celeste; Lyons, Renée; Schaink, Alexis K.; Tobias, Roy

doi:10.2190/il.22.2.d

Cited by 14 publications

(11 citation statements)

References 45 publications

(45 reference statements)

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“…The study is a component of a broader multimethod study that examined the characteristics, needs, and care experiences of hospitalized patients with complex chronic conditions. 18 , 19 Ethics approval was received on January 26, 2011 from the Joint Bridgepoint–West Park–Toronto Central Community Care Access Centre Research Ethics Board.…”

Section: Methodsmentioning

confidence: 99%

Perceived risk factors of health decline: a qualitative study of hospitalized patients with multimorbidity

Kuluski¹,

Tracy²,

Upshur³

2015

RMHP

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BackgroundEffectively preventing and managing chronic illness are key goals for health systems worldwide. A growing number of people are living longer with multiple chronic illnesses, accompanied by a high degree of treatment burden and heavy use of health care resources. People with multimorbidity typically have to manage their care needs for a number of years, and from this experience may offer valuable perspectives on factors that influenced their health outcome.PurposeThe purpose of this study was to explore factors that may serve as tipping points into poor health from the perspective of hospitalized patients with multimorbidity.Participants and methodsPatient interview data were analyzed from 43 hospitalized patients with multimorbidities who indicated that something could have been done to either avoid or slow down their health decline. The study used qualitative description as the analytic method to generate themes from a specific question collected through one-on-one interviews. Two reviewers independently analyzed and thematically coded the data and reached consensus on the final themes after a series of meetings.ResultsAccording to patient accounts, factors at the personal level (eg, personal behaviors), provider level (eg, late diagnoses), and health care system level (eg, poor care transitions) contributed to their health decline.ConclusionThis paper focuses on prevention in the context of multimorbidity. While some respondents indicated personal behaviors that impacted health, many pointed to factors outside themselves (providers and the broader health system). The orientation of health care systems, historically designed to support acute and episodic care and not multimorbidity, places patients, at least in some cases, at additional risk of decline. The patient accounts suggest that the notion of prevention should evolve throughout the course of illness. A successful health system would embrace this notion and see the goal as forestalling not only mortality (as achieved for the most part in high socioeconomic nations) but morbidity as well. High rates of multimorbidity and health system challenges suggest that we have not yet achieved this latter aim.

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Section: Methodsmentioning

confidence: 99%

Perceived risk factors of health decline: a qualitative study of hospitalized patients with multimorbidity

Kuluski¹,

Tracy²,

Upshur³

2015

RMHP

Self Cite

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“…CCDD is a term that identifies individuals who have been diagnosed with multimorbidities that affect psychological, social, physical, and vocational functioning and require ongoing health care resource utilization [36–38]. Individuals with complex health conditions have been identified as unique in terms of their specific health care needs and health-related experiences [36].…”

Section: Introductionmentioning

confidence: 99%

“…Individuals with complex health conditions have been identified as unique in terms of their specific health care needs and health-related experiences [36]. Although the disease combinations reported in multimorbidity are diverse, the most common diagnoses are diabetes, stroke, hypertension, cancer, arthritis, asthma, fractures, the presence of an artificial knee or hip, fatigue, multiple sclerosis, demyelinating diseases of the central nervous system, gonarthrosis, ataxia, COPD, dependence on renal dialysis, malignant neoplasm of breast/prostate, depressive episodes, and pure hypercholesterolemia [39, 40].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of a Specialized Yoga Program for Persons Admitted to a Complex Continuing Care Hospital: A Pilot Study

Curtis

Kuluski

Bechsgaard

et al. 2016

Evidence-Based Complementary and Alternative Medicine

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Introduction. The purpose of this study was to evaluate a specialized yoga intervention for inpatients in a rehabilitation and complex continuing care hospital. Design. Single-cohort repeated measures design. Methods. Participants (N = 10) admitted to a rehabilitation and complex continuing care hospital were recruited to participate in a 50–60 min Hatha Yoga class (modified for wheelchair users/seated position) once a week for eight weeks, with assigned homework practice. Questionnaires on pain (pain, pain interference, and pain catastrophizing), psychological variables (depression, anxiety, and experiences with injustice), mindfulness, self-compassion, and spiritual well-being were collected at three intervals: pre-, mid-, and post-intervention. Results. Repeated measures ANOVAs revealed a significant main effect of time indicating improvements over the course of the yoga program on the (1) anxiety subscale of the Hospital Anxiety and Depression Scale, F(2,18) = 4.74, p < .05, and η p 2 = .35, (2) Self-Compassion Scale-Short Form, F(2,18) = 3.71, p < .05, and η p 2 = .29, and (3) Magnification subscale of the Pain Catastrophizing Scale, F(2,18) = 3. 66, p < .05, and η p 2 = .29. Discussion. The results suggest that an 8-week Hatha Yoga program improves pain-related factors and psychological experiences in individuals admitted to a rehabilitation and complex continuing care hospital.

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“…И чрезвычайно важно найти собеседника, который может разделить с тобой это переживание, который может поддержать разговор о смерти. Тысячи работ написаны об умирании от рака, горечи от ухода близких и страха собственной смерти [Glaser, Strauss, 1965Dumont, Foss, 1972;Cooper, 1984;Kellehear, 1993;McNamara, 2000;Stewart, 2011;Bouchal et al, 2015], о переживании тяжёлых заболеваний, больничном или семейном уходе, новых, пограничных между жизнью и смертью состояниях [Gregory, 2005;Broom, Kirby, 2013;Li, Mak, Loke, 2013;Kuluski et al, 2014;, но невозможно понять, что такое смерть, не преодолев минуты отчаяния, не оказавшись на границе этого мира.…”

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Experience of Empathy to Death

Рогозин¹,

Kolosov²

2016

monitoring of public opinion

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РОГОЗИН Дмитрий Михайлович-кандидат социологических наук, заведующий лабораторией методологии социальных исследований Института социального анализа и прогнозирования Российской академии народного хозяйства и государственной службы при Президенте РФ, старший научный сотрудник Института социологии Российской академии наук,

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Life Interrupted: The Impact of Complex Chronic Disease from the Perspective of Hospitalized Patients

Cited by 14 publications

References 45 publications

Perceived risk factors of health decline: a qualitative study of hospitalized patients with multimorbidity

Perceived risk factors of health decline: a qualitative study of hospitalized patients with multimorbidity

Evaluation of a Specialized Yoga Program for Persons Admitted to a Complex Continuing Care Hospital: A Pilot Study

Experience of Empathy to Death

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