Multiple chronic diseases and quality of life: patterns emerging from a large national sample, Australia

Walker, Agnes

doi:10.1177/1742395307081504

Cited by 120 publications

(124 citation statements)

References 20 publications

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“…One would expect that patients who report a high satisfaction use their device without serious problems. However, Jannink et al [14] reported a number of serious deficiencies in the performance of AFOs despite the fact that the overall satisfaction was 8.1 (scale [1][2][3][4][5][6][7][8][9][10]. In other words, even a high satisfaction rate may cover up underexposed problems.…”

Section: Introductionmentioning

confidence: 99%

“…The phenomenon of non-use is strongly influenced by the expectations of the patient and his/her environment. Personal characteristics such as age, sex, and living environment also play an important role [9][10]. It is remarkable that many patients choose not to use their device, despite the fact that non-use hinders daily activities and social participation [4,[5][6][7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

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Use of and Satisfaction with Ankle Foot Orthoses

EJM¹

2015

Clin Res Foot Ankle

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Objective: The aim of this study was to obtain insight in specific elements influencing the use, non-use, satisfaction, and dissatisfaction of ankle foot orthoses (AFOs) and the presence of underexposed problems with respect to AFOs. Methods:A questionnaire was composed to obtain information from AFO users to investigate the variables associated with satisfaction and the relation between these variables. A specific feature of this study was the systematic analysis of the remarks made by the respondents about their AFO. Quantitative data analyses were used for analysing the satisfaction and qualitative analyses were used analysing the remarks of the respondents. A total of 211 users completed the questionnaire.Results: Our survey showed that 1 out of 15 AFOs were not used at all. About three quarters of the AFO users were satisfied and about one quarter was dissatisfied. Females and users living alone reported relatively high levels of dissatisfaction, especially in the field of dimensions, comfort, weight, safety and effectiveness. Dissatisfaction with respect to off-the-shelf AFOs for the item durability was higher than that for custom-made AFOs. In the delivery and maintenance process the items 'maintenance', 'professionalism' and 'delivery follow-up' were judged to be unsatisfactory. A large number of comments were made by the respondents to improve the device or process, mainly by the satisfied AFO users. These comments show that even satisfied users experience many problems and that a lot of problems of AFO users are 'underexposed'. Conclusion:To improve user satisfaction, the user practice has to be identified as an important sub-process of the whole orthopaedic chain especially in the diagnosis and prescription, delivery tuning and maintenance, and evaluation phase.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Use of and Satisfaction with Ankle Foot Orthoses

EJM¹

2015

Clin Res Foot Ankle

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“…The relationship between multiple conditions and poor psychological status has been demonstrated in community studies. 138 Studies focusing on those patients eligible for palliative forms of care are limited to the relationship between disease-specific conditions, comorbidities and psychological distress. The development of new comorbidities is associated with readmission of palliative care patients.…”

Section: Patient Symptom Burdenmentioning

confidence: 99%

Transitions to palliative care for older people in acute hospitals: a mixed-methods study

Gott

Ingleton

Gardiner

et al. 2013

Health Services and Delivery Research

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BackgroundImproving the provision of palliative and end-of-life care is a priority for the NHS. Ensuring an appropriately managed ‘transition’ to a palliative approach for care when patients are likely to be entering the last year of life is central to current policy. Acute hospitals represent a significant site of palliative care delivery and specific guidance has been published regarding the management of palliative care transitions within this setting.Aims(1) to explore how transitions to a palliative care approach are managed and experienced in acute hospitals and to identify best practice from the perspective of clinicians and service users; (2) to examine the extent of potentially avoidable hospital admissions amongst hospital inpatients with palliative care needs.DesignA mixed-methods design was adopted in two hospitals in England, serving diverse patient populations. Methods included (1) two systematic reviews; (2) focus groups and interviews with 58 health-care professionals to explore barriers to, and facilitators of, palliative care transitions in hospital; (3) a hospital inpatient survey examining palliative care needs and aspects of management including a self-/proxy-completed questionnaire, a survey of medical and nursing staff and a case note review; (4) in-depth interviews with 15 patients with palliative care needs; (5) a retrospective case note review of all inpatients present in the hospital at the time of the survey who had died within the subsequent 12 months; and (6) focus groups with 83 key decision-makers to explore the implications of the findings for service delivery and policy.ResultsOf the 514 patients in the inpatient survey sample, just over one-third (n = 185, 36.0%) met one or more of the Gold Standards Framework (GSF) prognostic indicator criteria for palliative care needs. The most common GSF prognostic indicator was frailty, with almost one-third of patients (27%) meeting this criteria. Agreement between medical and nursing staff and the GSF with respect to identifying patients with palliative care needs was poor. In focus groups, health professionals reported difficulties in recognising that a patient had entered the last 12 months of life. In-depth interviews with patients found that many of those interviewed were unaware of their prognosis and showed little insight into what they could expect from the trajectory of their disease. The retrospective case note review found that 35 (7.2%) admissions were potentially avoidable. The potential annual cost saving across both hospitals of preventing these admissions was approximately £5.3M. However, a 2- or 3-day reduction in length of stay for these admissions would result in an annual cost saving of £21.6M or £32.4M respectively.ConclusionsPatients with palliative care needs represent a significant proportion of the hospital inpatient population. There is a significant gap between NHS policy regarding palliative and end-of-life care management in acute hospitals in England and current practice.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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“…Evidences from both developed and developing countries show that older people are at much higher risk of multiple co-morbidities (Gijsen et al, 2001;Khanam et al, 2011;Salisbury, Johnson, Purdy, Valderas, & Montgomery, 2011;Salive, 2013;van den Akker, Buntinx, Metsemakers, Roos, & Knottnerus, 1998;Walker, 2007). Multiple morbidities have been proven to be directly associated with adverse health outcomes such as reduced physical functions (Fried, Bandeen-Roche, Kasper, & Guralnik, 1999;Kadam & Croft, 2007), reduced quality of life (Fortin et al, 2004), poor selfrated health (Galenkamp, Braam, Huisman, & Deeg, 2011), and mortality (Hoeymans, Feskens, Kromhout, & van den Bos, 1999).…”

Section: Introductionmentioning

confidence: 99%

Multi-Morbidity, Functional Limitations, and Self-Rated Health Among Older Adults in India

2015

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This article describes the prevalence of multi-morbidity and its association with self-rated and functional health using Longitudinal Aging Study in India (LASI), Pilot survey, 2010 data, on 1,683 older adults aged 45+. The prevalence of multimorbidity is assessed as count of self-reported chronic diseases for an older adult. Limitations in activities of daily living (ADL) are used as a measure of functional health. Zero-inflated Poisson regression is estimated to examine the covariates of multi-morbidity. Moreover, logit models are used to assess the association of multi-morbidity with functional health and self-rated health. Results depict a large prevalence of multi-morbidity, limitations in ADL and poor self-rated health with pronounced state variations. Prevalence of multimorbidity was higher at higher level of education, wealth, and caste. However, educational status of older adults is seen to be negatively associated with prevalence of ADL limitations and poor self-rated health. Household wealth and caste showed no clear association with limitations in ADL and poor self-rated health. Multimorbid older adults were found with substantially high risk of ADL limitations and poor self-rated health.

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Multiple chronic diseases and quality of life: patterns emerging from a large national sample, Australia

Abstract: Multiple chronic diseases were found to have a considerable negative impact on quality of life, not only in terms of how people felt about their lives generally, but also in terms of the extent of their psychological distress.

Cited by 120 publications

References 20 publications

Use of and Satisfaction with Ankle Foot Orthoses

Use of and Satisfaction with Ankle Foot Orthoses

Transitions to palliative care for older people in acute hospitals: a mixed-methods study

Multi-Morbidity, Functional Limitations, and Self-Rated Health Among Older Adults in India

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