OBJECTIVES: To identify generalizable ways that comorbidity affects older adults' experiences in a health service program directed toward an index condition and to develop a framework to assist clinicians in approaching comorbidity in the design, delivery, and evaluation of such interventions. DESIGN: A qualitative data content analysis of interview transcripts to identify themes related to comorbidity. SETTING: An outpatient low-vision rehabilitation program for macular disease. PARTICIPANTS: In 2007/08, 98 individuals undergoing low-vision rehabilitation and their companions provided 624 semistructured interviews that elicited perceptions about barriers and facilitators of successful program participation. RESULTS: The interviews revealed five broad themes about comorbidity: (i) "good days, bad days," reflecting participants' fluctuating health status during the program because of concurrent medical problems; (ii) "communication barriers." which were sometimes due to participant impairments and sometimes situational; (iii) "overwhelmed," which encompassed pragmatic and emotional concerns of participants and caregivers; (iv) "delays," which referred to the tendency of comorbidities to delay progress in the program and to confer added inconvenience during lengthy appointments; and (v) value of companion involvement in overcoming some barriers imposed by comorbid conditions. CONCLUSION: This study provides a taxonomy and conceptual framework for understanding consequences of comorbidity in the experience of individuals receiving a health service. If confirmed in individuals receiving interventions for other index diseases, the framework suggests actionable items to improve care and facilitate research involving older adults.
OBJECTIVES: To identify generalizable ways that comorbidity affects older adults' experiences in a health service program directed toward an index condition and to develop a framework to assist clinicians in approaching comorbidity in the design, delivery, and evaluation of such interventions. DESIGN: A qualitative data content analysis of interview transcripts to identify themes related to comorbidity. SETTING: An outpatientlow-vision rehabilitation program for macular disease. PARTICIPANTS: In 2007/08, 98 individuals undergoing low-vision rehabilitation and their companions provided 624 semistructured interviews that elicited perceptions about barriers and facilitators of successful program participation. RESULTS: The interviews revealed five broad themes about comorbidity: (i) "good days, bad days," reflecting participants' fluctuating health status during the program because of concurrent medical problems; (ii) "communication barriers." which were sometimes due to participantimpairments and sometimes situational; (iii) "overwhelmed," which encompassed pragmatic and emotional concerns of participants and caregivers; (iv) "delays," which referred to the tendency of comorbidities to delay progress in the program and to confer added inconvenience during lengthy appointments; and (v) value of companion involvement in overcoming some barriers imposed by comorbid conditions. CONCLUSION: This study provides a taxonomy and conceptual framework for understanding consequences of comorbidity in the experience of individuals receiving a health service. If confirmed in individuals receiving interventions for other index diseases, the framework suggests actionable items to improve care and facilitate research involving older adults.
Authors: Rosemary Yancik; William Ershler; William Satariano; William Hazzard; Harvey J Cohen; Luigi Ferrucci Journal: J Gerontol A Biol Sci Med Sci Date: 2007-03 Impact factor: 6.053
Authors: Martha M Funnell; Tammy L Brown; Belinda P Childs; Linda B Haas; Gwen M Hosey; Brian Jensen; Melinda Maryniuk; Mark Peyrot; John D Piette; Diane Reader; Linda M Siminerio; Katie Weinger; Michael A Weiss Journal: Diabetes Care Date: 2008-01 Impact factor: 19.112
Authors: Christine Vogeli; Alexandra E Shields; Todd A Lee; Teresa B Gibson; William D Marder; Kevin B Weiss; David Blumenthal Journal: J Gen Intern Med Date: 2007-12 Impact factor: 5.128
Authors: Daneng Li; Linda M McCall; Olwen M Hahn; Clifford A Hudis; Harvey J Cohen; Hyman B Muss; Aminah Jatoi; Jacqueline M Lafky; Karla V Ballman; Eric P Winer; Debu Tripathy; Bryan Schneider; William Barry; Maura N Dickler; Arti Hurria Journal: Breast Cancer Res Treat Date: 2018-05-22 Impact factor: 4.872
Authors: C Barrett Bowling; John N Booth; Monika M Safford; Heather E Whitson; Christine S Ritchie; Virginia G Wadley; Mary Cushman; Virginia J Howard; Richard M Allman; Paul Muntner Journal: J Am Geriatr Soc Date: 2013-04-25 Impact factor: 5.562
Authors: Heather E Whitson; Diane Whitaker; Guy Potter; Eleanor McConnell; Fay Tripp; Linda L Sanders; Kelly W Muir; Harvey J Cohen; Scott W Cousins Journal: JAMA Ophthalmol Date: 2013-07 Impact factor: 7.389