Elizabeth A DiNapoli1,2, Christopher Cinna3,4, Karen L Whiteman5,6,7, Lauren Fox3, Cathleen J Appelt3,4,8, John Kasckow9,10,11. 1. VISN 4 Mental Illness Research, Education and Clinical Center (MIRECC), VA Pittsburgh Healthcare System, Pittsburgh, PA, USA. Elizabeth.Dinapoli2@va.gov. 2. Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. Elizabeth.Dinapoli2@va.gov. 3. VISN 4 Mental Illness Research, Education and Clinical Center (MIRECC), VA Pittsburgh Healthcare System, Pittsburgh, PA, USA. 4. Graduate Center for Social and Public Policy, Duquesne University, Pittsburgh, PA, USA. 5. Dartmouth Centers for Health and Aging, Lebanon, NH, USA. 6. CDC Health Promotion Research Center at Dartmouth, Lebanon, NH, USA. 7. Department of Psychiatry, Geisel School of Medicine at Dartmouth, Pittsburgh, PA, USA. 8. Department of Sociology, Duquesne University, Pittsburgh, PA, USA. 9. Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. 10. MIRECC and Behavioral Health, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA. 11. VA Pittsburgh Center for Health and Equity Promotion, Pittsburgh, PA, USA.
Abstract
OBJECTIVE: To explore middle-aged and older veterans' current disease-management practices, mental health treatment preferences, and challenges of living with multiple chronic health conditions (i.e., multimorbidity). METHODS: Semi-structured qualitative interviews and self-report measures were collected from 28 middle-aged and older (50 years of age or older) veterans with multimorbidity. RESULTS: Our sample of veterans with multimorbidity was, on average, mildly depressed and anxious with elevated stress and disability. Veterans acknowledged the interaction of physical and emotional symptoms, which caused greater difficulty with health care management and daily functioning. Veterans had many concerns regarding their physical and emotional health conditions, such as continued disease progression and the addition of other emotional and physical health complications. Veterans also identified specific self-care approaches for disease management (e.g., medication, healthy lifestyle practices, and psychological stress management techniques), as well as barriers to engaging in care (e.g., money, transportation, and stigma). Participants preferred a combination of medication, psychotherapy, and healthy lifestyle practices for mental health treatment. The majority of participants (88.5%) agreed that these mental health treatments would be beneficial to integrate into disease management for older veterans with multimorbidity. Lastly, veterans provided an array of recommendations for improving Veteran's Administration services and reducing mental health stigma. CONCLUSIONS: These findings provide support for patient-centered approaches and integrated mental and physical health self-management in the Veteran's Administration for middle-aged and older veterans with multiple chronic conditions.
OBJECTIVE: To explore middle-aged and older veterans' current disease-management practices, mental health treatment preferences, and challenges of living with multiple chronic health conditions (i.e., multimorbidity). METHODS: Semi-structured qualitative interviews and self-report measures were collected from 28 middle-aged and older (50 years of age or older) veterans with multimorbidity. RESULTS: Our sample of veterans with multimorbidity was, on average, mildly depressed and anxious with elevated stress and disability. Veterans acknowledged the interaction of physical and emotional symptoms, which caused greater difficulty with health care management and daily functioning. Veterans had many concerns regarding their physical and emotional health conditions, such as continued disease progression and the addition of other emotional and physical health complications. Veterans also identified specific self-care approaches for disease management (e.g., medication, healthy lifestyle practices, and psychological stress management techniques), as well as barriers to engaging in care (e.g., money, transportation, and stigma). Participants preferred a combination of medication, psychotherapy, and healthy lifestyle practices for mental health treatment. The majority of participants (88.5%) agreed that these mental health treatments would be beneficial to integrate into disease management for older veterans with multimorbidity. Lastly, veterans provided an array of recommendations for improving Veteran's Administration services and reducing mental health stigma. CONCLUSIONS: These findings provide support for patient-centered approaches and integrated mental and physical health self-management in the Veteran's Administration for middle-aged and older veterans with multiple chronic conditions.
Authors: Karen L Whiteman; John A Naslund; Elizabeth A DiNapoli; Martha L Bruce; Stephen J Bartels Journal: Psychiatr Serv Date: 2016-06-15 Impact factor: 3.084
Authors: Daniel J Smith; Helen Court; Gary McLean; Daniel Martin; Julie Langan Martin; Bruce Guthrie; Jane Gunn; Stewart W Mercer Journal: J Clin Psychiatry Date: 2014-11 Impact factor: 4.384
Authors: Amy M Kilbourne; Margretta Bramlet; Michelle M Barbaresso; Kristina M Nord; David E Goodrich; Zongshan Lai; Edward P Post; Daniel Almirall; Lilia Verchinina; Sonia A Duffy; Mark S Bauer Journal: Contemp Clin Trials Date: 2014-07-30 Impact factor: 2.226
Authors: Wei Yu; Arliene Ravelo; Todd H Wagner; Ciaran S Phibbs; Aman Bhandari; Shuo Chen; Paul G Barnett Journal: Med Care Res Rev Date: 2003-09 Impact factor: 3.929
Authors: Amy M Kilbourne; David E Goodrich; Zongshan Lai; Edward P Post; Karen Schumacher; Kristina M Nord; Margretta Bramlet; Stephen Chermack; David Bialy; Mark S Bauer Journal: J Clin Psychiatry Date: 2013-07 Impact factor: 4.384
Authors: Ana Isabel Gonzalez; Christine Schmucker; Joerg J Meerpohl; Christiane Muth; Julia Nothacker; Edith Motschall; Truc Sophia Nguyen; Maria-Sophie Brueckle; Jeanet Blom; Marjan van den Akker; Kristian Röttger; Odette Wegwarth; Tammy Hoffmann; Sharon E Straus; Ferdinand M Gerlach Journal: BMJ Open Date: 2019-12-15 Impact factor: 2.692
Authors: Amika Shah; Neesha Hussain-Shamsy; Gillian Strudwick; Sanjeev Sockalingam; Robert P Nolan; Emily Seto Journal: J Med Internet Res Date: 2022-09-26 Impact factor: 7.076