Matthew E Dupre1, Alicia Nelson2, Scott M Lynch3, Bradi B Granger4, Hanzhang Xu4, Erik Churchill5, Janese M Willis2, Lesley H Curtis6, Eric D Peterson7. 1. Duke Clinical Research Institute, Duke University, Durham, North Carolina; Department of Population Health Sciences, Duke University, Durham, North Carolina; Department of Sociology, Duke University, Durham, North Carolina. Electronic address: matthew.dupre@duke.edu. 2. Department of Community and Family Medicine, Duke University, Durham, North Carolina. 3. Department of Sociology, Duke University, Durham, North Carolina. 4. Duke School of Nursing, Duke University Medical Center, Durham, North Carolina. 5. Duke Office of Clinical Research, Duke University Medical Center, Durham, North Carolina. 6. Duke Clinical Research Institute, Duke University, Durham, North Carolina; Department of Population Health Sciences, Duke University, Durham, North Carolina. 7. Duke Clinical Research Institute, Duke University, Durham, North Carolina; Department of Medicine, Duke University, Durham, North Carolina.
Abstract
BACKGROUND: Recent studies have drawn attention to nonclinical factors to better understand disparities in the development, treatment and prognosis of patients with cardiovascular disease. However, there has been limited research describing the nonclinical characteristics of patients hospitalized for cardiovascular care. METHODS: Data for this study come from 520 patients admitted to the Duke Heart Center from January 1, 2015 through January 10, 2017. Electronic medical records and a standardized survey administered before discharge were used to ascertain detailed information on patients' demographic (age, sex, race, marital status and living arrangement), socioeconomic (education, employment and health insurance), psychosocial (health literacy, health self-efficacy, social support, stress and depressive symptoms) and behavioral (smoking, drinking and medication adherence) attributes. RESULTS: Study participants were of a median age of 65 years, predominantly male (61.4%), non-Hispanic white (67.1%), hospitalized for 5.11 days and comparable to all patients admitted during this period. Results from the survey showed significant heterogeneity among patients in their demographic, socioeconomic and behavioral characteristics. We also found that the patients' levels of psychosocial risks and resources were significantly associated with many of these nonclinical characteristics. Patients who were older, women, nonwhite and unmarried had generally lower levels of health literacy, self-efficacy and social support, and higher levels of stress and depressive symptoms than their counterparts. CONCLUSIONS: Patients hospitalized with cardiovascular disease have diverse nonclinical profiles that have important implications for targeting interventions. A better understanding of these characteristics will enhance the personalized delivery of care and improve outcomes in vulnerable patient groups.
BACKGROUND: Recent studies have drawn attention to nonclinical factors to better understand disparities in the development, treatment and prognosis of patients with cardiovascular disease. However, there has been limited research describing the nonclinical characteristics of patients hospitalized for cardiovascular care. METHODS: Data for this study come from 520 patients admitted to the Duke Heart Center from January 1, 2015 through January 10, 2017. Electronic medical records and a standardized survey administered before discharge were used to ascertain detailed information on patients' demographic (age, sex, race, marital status and living arrangement), socioeconomic (education, employment and health insurance), psychosocial (health literacy, health self-efficacy, social support, stress and depressive symptoms) and behavioral (smoking, drinking and medication adherence) attributes. RESULTS: Study participants were of a median age of 65 years, predominantly male (61.4%), non-Hispanic white (67.1%), hospitalized for 5.11 days and comparable to all patients admitted during this period. Results from the survey showed significant heterogeneity among patients in their demographic, socioeconomic and behavioral characteristics. We also found that the patients' levels of psychosocial risks and resources were significantly associated with many of these nonclinical characteristics. Patients who were older, women, nonwhite and unmarried had generally lower levels of health literacy, self-efficacy and social support, and higher levels of stress and depressive symptoms than their counterparts. CONCLUSIONS:Patients hospitalized with cardiovascular disease have diverse nonclinical profiles that have important implications for targeting interventions. A better understanding of these characteristics will enhance the personalized delivery of care and improve outcomes in vulnerable patient groups.
Authors: Pamela H Mitchell; Lynda Powell; James Blumenthal; Jennifer Norten; Gail Ironson; Carol Rogers Pitula; Erika Sivarajan Froelicher; Susan Czajkowski; Marston Youngblood; Marc Huber; Lisa F Berkman Journal: J Cardiopulm Rehabil Date: 2003 Nov-Dec Impact factor: 2.081
Authors: David R Thompson; Sek Y Chair; Sally W Chan; Felicity Astin; Patricia M Davidson; Chantal F Ski Journal: J Clin Nurs Date: 2011-05 Impact factor: 3.036
Authors: Lisa D Chew; Joan M Griffin; Melissa R Partin; Siamak Noorbaloochi; Joseph P Grill; Annamay Snyder; Katharine A Bradley; Sean M Nugent; Alisha D Baines; Michelle Vanryn Journal: J Gen Intern Med Date: 2008-03-12 Impact factor: 5.128
Authors: Elizabeth Golembiewski; Katie S Allen; Amber M Blackmon; Rachel J Hinrichs; Joshua R Vest Journal: JMIR Public Health Surveill Date: 2019-10-07
Authors: Luigi Isaia Lecca; Marcello Campagna; Igor Portoghese; Maura Galletta; Nicola Mucci; Michele Meloni; Pierluigi Cocco Journal: Int J Environ Res Public Health Date: 2018-09-07 Impact factor: 3.390