Paolo Iovino1, Karen S Lyons2, Maddalena De Maria3, Ercole Vellone4, Davide Ausili5, Christopher S Lee6, Barbara Riegel7, Maria Matarese8. 1. University of Rome "Tor Vergata", Rome, Italy; Australian Catholic University, Melbourne, Australia. Electronic address: paolo.iovino@uniroma2.it. 2. Boston College, MA, United States. Electronic address: karen.lyons@bc.edu. 3. University of Rome "Tor Vergata", Rome, Italy. Electronic address: maddalena.demaria@outlook.it. 4. University of Rome "Tor Vergata", Rome, Italy. Electronic address: ercole.vellone@uniroma2.it. 5. University of Milan-Bicocca, Monza, Italy. Electronic address: davide.ausili@unimib.it. 6. Boston College, MA, United States. Electronic address: leeddo@bc.edu. 7. University of Pennsylvania, Philadelphia, United States. Electronic address: briegel@nursing.upenn.edu. 8. Campus Bio-Medico University of Rome, Rome, Italy. Electronic address: m.matarese@unicampus.it.
Abstract
BACKGROUND: Multiple chronic conditions (MCC) are highly prevalent worldwide, especially among older populations. Patient self-care and care partner (or caregiver) contributions to self-care are recommended to reduce the impact of MCC and improve patients' outcomes. OBJECTIVES: To describe patient self-care and care partner contributions to self-care and to identify determinants of patient self-care and care partner contributions to self-care at the patient and care partner level. DESIGN: Multicentre cross-sectional study. SETTING: Outpatient and community settings in Italy. PARTICIPANTS: A sample of 340 patients with MCC and care partner dyads was recruited between 2017 and 2018. METHODS: We measured patient's self-care and care partner contributions to self-care in dyads using the Self-care of Chronic Illness Inventory and the Caregiver Contribution to Self-care of Chronic Illness Inventory. To control for dyadic interdependence, we performed a multilevel modelling analysis. RESULTS: Patients' and care partners' mean ages were 76.65 (± 7.27) and 54.32 (± 15.25), respectively. Most care partners were female and adult children or grandchildren. The most prevalent chronic conditions in patients were diabetes (74%) and heart failure (34%). Patients and care partners reported higher levels of self-care monitoring than self-care maintenance and management behaviours. Important patient clinical determinants of self-care included cognitive status, number of medications and type of chronic condition. Care partner determinants of self-care contributions included age, gender, education, perceived income, care partner burden, caregiving hours per week and the presence of a secondary care partner. CONCLUSIONS: Our findings support the importance of taking a dyadic approach when focusing on patients with MCC and their care partners. More dyadic longitudinal research is recommended to reveal the modifiable determinants of self-care and the complex relationships between patients and care partners in the context of MCC.
BACKGROUND: Multiple chronic conditions (MCC) are highly prevalent worldwide, especially among older populations. Patient self-care and care partner (or caregiver) contributions to self-care are recommended to reduce the impact of MCC and improve patients' outcomes. OBJECTIVES: To describe patient self-care and care partner contributions to self-care and to identify determinants of patient self-care and care partner contributions to self-care at the patient and care partner level. DESIGN: Multicentre cross-sectional study. SETTING: Outpatient and community settings in Italy. PARTICIPANTS: A sample of 340 patients with MCC and care partner dyads was recruited between 2017 and 2018. METHODS: We measured patient's self-care and care partner contributions to self-care in dyads using the Self-care of Chronic Illness Inventory and the Caregiver Contribution to Self-care of Chronic Illness Inventory. To control for dyadic interdependence, we performed a multilevel modelling analysis. RESULTS: Patients' and care partners' mean ages were 76.65 (± 7.27) and 54.32 (± 15.25), respectively. Most care partners were female and adult children or grandchildren. The most prevalent chronic conditions in patients were diabetes (74%) and heart failure (34%). Patients and care partners reported higher levels of self-care monitoring than self-care maintenance and management behaviours. Important patient clinical determinants of self-care included cognitive status, number of medications and type of chronic condition. Care partner determinants of self-care contributions included age, gender, education, perceived income, care partner burden, caregiving hours per week and the presence of a secondary care partner. CONCLUSIONS: Our findings support the importance of taking a dyadic approach when focusing on patients with MCC and their care partners. More dyadic longitudinal research is recommended to reveal the modifiable determinants of self-care and the complex relationships between patients and care partners in the context of MCC.
Authors: Michael J Goldfarb; Christine Bechtel; Quinn Capers; Ann de Velasco; John A Dodson; Jamie L Jackson; Lisa Kitko; Ileana L Piña; Erin Rayner-Hartley; Nanette K Wenger; Martha Gulati Journal: J Am Heart Assoc Date: 2022-04-21 Impact factor: 6.106
Authors: Ana Maria Miranda Martins Wilson; Glauber Silva Mendes de Almeida; Bruna de Cassia Ferreira Dos Santos; Michele Nakahara-Melo; Ana Paula da Conceição; Diná de Almeida Lopes Monteiro da Cruz Journal: Rev Lat Am Enfermagem Date: 2022