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Koch G, Wakefield BJ, Wakefield D. Assessing Self Care Burden in Patients with Multiple Chronic Conditions. Poster session presented at: Midwest Nursing Research Society Annual Conference; 2013 Mar 8; Chicago, IL.
Background: Estimates indicate that more than 120 million people in the United States have at least one chronic health condition, and 24% of those have three or more conditions. Care for patients with multiple chronic conditions is guided by clinical guidelines that focus on single conditions and may be delivered by multiple providers. While there has been increasing attention to the difficulty of providing of care for these medically complex patients, less attention has been paid to the perspective of the patient with multiple chronic illnesses. The purpose of this study is to assess the self-management clinical care knowledge and skills being required of patients and their informal caregivers. Methods: Phase 1 of this study is a systematic literature review on complex chronic illness. In particular the review is focusing on development of a typology of clinical care knowledge and skills (i.e., symptom identification and assessment, medication management and other treatments, appropriate follow-up with providers) required of this population of patients and their informal caregivers. At the conclusion of the literature review and typology development, an interview guide will be developed and piloted with 30 patients having multiple chronic illnesses. Patient/informal caregiver responses will be compared with the patient self-care expectations (e.g., medications, diet, exercise) documented in their medical records. Patients will be recruited from Primary Care Clinics at the University of Missouri Healthcare System. Results: The literature review is in progress. Patient interviews and record abstracting will be conducted in winter 2012-13. Conclusions: Complex patients with multiple chronic conditions and their informal caregivers require unique self-management support. Barriers exist at the patient, provider, and system level. Identification of facilitators and barriers to effective self management for these medically complex patients is the first step in designing effective nursing interventions to improve patient outcomes.
