Treatment Burden in Adults Living with Multiple Chronic Conditions Transitioning from a Skilled Nursing Facility to Home
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Case Western Reserve University School of Graduate Studies / OhioLINK
2017
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| Online Access: | http://rave.ohiolink.edu/etdc/view?acc_num=case1491933628119571 |
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ndltd-OhioLink-oai-etd.ohiolink.edu-case14919336281195712021-08-03T07:01:32Z Treatment Burden in Adults Living with Multiple Chronic Conditions Transitioning from a Skilled Nursing Facility to Home Schreiner, Nathanial J. Nursing treatment burden adults with multiple chronic conditions transitions in care skilled nursing facilities Treatment Burden in Adults Living with Multiple Chronic Conditions Transitioning from a Skilled Nursing Facility to HomeAbstractbyNathanial James SchreinerDue the increasing complexity of managing multiple chronic conditions (MCC), the adult population living with MCC is experiencing high levels of treatment burden (TB). The definition of TB is the self-management and coordination of health services patients undertake in order to manage MCC resulting from the prescribed plan of treatment and disease trajectory. TB is associated with poor treatment adherence, which contributes to poor health-related outcomes, higher health care resource usage, and higher associated health care costs. The purpose of study was to describe three constructs of TB: (1) the level of subjective TB experienced by this population, (2) the association between TB and potential antecedent factors, and (3) an exploration of an improvement or decline in TB and its antecedent factors during a 30-day transition period from baseline. This study characterized and correlated antecedent factors of TB at three conceptual levels: intrapersonal, interpersonal, and organizational.Eighty-two adult participants diagnosed with MCC transitioning from SNF to home enrolled in this exploratory, descriptive study. This longitudinally designed study collected data at two time points: baseline prior to SNF discharge and 30 days post-discharge.The level of TB at baseline (M=39.06; SD=25.97) and 30-day post-discharge home (M=37.01; SD=24.45) did not significantly change. The antecedent factors of anxiety, depression, fatigue, pain interference, pain intensity, physical function, the number of MCC, the severity of MCC, and self-rated health, as well as the presence of a caregiver, the Provider Prescribed Treatment Index (an objective measure of potential burdensome tasks) and emergency department visits were significantly correlated with TB (p< .05). In a multivariate model, antecedent factors of TB had the following effects on TB: fatigue (Standardized Beta = .44; p< .01), number of MCC (Standardized Beta = .28, p< .05), pain interference (Standardized Beta = .33, p< .05) and presence of a caregiver (Standardized Beta= -.35, p< .05), explaining 51% of the variance. The following antecedent factors of TB statistically improved over 30 days: anxiety, depression (p = .01); fatigue, pain interference, pain intensity, and physical function (p< .001). Study results filled gaps in current TB literature and provided important direction for future studies. 2017-06-05 English text Case Western Reserve University School of Graduate Studies / OhioLINK http://rave.ohiolink.edu/etdc/view?acc_num=case1491933628119571 http://rave.ohiolink.edu/etdc/view?acc_num=case1491933628119571 unrestricted This thesis or dissertation is protected by copyright: all rights reserved. It may not be copied or redistributed beyond the terms of applicable copyright laws. |
| collection |
NDLTD |
| language |
English |
| sources |
NDLTD |
| topic |
Nursing treatment burden adults with multiple chronic conditions transitions in care skilled nursing facilities |
| spellingShingle |
Nursing treatment burden adults with multiple chronic conditions transitions in care skilled nursing facilities Schreiner, Nathanial J. Treatment Burden in Adults Living with Multiple Chronic Conditions Transitioning from a Skilled Nursing Facility to Home |
| author |
Schreiner, Nathanial J. |
| author_facet |
Schreiner, Nathanial J. |
| author_sort |
Schreiner, Nathanial J. |
| title |
Treatment Burden in Adults Living with Multiple Chronic Conditions Transitioning from a Skilled Nursing Facility to Home |
| title_short |
Treatment Burden in Adults Living with Multiple Chronic Conditions Transitioning from a Skilled Nursing Facility to Home |
| title_full |
Treatment Burden in Adults Living with Multiple Chronic Conditions Transitioning from a Skilled Nursing Facility to Home |
| title_fullStr |
Treatment Burden in Adults Living with Multiple Chronic Conditions Transitioning from a Skilled Nursing Facility to Home |
| title_full_unstemmed |
Treatment Burden in Adults Living with Multiple Chronic Conditions Transitioning from a Skilled Nursing Facility to Home |
| title_sort |
treatment burden in adults living with multiple chronic conditions transitioning from a skilled nursing facility to home |
| publisher |
Case Western Reserve University School of Graduate Studies / OhioLINK |
| publishDate |
2017 |
| url |
http://rave.ohiolink.edu/etdc/view?acc_num=case1491933628119571 |
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AT schreinernathanialj treatmentburdeninadultslivingwithmultiplechronicconditionstransitioningfromaskillednursingfacilitytohome |
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