Diabetes and Chronic Illness Experiences

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Living with diabetes mellitus as a chronic illness: A review of literature

Living with diabetes mellitus as a chronic illness: A review of literature

dysfunction among people living with the illness. Both type 1 and type 2 diabetes mellitus have been recognised as major risk factors for impaired sexual function, primarily erectile dysfunction in men (Bhasin, Enzlin, Coviello and Basson, 2007). Burke, Jacobson, McGree, Nehra, Roberts, Girman, et al, (2007), revealed that individuals especially men, living with diabetes mellitus had significantly greater dysfunction in sexual domains including sexual drive, ejaculatory function, erectile dysfunction, and sexual satisfaction. They found that erectile dysfunction was the most common dysfunction amongst the sexual domains. Consistent with research Burke et al, (2007); Rosen, Wing, Schneider, Wadden, Foster and West, et al. (2009) reported that erectile dysfunction was more common among men living with diabetes mellitus. The researchers revealed that with the presence of more than one disease and diabetes mellitus-related complications among men living with diabetes mellitus, sexual dysfunction was aggravated. Women living with diabetes mellitus are also not spared from these experiences of decreased sexual function. Diabetes mellitus could affect women’s sexual function through vascular changes in the urogenital tissues impacting negatively on genital lubrication and neuropathy-mediated alterations in genital arousal response (Copeland, Brown, Creasman, Van Den Eeden, Subak, Thom, Ferrara and Huang, 2012). According to a study by Ali, Al-Hajem, Khader, Shegem, and Ajlouni, (2008) the prevalence of sexual dysfunction among women living with diabetes mellitus aged 50 years or older was found to be 59.6% compared to 45.6% among non-diabetic women.
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Non-acute Care Clinical for BSN Students Chronic Illness Care and Diabetes Self-management Support

Non-acute Care Clinical for BSN Students Chronic Illness Care and Diabetes Self-management Support

baccalaureate nursing curricula to integrate managed care concepts such as case management and care coordination into learning experiences (Jackson, 2006). In a qualitative exploratory study Kenyon and Peckover (2008) investigated the issues related to clinical placements in community settings. Data was collected through semi-structured audio-recorded interviews with a sample of 28 nurses that precept students in community based non-acute care clinical experience in the Primary Care Trust (PCT) in the United Kingdom. Analysis of indexed transcripts revealed these primary themes: 1) working with the students takes time; 2) it is necessary to balance the needs of the clients and the students; 3) unplanned interruptions in learning required student flexibility; and 4) there were limited resources such as work space for students. Although no mention of data saturation or triangulation is noted, researchers looked for alternative explanations to assure rigor for the themes that emerged (Kenyon & Peckover, 2008).
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An Examination of How Dominant Notions of Normalcy Inform the Experiences of Non-
White Subjects Living with Chronic Illness

An Examination of How Dominant Notions of Normalcy Inform the Experiences of Non- White Subjects Living with Chronic Illness

J.E., a person living with diabetes, discussed his experiences trying to fit in while being someone who immigrated to Canada from Jamaica in his youth. Fitting in within his context involved a conceptualization of what it means to be Canadian. Although he spent much of his youth attempting to fit in, J.E. realized that he was expected to perform in ways that were similar to his peers, thus replicating normalcy within his context. His experience reflects how people living with disability are expected to adjust to the pace of the dominant population, while also not receiving an opportunity that is equitable. These kinds of realities were exhibited in the article written by Dyson et al. (2007), where the experiences of students living with sickle cell disorder were discussed in relation to how well they thrived within the education system. Within this discussion, participants were expected to attend school, engage in various school related activities while also managing the realities of living with sickle cell disorder. However, for many of these students, their illness led to fatigue, absenteeism (due to treatment and hospital appointments), and needing more rest as a result of other symptoms associated with living with sickle cell disorder (p. 589). This study by Dyson et al. (2007) demonstrate how the education system enforces a capitalist structure onto students, leaving little room to care for oneself, an important aspect of living with chronic illness.
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Self-management interventions for chronic illness

Self-management interventions for chronic illness

Many (14 [78%]) asthma interventions targeted some aspect of behaviour, usually adherence to preventive medications, recognition and appropriate use of rescue medications as well as inhaler technique, self-monitoring, and avoidance of asthma triggers. Significant changes in behaviour were reported in eight (57%) of these studies, six of which used an education and action-plan approach. Behaviour change, the focus of SMIs, is the most successful outcome assessed in these studies. Importantly, the behaviours examined are very different in the three illnesses. Some, as in asthma, are specifically related to the illness, whereas others such as diet and exercise are more integrated with lifestyle and potentially more difficult to change. The fact that other variables did not change as a result of behaviour change in some studies makes it important to consider the relation between behaviour and more clinical outcomes, and raises the important question of whether changes in behaviour should be the key outcome for SMIs.
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The care of chronic illness in general practice

The care of chronic illness in general practice

Appendix 2.5 Your views on chronic disease and illness Experience of chronic disease, chronic disease patients The role of the GP and general practice /Issues/Problems in Chronic Disease[r]

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Patient perspectives on health in chronic illness

Patient perspectives on health in chronic illness

Three patients (10.3%) specifically mentioned a poor relationship with family. All of these patients had concerns about being a financial as well as a social burden, with family members having to stop work to care for them. One family had to sell land to pay for the patient’s care. Another relative whose mother had Chronic Obstructive Pulmonary Disease (COPD) yet continued smoking, said, “I earn money with lots of hard work and when my mother burns them with smoke my heart burns too”. Some students noted that even when the patient didn’t directly complain about the family, “her body languages speak that they are caring her as their responsibility rather than by their own interest.”
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Living with chronic illness : experiences of diagnosis and treatment

Living with chronic illness : experiences of diagnosis and treatment

partner’s PCA, emotions such as being scared, concerned, worried, nervous and angry as well as feelings of emotional turmoil and devastation (Butler et al., 2000) or insecurity (O’Shaughnessy et al., 2016) were highlighted by partners. Shock was acknowledged in a number of the studies (Gray et al., 1999; Gray et al., 2000; Harden et al., 2002; Maliski et al., 2002), as was fear or anxiety (Ervik et al., 2012; Gray et al., 1999; Gray et al., 2000; Lavery & Clarke, 1999; Maliski et al., 2002; Street et al., 2009; Tanner et al., 2011; Wootten et al., 2014). A number of sources of anxiety were highlighted. These included the illness itself (Ervik et al., 2012), how the partner would deal with it (Ervik et al., 2012; Maliski et al. 2002; Wootten et al., 2014), disease progression (Rossen et al., 2016) and the potential future loss of their partner (Ervik et al., 2012; Harden et al., 2002; Street et al., 2009). Fears revolved around death, pain and the unknown of what would happen next (Tanner et al., 2011) and for some partners these anxieties diminished over time (Ervik et al., 2012). However, in contrast to this, a couple of lower quality studies reported that partners expressed acceptance of the diagnosis quite early on (Butler et al., 2000; Lavery & Clarke, 1999), whilst others were grateful that their husband could receive medical treatment (Tanner et al., 2011), showing variance in the emotions experienced. One good quality study highlighted how some partners directed anger at themselves for not knowing that screening could be performed (Harden et al., 2002). In addition, feelings of isolation (Street et al., 2009) or loneliness were experienced by partners in a range of areas related to living with a man’s PCA diagnosis (Bruun et al., 2011).
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The Care of Patients with Severe Chronic Illness:

The Care of Patients with Severe Chronic Illness:

The use of best-practice benchmarks in evaluating the relative efficiency of regions or hospitals in their management of chronic illnesses was described in a recent study of California hospitals pub- lished in Health Affairs.* Briefly, the process identifies providers that have achieved reasonably high quality (according to reputation and to available objective measures) and lower Medicare spending and resource inputs. The Medicare spending and/or resource input levels of these pro- viders are used as benchmarks for quantifying overuse in less efficient regions and/or hospitals. Overuse is quantified as the difference in the level of spending or resource inputs per person at the less efficient hospital compared to the benchmark, multiplied by the number of patients who received care at the less efficient hospital. While it would be preferable if the evaluation of efficien- cy could be based on detailed information on cost effectiveness, such evidence is not available. Evidence at the population level, however, indicates no marginal gain from greater resource inputs across the range of practice observed among the nation’s academic medical centers or among regions within the United States (Chapter One). Regions and academic medical centers with lower costs and fewer resource inputs, and relatively good quality measures, were more efficient because they achieved the same or better outcomes using fewer resources and less spending. The Health Affairs article measured performance in managing chronic illnesses among academic medical centers belonging to the University of California system. Performance was measured along four dimensions: Medicare spending, resource inputs, utilization, and quality. Although both hospitals were highly acclaimed by U.S. News & World Report’s reputation-based ranking, objec- tive quality measures indicated that the quality of care was as good — and on some measures better — at the UCSF Medical Center. For example, a survey of patients’ ratings of their hospital experiences conducted by the California Healthcare Foundation showed that patients gave higher ratings to UCSF (“above average”) than to UCLA (“average”). Chronically ill Medicare patients who were loyal to the UCLA Medical Center had higher spending levels and their physicians used many more resource inputs on a per-patient basis than did physicians treating patients loyal to the UCSF Medical Center. On the basis of its quality and efficiency, UCSF provides a reasonable benchmark for evaluating resource management at UCLA.
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OUR CHILDREN WITH CHRONIC ILLNESS IN SCHOOL

OUR CHILDREN WITH CHRONIC ILLNESS IN SCHOOL

Teacher knowledge of and confidence in meeting the needs of children with chronic medical conditions: Pediatric psychology's contribution to education. Limited concordance between tea[r]

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Diabetes and mental illness have long

Diabetes and mental illness have long

The results from the placebo group were consistent with other prevalence studies; 11% progressed to dia- betes after 1 year in the study (Figure 3)—ie, when no medication or lifestyle interventions were incorporat- ed. In the metformin group, 7.8% progressed to dia- betes, representing a 31% reduction in those who progressed to diabetes. However, those in the diet and exercise group fared best. Only 5% progressed to dia- betes, representing a 58% reduction in diabetes devel- opment. The study was stopped early because of the significant impact of metformin and lifestyle interven- tions. This study clearly shows the benefits of inter- vention because it is much easier to treat a patient with impaired fasting glucose than one with diabetes. 17
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Patients’ assessment of chronic illness care: a validation study among patients with type 2 diabetes in Finland

Patients’ assessment of chronic illness care: a validation study among patients with type 2 diabetes in Finland

Quality improvement in healthcare services, especially in primary health care – in order to answer the challenge of a rising prevalence of chronic conditions within the population – is a focus for health policy makers in many countries. International quality improvement models and measures ensure possibilities to learn from each other, both concerning strengths and weaknesses of quality improvement efforts. To be able to track changes in standards of care, as well as to assess the effectiveness of interventions, good measures are needed [12]. As concerns patients with chronic conditions, their evalu- ation of care quality and improvements in care quality are important, meaning that measures that assess specif- ically patients’ perceptions are crucial. In this study, we have assessed the validity and reliability of a Finnish translation of the internationally validated PACIC scale, as well as its utility, in the Finnish healthcare system.
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Chronic Illness Benefit application form

Chronic Illness Benefit application form

Contact details Tel: 0860 103 933 • PO Box 652509, Benmore 2010 • www.lahealth.co.za This application form is to apply for the Chronic Illness Benefit The latest version of the application form is available on www.lahealth.co.za. Alternatively members can phone 0860 103 933 and health professionals can phone 0860 44 55 66.

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Methamphetamine: Our Nation’s Chronic Illness

Methamphetamine: Our Nation’s Chronic Illness

possible exemption from these new requirements was established for scheduled listed chemical products that the Attorney General determined could not be used in the illicit manufacture [r]

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Collaborative Chronic Care Networks (C3Ns) to Transform Chronic Illness Care

Collaborative Chronic Care Networks (C3Ns) to Transform Chronic Illness Care

Despite signi fi cant gains by pediatric collaborative improvement net- works, the overall US system of chronic illness care does not work well. A new paradigm is needed: a Collaborative Chronic Care Network (C3N). A C3N is a network-based production system that harnesses the collective intelligence of patients, clinicians, and researchers and distributes the production of knowledge, information, and know-how over large groups of people, dramatically accelerating the discovery process. A C3N is a platform of “ operating systems ” on which inter- connected processes and interventions are designed, tested, and implemented. The social operating system is facilitated by community building, engaging all stakeholders and their expertise, and providing multiple ways to participate. Standard progress measures and a ro- bust information technology infrastructure enable the technical oper- ating system to reduce unwanted variation and adopt advances more rapidly. A structured approach to innovation design provides a scien- ti fi c operating system or “ laboratory ” for what works and how to make it work. Data support testing and research on multiple levels: comparative effectiveness research for populations, evaluating care delivery processes at the care center level, and N-of-1 trials and other methods to select the best treatment of individual patient circum- stances. Methods to reduce transactional costs to participate include a Federated IRB Model in which centers rely on a protocol approved at 1 central institutional review board and a “ commons framework ” for organizational copyright and intellectual property concerns. A fully realized C3N represents a discontinuous leap to a self-developing learning health system capable of producing a qualitatively different approach to improving health. Pediatrics 2013;131:S219 – S223 AUTHORS: Peter A. Margolis, MD, PhD, a Laura E. Peterson,
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Adherence to Treatment among Adolescents with Chronic Illness

Adherence to Treatment among Adolescents with Chronic Illness

Chronic conditions were earlier assumed to be protective against impulsive behaviours by restricting them from getting involved in high risk behaviour. This is refuted by research indicating that ―young people with a chronic condition are not less likely to undertake risk behaviours than their healthy peers‖ (72). These behaviours increase adverse health outcomes. E.g. with smoking habit, in adolescents with asthma, there is risk for increased pulmonary deterioration; those with sickle-cell disease are at increased risk of acute chest syndrome. Use of tobacco accelerates cardiovascular complications, alcohol increases the degree of hepatotoxicity associated with hepatotoxic drugs used in the treatment of many chronic autoimmune conditions. It is therefore essential to prevent adolescent high risk behaviour especially when they have a chronic illness.
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Chronic Illness Benefit application form 2015

Chronic Illness Benefit application form 2015

I consent to LA Health Medical Scheme and Discovery Health (Pty) Ltd disclosing, from time to time, information supplied to LA Health Medical Scheme and Discovery Health (Pty) Ltd (including general or medical information that is relevant to my application) to my healthcare provider, to administer my Chronic Illness Benefit. I agree that LA Health Medical Scheme and Discovery Health (Pty) Ltd may disclose this information at its discretion, but only as long as all the parties involved have agreed to keep the information confidential.

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Chronic Illness Monitoring and Habit Stabilization for Patients

Chronic Illness Monitoring and Habit Stabilization for Patients

ABSTRACT: This project presents habit stabilization platform for communication, processing, presentation, storage, aimed to wireless monitor lifestyle, In general clinical status of patients affected by chronic diseases. Such the process is useful to support in an innovating Chronic Care Model. The platform exploits sensor, Wireless connectivity to the local gateway, and using a Standard format. The process allows the clinicians and practitioner to realize mistakes and Habit, before they become lead to hospitalization. The system also implements data analysis. As well as monitoring the state of health, the proposed chronic illness monitoring can be also used to wearable sensor. Two kinds of monitor kit have been developed. The first is dedicated to patient self-acquisition usually delivered directly to the patient when enrolled the medicine service. The second is design to support medical operator during the planned periodic home visits. Differ to the version of the gateway and usually in the set of sensors included in the kit depending on the target user of the system. The patient-oriented gateway is conceived to maximize the usability and to minimize the impact on the patient. It enables the patient to follow autonomously the personalized treatment plan, defined and updatable by the care team members via the server application, thanks to audio-visual remind messages helpers. The data acquisition, elaboration transmission completely automatic, transparent. Moreover, the gateway is able to collect out-of-plan activities performed on a personal basis.
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Promoting Healthy Work for Employees with Chronic Illness

Promoting Healthy Work for Employees with Chronic Illness

responsibility. The company has a systematical approach at retaining both own employees and persons referred from six surrounding municipalities. These partnerships were formed on a win-win-base. The core in the partnership agreements are a clear and distinct division of tasks between company and municipality and a set of procedures guiding the day-to-day cooperation. On the bases of practical experiences a set of tools and models have been developed. One is a four phase model from referral to integration in the workplace:

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Chronic illness and women: a model of disclosure at work

Chronic illness and women: a model of disclosure at work

undertaken by women with chronic illness, when considering the disclosure of information about their chronic illness in their workplace. A model is presented based on the individual‟s assessment of, the risks of disclosure, risks of non-disclosure and the influence of personal preferences for privacy or openness, which form the basis for decisions regarding disclosure. A number of factors are assessed by women when considering disclosure and these can be broadly grouped into: expected management and peer support, stigma associated with illness, severity or variability of illness, individual labour market power, institutionalised contingent flexibilities, institutionalised non-contingent flexibilities and outside influences such as caring responsibilities. The various aspects of this model and the relationship of each of these factors to the disclosure decision will be assessed on the basis of the preliminary data drawn from a study on the workforce outcomes of women with chronic illness. The use of the model to interpret the qualitative data shows that disclosure decisions are influenced by a broad number of factors. Each of these factors need to be considered during in the process of evaluating the risk of disclosure or non-disclosure of a chronic illness in the work environment.
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Supporting Self-management in Patients with Chronic Illness

Supporting Self-management in Patients with Chronic Illness

Practical applications for Physicians There are many ways that physicians can translate this evidence for self-management support into daily practice. Primarily, this involves a shift of focus away from clin- ical outcomes (e.g., reducing A1C levels) and toward providing help with the day-to- day problems of living with chronic illness (e.g., making healthful food selections in

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