Chronic Illness Resources Research Articles

Factors Influencing Self-Management in Chinese Adults with Type 2 Diabetes: A Systematic Review and Meta-Analysis.

Diabetes is a major public health problem in China. Diabetes self-management is critical for patients to achieved better health outcomes, however, previous studies have shown suboptimal diabetes self-management performance. We conducted a systematic review and meta-analysis to identify factors associated with diabetes self-management in Chinese adults. The results showed that confrontation, resignation, overall health beliefs, perceived susceptibility, perceived barriers, and self-efficacy were factors associated with overall diabetes self-management performance and six aspects of diabetes self-management behaviors. There is some limited evidence to suggest that provider-patient communication, married individuals, higher educational level, and higher household income level may also be linked to better diabetes self-management practice. Having healthcare insurance and utilizing chronic illness resources generally appeared to have a favorable effect on diabetes self-management performance. In addition, there were a number of factors for which the evidence is too limited to be able to ascertain its strength of association with diabetes self-management practice. The findings of this review suggest that diabetes self-management behaviors are affected by a wide range of personal and environmental factors, which allow health care providers to develop theory-based strategies to improve diabetes-self-management behaviors in this population.

Do Personal Resources Influence Health-Related Quality of Life for People Receiving Hemodialysis Treatment in Latin America?

We used the Kidney Disease Quality of Life Survey and Chronic Illness Resources Survey to determine the personal resources that influence health-related quality of life (HRQOL) of 128 individuals receiving treatment for end-stage renal disease in Antofagasta, Chile. The results showed that personal and community resources protect against disability and physical deterioration among individuals receiving hemodialysis. Further, these resources had a direct influence on HRQOL, especially in relation to the burden of the disease and for those who are not in paid employment. Our findings show the importance of the availability and use of measures required for the community to improve HRQOL, and to protect the physical health of people undergoing hemodialysis.

Beverage consumption, and its associations with BMI and lifestyle factors in rural community participants

Beverages with little nutritional value, such as carbonated beverages, may negatively impact nutrition and have long-term health implications, including but not limited to obesity. This study examined the risks for beverage consumption choices and intake of participants living in a rural community. Multiple questionnaires adapted from the Chronic Illness Resources Survey, the Harvard Food Frequency Questionnaire, Michigan Alcohol Screening Test (MAST), the Alcohol Use Disorders Identification Test Questionnaire and 24 Hour Food Recall were administered to a cross sectional sample (n=706) using trained interviewers. The mean age of participants was 23.67 years of age (SD +/- 7.32) with 49.7% females and 50.1% males. Results indicated that carbonated beverages and alcohol consumption were related to increased caloric intake and Body Mass Index (BMI) in the sample (p< 0.05). Calories derived from carbonated beverages and alcohol consumption in younger persons (below age 35) exceeded (p < 0.5) weight and age recommendations for intake as determined by the National Research Council. Older persons (34-53 and > 53 years old), both male and female, drank fewer carbonated beverages and consumed significantly (p < .05) more caffeinated beverages such as coffee, tea and hot chocolate. The study results suggest an increased need for research into beverage consumption and its relationship to BMI.

The pathway to dementia diagnosis

To describe the steps taken by health professionals to diagnose dementia and the timeframes for these steps, as reported by carers. A cross-sectional, anonymous survey was mailed or distributed by Alzheimer's Australia New South Wales, six Sydney residential aged care facilities and 13 Sydney general practitioners to 415 carers or family members of patients with dementia between May and August 2007. First symptoms noticed and actions taken; time to first health professional consultation and diagnosis; reported actions of first health professional; satisfaction with first consultation; and use of dementia and chronic illness resources. 209 surveys were returned. Family members noticed the first symptoms of dementia at a mean of 1.9 years before the first health professional consultation about dementia, and 3.1 years before a firm diagnosis. Resource use first occurred 2.8 years after the first symptoms. Most carers (72%) were satisfied with the first consultation, which was usually with a GP (84%). Two-thirds of carers (64%) reported that the first health professional had performed a memory test. Delays in presentation, diagnosis and resource use may have clinical and social implications for people with dementia and their families, in addition to the challenges of the process of obtaining a firm diagnosis.

Validation of the spanish-language version of the chronic Illness resources survey

This article describes the reliability and validity of the Spanish-language version of the Chronic Illness Resources Survey (CIRS-Spanish), an instrument used to tailor and evaluate behaviorally focused chronic disease self-management interventions. Forty Spanish-speaking adults with 1 or more chronic conditions completed the CIRSSpanish on 2 occasions, separated by 2 weeks. They also completed a series of 5 other measures to evaluate criterion, convergent validity, and divergent validity. The 22-item CIRS-Spanish demonstrated reasonable levels of reliability and validity similar to the previously validated English-language version and was easily understood by patients. The CIRS-Spanish is a reliable and valid instrument for measurement of multilevel support for chronic illness management in low-income, Spanish-speaking patients with a variety of chronic conditions.

The Chronic Illness Resources Survey: cross-validation and sensitivity to intervention

There is great interest in, but few instruments to assess, multiple levels of support and community resources from a social-ecological perspective. This study evaluated the psychometric characteristics of the Chronic Illness Resources Survey (CIRS) and its sensitivity to a multifaceted social-ecological intervention to enhance personally relevant community resources supportive of healthful lifestyles. Participants were 293 post-menopausal women having type 2 diabetes who were part of a multiple-behavior lifestyle change program. Key measures included the CIRS, a validated Food Frequency Questionnaire, the Kristal Fat and Fiber Behavior Questionnaire, the CHAMPS Activities Questionnaire for Older Adults, and other measures of social support. Results revealed that the CIRS displayed good psychometric characteristics in this new sample, was significantly correlated as predicted with established measures of social support, was sensitive to intervention, and partially mediated the effects of intervention on both dietary and physical activity outcomes. The 22-item CIRS scale appears useful for assessing multilevel support resources, predicting successful behavior change and detecting social-ecological intervention effects.

A social-ecologic approach to assessing support for disease self-management: the Chronic Illness Resources Survey.

We report on the development and validation of an instrument to assess support and resources for chronic illness management (the Chronic Illness Resources Survey; CIRS). The 64-item full instrument and the 29-item Brief CIRS are based on a social-ecologic model, designed to apply across chronic diseases, and assess support and resources at each of seven levels (e.g., family and friends, physician and health care team, neighborhood/community). A prospective evaluation with 123 patients having heart disease, arthritis, diabetes, and/or COPD revealed that the overall instrument, as well as subscales and the brief instrument, had acceptable internal consistency, moderate to high test-retest reliability, good construct validity, and moderate concurrent and prospective criterion validity. We discuss potential uses of the CIRS for assessment, feedback, tailoring intervention, and evaluation and make recommendations for future research.