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Patient and caregiver contributions to self-care in multiple chronic conditions : A multilevel modelling analysis
Iovino, Paolo Lyons, Karen S. De Maria, Maddalena Vellone, Ercole Ausili, Davide Lee, Christopher S. Riegel, Barbara Matarese, Maria
Iovino, Paolo
Lyons, Karen S.
De Maria, Maddalena
Vellone, Ercole
Ausili, Davide
Lee, Christopher S.
Riegel, Barbara
Matarese, Maria
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.
Keywords
determinants, dyads, multiple chronic conditions, older people, self-care, caregivers
Date
2021
Type
Journal article
Journal
International Journal of Nursing Studies
Book
Volume
116
Issue
Page Range
1-8
Article Number
Article 103574
ACU Department
Faculty of Health Sciences
Mary MacKillop Institute for Health Research
Mary MacKillop Institute for Health Research
Collections
Relation URI
Source URL
Event URL
Open Access Status
License
All rights reserved
File Access
Controlled