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Engaging patients in population-based chronic disease management: A qualitative study of barriers and intervention opportunities.
Fang, Anya; Abdelgadir, Dana; Gopalan, Anjali; Ross, Thekla; Uratsu, Connie S; Sterling, Stacy A; Grant, Richard W; Iturralde, Esti.
Afiliación
  • Fang A; Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612, USA.
  • Abdelgadir D; Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612, USA.
  • Gopalan A; Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612, USA.
  • Ross T; Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612, USA.
  • Uratsu CS; Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612, USA.
  • Sterling SA; Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612, USA.
  • Grant RW; Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612, USA. Electronic address: Richard.W.Grant@kp.org.
  • Iturralde E; Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612, USA.
Patient Educ Couns ; 105(1): 182-189, 2022 01.
Article en En | MEDLINE | ID: mdl-33975772
OBJECTIVE: Cardiovascular disease (CVD) continues to be a leading cause of morbidity in the U.S. Managing CVD risk factors, such as diabetes or hypertension, can be challenging for many individuals. We investigated the barriers experienced by patients who persistently struggled to reach their CVD risk factor control goals. METHODS: This qualitative study examined patient, clinician, and researcher observations of individuals' experiences in a chronic disease management program. All participants (n = 332) were enrolled in a clinical trial testing a skills-based group intervention seeking to improve healthcare engagement. Data were analyzed through a general inductive approach and resulting themes were structured along the Capability-Opportunity-Motivation-Behavior framework. RESULTS: Analyses identified care engagement barriers related to participants' communication skills and activation, care team relationship processes, and emotional factors. Although most participants reported benefitting from skills training, persistent barriers included distrust of their providers, shame about health challenges, and dissatisfaction with care team interactions that were described as impersonal or unresponsive. CONCLUSIONS AND PRACTICE IMPLICATIONS: Efforts to support engagement in CVD risk factor management programs should address whether patients and their care team have the necessary skills, opportunities and confidence to proactively communicate health needs and engage in non-judgmental interactions for goal-setting, rapport-building, and shared decision-making.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades Cardiovasculares / Motivación Tipo de estudio: Clinical_trials / Prognostic_studies / Qualitative_research / Risk_factors_studies Aspecto: Implementation_research / Patient_preference Límite: Humans Idioma: En Revista: Patient Educ Couns Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Irlanda
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades Cardiovasculares / Motivación Tipo de estudio: Clinical_trials / Prognostic_studies / Qualitative_research / Risk_factors_studies Aspecto: Implementation_research / Patient_preference Límite: Humans Idioma: En Revista: Patient Educ Couns Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Irlanda