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8 results

  • 12 - Evidence-based care of children with complex medical needs

  • from Part C - Nursing children and young people
  • Edited by Jennifer Fraser, University of Sydney, Donna Waters, University of Sydney, Elizabeth Forster, Griffith University, Queensland, Nicola Brown
  • Book:
    Paediatric Nursing in Australia and New Zealand
    Published online:
    05 January 2022
    Print publication:
    05 January 2022, pp 326-348

  • Summary

    It can be difficult to determine when a child can be defined as having complex medical needs (Cohen et al., 2011). What one family finds complex, another family may adapt to more easily. One child with a particular condition may have less severity and more function than another child with the same or a similar condition. Furthermore, the discussion around the care of children with complex medical needs has often used different terms for similar things – care that is ‘medically complex’, or children who are ‘technology dependent’ or ‘medically frail’.

    This chapter explores some of the causes of complex medical needs in children and young people, and discusses related nursing care and interventions. The important and central role of parents, caregivers and families in the care of children with complex needs is also considered. The chapter concludes by discussing the challenges facing young people with complex conditions and their families as they transition from paediatric to adult healthcare services.

  • 13 - Managing chronic health conditions

  • from Part II - Skills for practice
  • Edited by Diana Guzys, University of Tasmania, Rhonda Brown, Deakin University, Victoria, Elizabeth Halcomb, University of Wollongong, New South Wales, Dean Whitehead, University of Tasmania
  • Book:
    An Introduction to Community and Primary Health Care
    Published online:
    15 December 2020
    Print publication:
    30 November 2020, pp 222-239

  • Summary

    This chapter discusses the impact of chronic conditions on idividuals, their families and the broader community. The World Health Organization (WHO, 2018) has reported that chronic conditions, or non-communicable diseases, are the leading cause of deaths worldwide. In 2016, chronic conditions were responsible for 41 million of the 57 million deaths occurring globally (WHO, 2018). The majority of these deaths are due to four major chronic diseases: cardiovascular disease (CVD), chronic respiratory disease, diabetes and cancer (WHO, 2018). However, other chronic conditions, including injuries that result in persistent disability and mental health disorders, also contribute to increased morbidity and mortality. The significant increase in preventable chronic conditions and the management of these are major health care concerns of the industrialised world.

  • 13 - Managing chronic health conditions

  • from Part 2 - Skills for practice
  • Edited by Diana Guzys, University of Tasmania, Rhonda Brown, Deakin University, Victoria, Elizabeth Halcomb, University of Wollongong, New South Wales, Dean Whitehead, University of Tasmania
  • Book:
    An Introduction to Community and Primary Health Care
    Published online:
    15 December 2020
    Print publication:
    30 November 2020, pp 222-239

  • Summary

    This chapter discusses the impact of chronic conditions on idividuals, their families and the broader community. The World Health Organization (WHO, 2018) has reported that chronic conditions, or non-communicable diseases, are the leading cause of deaths worldwide. In 2016, chronic conditions were responsible for 41 million of the 57 million deaths occurring globally (WHO, 2018). The majority of these deaths are due to four major chronic diseases: cardiovascular disease (CVD), chronic respiratory disease, diabetes and cancer (WHO, 2018). However, other chronic conditions, including injuries that result in persistent disability and mental health disorders, also contribute to increased morbidity and mortality. The significant increase in preventable chronic conditions and the management of these are major health care concerns of the industrialised world.

  • Online psychological interventions to reduce symptoms of depression, anxiety, and general distress in those with chronic health conditions: a systematic review and meta-analysis of randomized controlled trials

  • V. White, J. Linardon, J. E. Stone, E. Holmes-Truscott, L. Olive, A. Mikocka-Walus, C. Hendrieckx, S. Evans, J. Speight
  • Journal:
    Psychological Medicine / Volume 52 / Issue 3 / February 2022
    Published online by Cambridge University Press:
    17 July 2020, pp. 548-573
  • Background

    Over the past 15 years, there has been substantial growth in web-based psychological interventions. We summarize evidence regarding the efficacy of web-based self-directed psychological interventions on depressive, anxiety and distress symptoms in people living with a chronic health condition.

    Method

    We searched Medline, PsycINFO, CINAHL, EMBASE databases and Cochrane Database from 1990 to 1 May 2019. English language papers of randomized controlled trials (usual care or waitlist control) of web-based psychological interventions with a primary or secondary aim to reduce anxiety, depression or distress in adults with a chronic health condition were eligible. Results were assessed using narrative synthases and random-effects meta-analyses.

    Results

    In total 70 eligible studies across 17 health conditions [most commonly: cancer (k = 20), chronic pain (k = 9), arthritis (k = 6) and multiple sclerosis (k = 5), diabetes (k = 4), fibromyalgia (k = 4)] were identified. Interventions were based on CBT principles in 46 (66%) studies and 42 (60%) included a facilitator. When combining all chronic health conditions, web-based interventions were more efficacious than control conditions in reducing symptoms of depression g = 0.30 (95% CI 0.22–0.39), anxiety g = 0.19 (95% CI 0.12–0.27), and distress g = 0.36 (95% CI 0.23–0.49).

    Conclusion

    Evidence regarding effectiveness for specific chronic health conditions was inconsistent. While self-guided online psychological interventions may help to reduce symptoms of anxiety, depression and distress in people with chronic health conditions in general, it is unclear if these interventions are effective for specific health conditions. More high-quality evidence is needed before definite conclusions can be made.

  • Determinants of Overnight Stay in Health Centres and Length of Admission: A Study of Canadian Seniors

  • Prince M. Amegbor, Kyle B. Plumb, Mark W. Rosenberg
  • Journal:
    Canadian Journal on Aging / La Revue canadienne du vieillissement / Volume 39 / Issue 4 / December 2020
    Published online by Cambridge University Press:
    24 February 2020, pp. 533-544
    • Article
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  • This study examines the influence of chronic health conditions and socio-economic status on overnight admission and length of stay among Canadian seniors. Incremental multivariate logistic and zero-inflated negative binomial regression models assessed the relationship between selected predictors, overnight admission, and duration of stay. The findings show that all chronic health conditions and socio-economic factors examined were significantly associated with overnight hospital admission. However, seniors with cardiovascular health conditions, the very old, and seniors living in lower-income households had a greater risk of longer stays. Canadian seniors diagnosed with hypertension, cancer, diabetes, and stroke had greater risk of longer overnight hospital stays. Seniors aged 75 to 79 years, 80 years or older, and those living in lower-income households (≤ $39,999) were more likely to have a longer overnight hospital stay. Findings suggest that improving seniors’ health and socio-economic status may reduce the risk of overnight admission and longer stays of hospitalisation.

  • Modelling the Age Dynamics of Chronic Health Conditions: Life-Table-Consistent Transition Probabilities and their Application*

  • Frank T. Denton, Byron G. Spencer
  • Journal:
    Canadian Journal on Aging / La Revue canadienne du vieillissement / Volume 34 / Issue 2 / June 2015
    Published online by Cambridge University Press:
    28 April 2015, pp. 176-193

  • Surveys of chronic health conditions provide information about prevalence but not incidence and the process of change within the population. Our study shows how “age dynamics” of chronic conditions – the probabilities of contracting conditions at different ages, of moving from one chronic condition state to another, and of dying – can be inferred from prevalence data for those conditions that can be viewed as irreversible. Transition probability matrices are constructed for successive age groups, with the sequence representing the age dynamics of the health conditions for a stationary population. We simulate the life path of a cohort under the initial probabilities, and again under altered probabilities, to explore the effects of reducing the incidence or mortality rate associated with a particular condition. We show that such surveys of chronic conditions can be made even more valuable by allowing the calculation of the transition probabilities that define the chronic conditions aging process

  • 1 - Introduction

  • Edited by Jo Ann Rosenfeld, The Johns Hopkins University
  • Book:
    Women's Health in Mid-Life
    Published online:
    21 August 2009
    Print publication:
    25 March 2004, pp 1-4

  • Summary

    The middle ages of women are an often forgotten time and the women are often overlooked in healthcare. Regularly, healthcare providers address only the women's hormonal needs and minimize discussion of their health and wellbeing. The opportunities for improvement for future health are immense. Women can make lifestyle changes that will profoundly affect their future health, comfort, and length of life. Treatment of hypertension and diabetes is believed to improve mortality and morbidity. Health promotion and disease prevention are possible if each woman is considered an individual and her health needs addressed personally. The medical variation in women this age is tremendous. Most women enter this age group in good health, but chronic health conditions often intrude. Changes or modifications to their healthcare, changes that are possible working collaboratively between woman and physician, will have profound effects on the way they meet their later years.