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Self-management, preventable conditions and assessment of care among young adults with myelomeningocele

Mahmood, D and Dicianno, B and Bellin, M (2011) Self-management, preventable conditions and assessment of care among young adults with myelomeningocele. Child: Care, Health and Development, 37 (6). 861 - 865. ISSN 0305-1862

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Abstract

Aim In this multicentre cross-sectional study we aimed to identify whether self-management ability and healthcare service delivery factors were related to preventable conditions [urinary tract infections (UTIs), pressure ulcers] and healthcare utilization [emergency room (ER) visits, hospitalizations] specifically in a sample of young adults with myelomeningocele. Background Spina bifida is one of the most common congenital birth defects, affecting over 166000 individuals living in the USA. Participants completed a questionnaire comprised of a self-report measure of healthcare services (Patient Assessment of Chronic Illness Care), recent healthcare utilization and preventable medical conditions. A structured clinical interview [Adolescent Self-Management and Independence Scale 2 (AMIS)] was administered to assess self-management. Multiple linear regression models were run to explore individual and combined effects of the AMIS, Patient Assessment of Chronic Illness Care, condition severity variables (shunted hydrocephalus, lesion level) and demographic factors in explaining variability in ER visits, hospitalizations, UTIs and pressure ulcers. Results Higher number of UTIs were associated with no history of shunting, lower educational levels, higher employment levels and lower AMIS scores (adjusted R =0.774, P=0.002). Higher number of ulcers was associated with higher motor level and higher educational level (adjusted R =0.378, P=0.017). Higher number of hospitalizations was associated with higher number of wounds and lower AMIS scores (adjusted R =0.544, P=0.012). A significant model for ER visits was not identified. Conclusions Initiatives aimed at improving self-management skills or providing support for skin and bladder care may be warranted for those with high levels of motor impairment or lower educational levels. Better detection of wounds may be seen in those with higher employment levels. Spina bifida is a complex condition, but one whose most prevalent concomitant secondary conditions may be preventable through simple measures that improve self-management and through health educational initiatives targeted to specific patient groups. © 2011 Blackwell Publishing Ltd. 2 2 2


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Mahmood, D
Dicianno, Bdicianno@pitt.eduDICIANNO0000-0003-0738-0192
Bellin, M
Centers: Other Centers, Institutes, Offices, or Units > Human Engineering Research Laboratories
Date: 1 November 2011
Date Type: Publication
Journal or Publication Title: Child: Care, Health and Development
Volume: 37
Number: 6
Page Range: 861 - 865
DOI or Unique Handle: 10.1111/j.1365-2214.2011.01299.x
Schools and Programs: School of Health and Rehabilitation Sciences > Rehabilitation Science and Technology
Refereed: Yes
ISSN: 0305-1862
MeSH Headings: Adolescent; Adult; Age Factors; Cross-Sectional Studies; Female; Health Services Needs and Demand; Health Status Indicators; Humans; Linear Models; Male; Meningomyelocele--complications; Meningomyelocele--pathology; Pressure Ulcer--prevention & control; Questionnaires; Self Care--methods; Statistics as Topic; Transition to Adult Care; Urinary Tract Infections--prevention & control; Young Adult
PubMed ID: 22007986
Date Deposited: 10 Oct 2012 21:50
Last Modified: 30 Mar 2021 17:55
URI: http://d-scholarship.pitt.edu/id/eprint/15714

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