COVID 19 prevention practice of patients with known chronic illness in Ethiopia: A systemic review and meta-analysis.

Introduction: There were different studies done and found a highly variable level of COVID 19 prevention practice; however, there was no summarized evidence on the prevention practice of chronic disease patients in Ethiopia. This systematic review and meta-analysis aims to assess the pooled prevalence of COVID 19 prevention practice and associated factors among chronic disease patients in Ethiopia. Method: Systematic review and meta-analysis were conducted using PRISMA guidelines. Comprehensive literature was searched in international databases. A weighted inverse variance random effect model was used to estimate pooled prevalence. Cochrane Q-test and I2 statistics were computed to assess heterogeneity among studies. Funnel plot and Eggers test were done to assess publication bias. Review manager software was used to identify determinants of COVID 19 prevention practice. Result: Overall, 437 articles were retrieved and finally 8 articles were included in this review. The pooled prevalence of good COVID 19 prevention practices was 44.02% (95%CI (35.98%-52.06%). Being rurally reside (AOR = 2.39, 95% CI (1.30-4.41)), having educational status of cannot read and write (AOR = 2.32, 95% CI (1.22-4.40)), and poor knowledge (AOR = 2.43, 95% CI (1.64-3.60)) positively associated with poor practice. Conclusion: Good COVID 19 prevention practices of chronic disease patients in Ethiopia was low. Rural residence, educational status of cannot read and write and poor knowledge was positively associated with poor practice. Therefore, policymakers and program planners should target those high-risk groups in improving their awareness to enhance their practice specifically focusing on those who are rural reside and with low educational status.

Hospital selection framework for remote MCD patients based on fuzzy q-rung orthopair environment.

This research proposes a novel mobile health-based hospital selection framework for remote patients with multi-chronic diseases based on wearable body medical sensors that use the Internet of Things. The proposed framework uses two powerful multi-criteria decision-making (MCDM) methods, namely fuzzy-weighted zero-inconsistency and fuzzy decision by opinion score method for criteria weighting and hospital ranking. The development of both methods is based on a Q-rung orthopair fuzzy environment to address the uncertainty issues associated with the case study in this research. The other MCDM issues of multiple criteria, various levels of significance and data variation are also addressed. The proposed framework comprises two main phases, namely identification and development. The first phase discusses the telemedicine architecture selected, patient dataset used and decision matrix integrated. The development phase discusses criteria weighting by q-ROFWZIC and hospital ranking by q-ROFDOSM and their sub-associated processes. Weighting results by q-ROFWZIC indicate that the time of arrival criterion is the most significant across all experimental scenarios with (0.1837, 0.183, 0.230, 0.276, 0.335) for (q = 1, 3, 5, 7, 10), respectively. Ranking results indicate that Hospital (H-4) is the best-ranked hospital in all experimental scenarios. Both methods were evaluated based on systematic ranking and sensitivity analysis, thereby confirming the validity of the proposed framework.

Adherence to healthy behavioral practices promotes COVID 19 preventive behavior among chronic disease patients: A cross-sectional study from urban Rajasthan, India.

Background: The coronavirus disease-19 (COVID-19) pandemic has led to unprecedented morbidity and mortality across the world. Chronic disease patients of urban poor neighbourhoods are one of the most vulnerable population subgroups as the number of cases and deaths increase exponentially in India. The study aims to explore the factors associated with desirable health behaviours among chronic disease patients availing care from a primary health facility and examine their association with the COVID-19 preventive behaviour. Material and Methods: A cross-sectional study was conducted among chronic disease patients attending a health centre in an urban area of Jodhpur, Rajasthan. A interviewer administered semi-structured questionnaire was pilot tested and validated prior to initiation of data collection. A total of 520 patients were enrolled for the study. Results: Poor adherence to health behaviour was observed among a majority of the respondents (infrequent physical activity: 72.0%, one or less fruit serving per day: 96.5%, one or less vegetable serving per day: 88.8%). A factor analysis revealed three domains of COVID-19 preventive behaviour: sanitisation, preventive hygiene and social distancing. Multiple regression revealed respondents opting for COVID-19 screening and those with lower salt intake followed the overall and individual COVID-19 preventive behaviour. Conclusion: The health behaviour assessment and inter-personal counselling by the health care providers at the primary health facilities may contribute to the increasing adherence for the COVID-19 preventive behaviour among chronic disease patients.

PPSV-23 recommendation and vaccination coverage in China: a cross-sectional survey among healthcare workers, older adults and chronic disease patients.

BACKGROUND: 23-valent pneumococcal polysaccharide vaccine (PPSV-23) is crucial to protecting high-risk groups. This study aimed to investigate the influencing factors of PPSV-23 recommendation among healthcare workers, and PPSV-23 coverage among Chinese older adults and chronic disease patients. RESEARCH DESIGN AND METHODS: In 2019, a cross-sectional questionnaire survey was conducted in ten provinces in China among older adults aged ≥65 years, chronic disease patients aged 18-64 years, and primary healthcare workers. Multiple logistic regression model was adopted to identify the influencing factors of PPSV-23 recommendation and vaccination uptake. RESULTS: Of the 1138 healthcare workers, 46.75% often recommended PPSV-23 to target groups, and public health workers were more likely to recommend than general practitioners. PPSV-23 vaccination rate was 3.29% among chronic disease patients aged <65 years, 6.69% among older adults without chronic disease(s), and 8.87% among chronic disease patients aged ≥65 years. Multiple logistic regression revealed that only general practitioners' recommendation was associated with increased PPSV-23 coverage (p < 0.05). CONCLUSIONS: The findings highlighted the suboptimal PPSV-23 coverage rate in China and the strong association between healthcare workers' recommendation and residents' vaccination uptake. Targeted and coherent PPSV-23-related training is suggested for general practitioners to encourage effective health promotion in clinical practices.

The Effect of Medical Choice on Health Costs of Middle-Aged and Elderly Patients with Chronic Disease: Based on Principal-Agent Theory.

(1) Background: The discussion on how to reduce the health costs of chronic disease patients has become an important public health issue. Limited research has been conducted on how chronic disease patients' medical choice of public and private medical institutions affect health costs. (2) Methods: This study used the panel data composed of the China Health and Retirement Longitudinal Survey (CHARLS) from 2011 to 2018, adopted the quasi-natural experimental research method, and set up a control group and an experimental group that chose public medical institutions and private medical institutions, to analyze the association between the medical choice and health costs of chronic disease patients. (3) Results: Compared with chronic disease patients who chose private medical institutions, patients who chose public medical institutions increased their total cost by 44.9%, total out-of-pocket cost by 22.9%, and decreased the total out-of-pocket ratio by 0.117%, total drug cost out-of-pocket ratio by 0.075%, and drug cost ratio by 0.102%. (4) Conclusions: According to the triple principal-agent relationships, the resource advantages given by the government to public medical institutions, the salary incentive system of medical institutions, and the information asymmetry advantage held by physicians may be important factors for the increase in health costs for chronic disease patients.

Association between Educational Level and Physical Activity in Chronic Disease Patients of Eastern Slovakia.

AIMS: This study aimed to investigate selected chronic diseases patients with different educational attainment regarding their awareness of and compliance with recommended physical activity. METHOD: This cross-sectional study was conducted from October 2018 to February 2019 in cooperation with chronic diseases clinics in eastern Slovakia. The study involved 893 patients. RESULTS: People with higher education apparently recognise to a greater extent the importance of nutrition, diet, and the role of physical activity in treating their disease. Moreover, they have knowledge of physical exercises appropriate for their disease. Conversely, a noticeably higher number of less educated patients reported receiving general, respectively detailed information about the importance of physical activity in treating their disease. Differences in awareness of appropriate exercises and their implementation were not statistically significant. CONCLUSIONS: The results fail to prove educational attainment being a key determinant of chronic diseases. However, it can be reasonably argued that lower educational attainment may be a reliable risk signal of chronic diseases in later life.

Knowledge, attitude and practice of patients with chronic diseases towards COVID-19 pandemic in Dessie town hospitals, Northeast Ethiopia.

BACKGROUND AND AIMS: Corona virus disease-19 first detected in China, December 2019. The government of Ethiopia takes preventive measures but the number of peoples infected with COVID-19 has been increased. Control of the pandemic requires changing of knowledge, attitude and practice of people. Hence, the objective of this study was to assess chronic disease patients' knowledge, attitude and practice towards COVID-19 pandemic. METHODS: Institution based cross-sectional study was done among 413 chronic disease patients from July 20 to August 5, 2020 in Dessie town hospitals. Multinomial logistic regression analysis was used and significant association declared at p-value of <0.05. RESULTS: From the total participants 34.6%, 81.4% and 40.7% had good knowledge, attitude and practice while 35.1%, 12.1% and 24.7% had moderate knowledge, attitude and practice towards COVID-19 pandemic, respectively. In multinomial logistic regression young age, urban residency, attainment of secondary education and presence of additional co-morbidity were predictors of moderate knowledge whereas urban residency, not attended formal education and presence of additional co-morbidity were predictors of good knowledge about COVID-19. Household family size and presence of additional co-morbidity were factors significantly associated with moderate practice of COVID-19 prevention methods. Furthermore, male sex, household family size, knowledge of COVID-19 and attitude towards COVID-19 were factors significantly associated with good practice of COVID-19 prevention methods. CONCLUSION: Significant number of chronic disease patients had poor knowledge and practice towards COVID-19. Therefore, government, health professionals, Medias, researchers and health institution should do to improve the gaps of chronic diseases patients.

A experiência emocional dos familiares cuidadores perante a alta da pessoa com doença crónica avançada para o domicílio / The emotional experience of family caregivers when faced with the discharge of a person with advanced chronic disease to home

Viver com qualidade é um desafio da sociedade atual. Apesar de vivermos mais anos, o aumento das doenças crónicas progressivas e incapacitantes, verificado nas últimas décadas, acarreta uma série de limitações e consequências na vida das pessoas, famílias e sociedade em geral que, por si só, fundamentam a importância de um cuidador na comunidade. Contudo, cuidar da pessoa com doença crónica avançada no domicílio revela-se uma tarefa árdua pela complexidade que a sua condição impõe nas várias dimensões da pessoa doente e familiar cuidador. Tornar-se cuidador é considerada uma transição que exige a redefinição de papéis e responsabilidades, bem como uma adaptação e o uso de estratégias que permitam uma eficaz gestão emocional perante as vivências e as exigências que o exercício do papel acarreta no dia-a-dia. Assim, tendo em conta estes pressupostos, pareceu-nos ser primordial conhecer a experiência emocional dos familiares cuidadores em unidades de cirurgia, perante a alta da pessoa com doença crónica avançada para o domicílio, de forma a contribuir para que as famílias cuidadoras continuem os seus projetos de vida com qualidade, e para o desenvolvimento de estratégias de intervenção que visem preservar o bem-estar das famílias cuidadoras e da pessoa cuidada. Metodologia: Estudo qualitativo, estudo de caso. Para a recolha de dados foi realizada entrevista semiestruturada a dez familiares cuidadores de pessoas com doença crónica avançada, internadas em unidades de cirurgia de uma Unidade Local de Saúde (ULS) da área metropolitana do Porto, e com alta para o domicílio. Efetuada análise de conteúdo segundo o referencial de Bardin (2011). O estudo respeitou os princípios ético-morais. Resultados: Perante o regresso ao domicílio da pessoa com doença crónica avançada, após um evento que originou a necessidade de internamento hospitalar, o familiar cuidador experiencia uma série de sentimentos e emoções que se estendem desde a incerteza, choro, alegria, alívio, misto de emoções ao dever de cuidar. Mobilizam diversas estratégias na sua autogestão emocional, dando ênfase ao recurso familiar. Têm a perceção que podem cuidar da pessoa com doença crónica no domicílio, enfatizando que para além de ser um dever familiar e demonstração de gratidão, devem satisfazer o desejo do doente. Grande parte dos familiares cuidadores enfatiza que obtiveram uma resposta efetiva dos enfermeiros dos cuidados hospitalares e dos enfermeiros dos Cuidados de Saúde Primários às necessidades presentes. Salientam vários benefícios da permanência da pessoa com doença crónica avançada no domicílio, tais como proporcionar amor, conforto e um processo de fim de vida acompanhado. Contudo, mencionam várias consequências para si, nomeadamente a perda do papel social, perda de emprego, perda de liberdade, sobrecarga de tarefas, sobrecarga financeira, perda do espaço familiar, alterações de rotinas quotidianas, cansaço físico e conflitos familiares. Recorrem a diversos apoios para poderem cuidar e expressam vários desejos. É primordial existir apoio de enfermeiros especialistas de forma a dignificar os cuidados no domicílio à pessoa com doença irrecuperável.

Living with quality is a challenge for today's society. Despite the increasing in the average life expectancy seen in the last decades, the growth of chronic and disabling chronic diseases generates a series of limitations and consequences in people's lives, their families and society, which justifies the importance of a caregiver in the community. However, taking care of a person with an advanced chronic disease at home proves to be an arduous task, due to the complexity that their illness imposes on the different dimensions of the sick person and the family caregiver. Becoming a caregiver is a transition that requires a redefinition of roles and responsibilities of the individual. It is useful to acquire strategies that allow an effective emotional management to face the challenges and demands that the exercise of that role imposes on daily life. Therefore, taking this into account, it seemed essential to understand the emotional experiences of family caregivers, in surgery units, before the home discharge of patients with advanced chronic diseases. This may contribute towards the continuity of the carer's life projects and for the development of intervention strategies that aim to preserve the family caregiver and the patient's well-being. Methodology: Qualitative study, case study. A semi-structured interview was conducted with ten family caregivers of advanced chronic disease patients, that were admitted in a surgery unit of a Local Health Unit (ULS), in the metropolitan area of Porto, at the time of home discharge. Data analysis was performed according to Bardin referential (2011). This study was approved by Ethical committee. Results: At the time advanced chronic disease patients return home, after an event that led to hospitalization, the family caregiver experiences a series of feelings and emotions that range from uncertainty, crying, joy, relief, mixed feelings and the duty to care. They gather strategies for emotional self-management, emphasizing the support of family members as a resource. They believe they are able to take care of the patient at home, enhancing the importance of satisfying the patient's desire, besides considering this task as a family duty and a showing of gratitude. Most family caregivers state they obtained an effective response from hospital-care nurses and primary health-care nurses. They highlight several benefits of home care, such as providing love, comfort and being able to manage the patient´s end-of-life process. However, they mention several negative consequences as individuals, such as losing their social role, unemployment, losing freedom, tasks overload, financial overload, loss of their family space, changing daily routines, tiredness and having family conflicts. Carers report using several sources of support that help being able to care for, and they express various desires. Therefore, it is essential to have support from specialist nurses in order to dignify home care for patients with unrecoverable diseases.

Knowledge, Attitude and Practice Towards COVID-19 Among Chronic Disease Patients at Addis Zemen Hospital, Northwest Ethiopia.

PURPOSE: The recent outbreak of coronavirus disease 2019 (COVID-19) is the worst global crisis after the Second World War. Since no successful treatment and vaccine have been reported, efforts to enhance the knowledge, attitudes, and practice of the public, especially the high-risk groups, are critical to manage COVID-19 pandemic. Thus, this study aimed to assess knowledge, attitude, and practice towards COVID-19 among patients with chronic disease. PATIENTS AND METHODS: A cross-sectional study was conducted among 404 chronic disease patients from March 02 to April 10, 2020, at Addis Zemen Hospital, Northwest Ethiopia. Both bivariable and multivariable logistic regression analyses with a 95% confidence interval were fitted to identify factors associated with poor knowledge and practice towards COVID-19. The adjusted odds ratio (AOR) was used to determine the magnitude of the association between the outcome and independent variables. P-value <0.05 was considered statistically significant. RESULTS: The mean age of the participants was 56.5±13.5. The prevalence of poor knowledge and poor practice was 33.9% and 47.3%, respectively. Forty-one percent of the participants perceived that avoiding of attending a crowded population is very difficult. Age (AOR=1.05, (95% CI (1.01-1.08)), educational status of "can't read and write" (AOR=7.1, 95% CI (1.58-31.93)), rural residence (AOR=19.0, 95% CI (6.87-52.66)) and monthly income (AOR=0.8, 95% CI (0.79-0.89)) were significantly associated with poor knowledge. Being unmarried (AOR=3.9, 95% CI (1.47-10.58)), cannot read and write (AOR=2.7, 95% CI (1.03-7.29)), can read and write (AOR=3.5, 95% CI (1.48-8.38)), rural residence (AOR=2.7, 95% CI (1.09-6.70)), income of <7252 Ethiopian birr (AOR=2.3, 95% CI (1.20-4.15)) and poor knowledge (AOR=8.6, 95% CI (3.81-19.45)) were significantly associated with poor practice. CONCLUSION: The prevalence of poor knowledge and poor practice was high. Leaflets prepared in local languages should be administered and health professionals should provide detailed information about COVID-19 to their patients.

The use of herbal medicines among chronic disease patients in Thailand: a cross-sectional survey.

BACKGROUND: The study aimed to assess the prevalence and correlates of herbal medicine use among chronic disease patients in health care settings in Thailand. METHODS: In a cross-sectional study, 1374 adult chronic disease patients (median age 60 years) were consecutively sampled from health care facilities in Thailand. Logistic regression was used to estimate the independent predictors of herbal medicine use in the past 12 months. RESULTS: The prevalence of herbal medicine use in the past 12 months was 35.9%. Of participants who were using herbal medicine in the past 12 month, 53.7% used it for treating a long-term health condition, 40.0% used herbal medicine in order to improve well-being and 6.3% for treating an acute illness. More than half of the herbal medicine users (57.2%) rated their herbal medicine use as very helpful, 33.3% as somewhat helpful and 6.5% not at all helpful or do not know. In adjusted logistic regression analysis, having Grade 6 to 12 education (Odds Ratio-OR: 1.71, Confidence Interval-CI: 1.04, 2.82), rural residence (OR: 0.76, CI: 0.60, 0.97), other religion (OR: 0.57, CI: 0.35, 0.97), anxiety (OR: 1.64, CI: 1.25, 2.16), low quality of life (OR: 0.42, CI: 0.31, 0.56) and having multiple chronic conditions (OR: 1.82, CI: 1.30, 2.56) were associated with past 12-month herbal medicine use. Further, in adjusted logistic regression analysis, having arthritis, asthma, cancer, cardiovascular disease, dyslipidaemia, gastrointestinal disease, dyslipidaemia were positively and hypertension negatively associated with past 12-month herbal medicine use. CONCLUSIONS: The study found a high prevalence of herbal medicine use among chronic disease patients in Thailand. Several factors (education, rural residence, anxiety, low quality of life and multiple chronic conditions) associated with herbal medicine use were identified. This knowledge will support health care providers and policy makers in decision making on the use of herbal medicine.

Path analysis of health behavior improvement in chronic disease patients based on family function theory / 中华疾病控制杂志

Objective To explore the path and effect of family cohesion, family adaptability and health remind on health behavior improvement of chronic disease patients, so as to provide evidences for the family-centered chronic disease management. Methods Data of all 1 134 patients with chronic diseases was selected from the national sample survey database. t-test was used to compare family cohesion, family adaptability, health remind and health behavior improvement between different groups, and Pearson correlation was used to analyze the correlation between variables. In the process of path analysis, parameters were estimated by maximum likelihood. Results Among the 1 134 chronic diseases patients, male accounted for 41.4%, and female accounted for 58.6%. The average age of participants was (53.6±10.0) years old. The score of health behavior improvement was (1.89±1.20). Path analysis showed that family cohesion had indirect effects on behavior improvement (effect size=0.072); family adaptability had both direct and indirect effects on behavior improvement (effect size=0.156); Health remind had direct effect on behavior improvement (effect size=0.357). Conclusions The high-level family cohesion and adaptability can improve patients’ health behavior by improving the health remind. It is suggested that family-centered health management services for chronic disease patients should emphasize the participation of family members as well as the improvement of family function.

The Impact of Chronic Diseases on the Quality of Life of Primary Care Patients in Cambodia, Myanmar and Vietnam.

BACKGROUND: Quality of life is a key measure in estimating the burden of disease, especially of chronic diseases. This study investigated the impact of a variety of chronic diseases on quality of life (QoL) in primary health care patients in three Southeast Asian countries (Cambodia, Myanmar, and Vietnam). METHODS: This cross-sectional survey was conducted on 4803 adult chronic disease patients (mean age 49.3 yr; SD=16.5) recruited systematically from primary health care centers in rural and urban areas in Cambodia, Myanmar and Vietnam in 2015. RESULTS: In ANCOVA analysis, adjusted for age, sex, marital status, geo locality, education, income and country, the poorest summative QoL was found among patients with cancer (49.8 mean score), followed by Parkinson's disease (50.7), mental disorder (53.2), epilepsy (53.3), asthma (54.3), kidney disease (54.3), chronic obstructive pulmonary disease (COPD) (54.5) and cardiovascular diseases (CVD) (55.1). Patients having three or more chronic conditions had a significantly lower summative QoL than patients with two chronic conditions (56.4) and one chronic condition (58.0). In multivariable linear regression analysis, younger age, being married or cohabitating, better education, living in an urban area, having only one chronic condition, not experiencing chronic disease stigma and good medication adherence was associated with better QoL in two or three of the study countries. CONCLUSION: Major chronic diseases were found to have poor QoL. The determined QoL of chronic disease patients in this study provides information to improve the management of chronic diseases.

Electronic, heat-not-burn, and combustible cigarette use among chronic disease patients in Japan: A cross-sectional study.

INTRODUCTION: Although tobacco smoking adversely affects health, many people continue to smoke while suffering from chronic disease. Few studies have examined electronic and heat-not-burn cigarette use among chronic disease patients. Our objective was to investigate electronic, heat-not-burn and combustible cigarette use among chronic disease patients with hypertension, diabetes, cerebrovascular disease, COPD (chronic obstructive pulmonary disease), asthma, atopic dermatitis, cancer, or mental disorders. METHODS: We analyzed 4432 eligible respondents aged 40-69 years from a 2015 internet survey (randomly sampled research agency panelists) with a propensity score weighting adjustment for 'being a respondent in an internet survey' in Japan. The outcome measure was the prevalence of electronic, heat-not-burn, and combustible cigarette use. Intention to quit was also calculated. RESULTS: In all, 32.1% (n=80) of male patients with more than two diseases and 10.3% (n=16) of female patients were current smokers. Of the patients who had no intention to quit smoking, 15.5% were male patients with atopic dermatitis and 63.7% with mental disorders. Of the men, 7.7% without any diseases had ever used e-cigarettes, while 7.7% and 6.4% of men with one disease or more than two diseases, respectively, had ever used e-cigarettes. Of the women, 3.5% without any diseases had ever used e-cigarettes, while 2.1% and 2.9% of women with one disease or more than two diseases, respectively, had ever used e-cigarettes. Percentage of heat-not-burn tobacco current or ever use was low (<0.1%) among both men and women. CONCLUSIONS: Differences in the use of electronic and combustible cigarettes according to the number of diseases were not obvious. However, sex differences for smoking among chronic disease patients, especially in atopic dermatitis and mental disorders, were found.

Anticipated stigma in chronic illness patients in Cambodia, Myanmar and Vietnam.

The aim of this study was to explore the prevalence and relationship of anticipated chronic illness stigma among patients diagnosed with a variety of chronic diseases in three Southeast Asian countries (Cambodia, Myanmar and Vietnam). A cross-sectional survey was conducted in 4,803 adult chronic disease patients (mean age 49.3 years; SD=16.5) recruited systematically from health facilities. Overall, the results indicate that 20.7% of patients reported that for any of the 12 stigma items, they anticipated they were likely or very likely to experience chronic disease stigma. A multivariate analysis of sociodemographics revealed the following were associated with anticipated chronic disease stigma: older versus younger age, OR (odds ratio) = 0.71; 95% Confidence Interval (CI) [0.58, 0.87]; higher versus lower education, OR = 2.23; 95% CI [1.81, 2.75]; origin from Myanmar or Vietnam, being single, divorced or widowed, rural residence, and health status (having three or more chronic conditions versus having one chronic condition), OR = 1.93; 95% CI [1.58, 2.35]; lower versus higher quality of life, OR = 0.73; 95% CI [0.63, 0.85]); health risk behavior (physical inactivity, poor diet, current smoking, and problem drinking) and low versus medium or high medication adherence (OR = 0.69; 95% CI [0.55,0.86]). This study demonstrated the possible consequences of anticipated stigma on the health and behavior of people living with chronic diseases, and several factors for chronic disease stigma were identified that can help guide interventions to reduce chronic illness stigma in this population.

A Telemedicine Service as Partial Replacement of Face-to-Face Physical Rehabilitation: The Relevance of Use.

BACKGROUND: Different kinds of telemedicine services have made their entry into healthcare. In this article we focus on a telerehabilitation service for physical exercise, designed and implemented as partial replacement of a 3-day outpatient rehabilitation program for chronic disease patients. The aim of this article is to examine the use pattern of this telerehabilitation service by chronic disease patients and to examine the association between actual use and clinical benefit experienced by these patients. MATERIALS AND METHODS: Chronic lower back pain (CLBP) patients and pulmonary disease (PD) patients referred to the physical outpatient rehabilitation programs were asked to participate in and to use the telerehabilitation service. The actual use was expressed as frequency and duration of use, and the measurement of clinical benefit focused on complaints and physical functioning. RESULTS: Sixty-two patients finished the outpatient rehabilitation using the telerehabilitation service. During the weeks of home rehabilitation the majority of the patients used the service. On average the service was used one or two times a week for a total of 35-38 min for both pathologies, with this value being lower than the time that was replaced. Frequency of use was significantly associated with the change in physical functioning outcome for both pathologies (CLBP, r=0.41, p=0.02; PD, r=0.55, p=0.003). CONCLUSIONS: Chronic disease patients used a telerehabilitation service as partial replacement of their face-to-face rehabilitation program, and more frequent use was positively related to higher clinical benefit.

Analysis of Nursing Research Trends in Study of Families of Patients with Chronic Diseases / 기본간호학회지

PURPOSE: The purpose of this study was to analyze research trends and to suggest future directions for research on families of patients with chronic disease. METHOD: The method used was a review of 83 dissertations and articles related to these families published in Korea between 1980 and 2002. Analysis included design of the study, sources of data, interventions for experimental research and main concepts for non-experimental research. RESULT: It was found that 80.7% of the studies were non-experimental research and 85.1% of these were descriptive surveys. In 79.5% of research studies, data were collected at a hospital. Nursing interventions in the experimental studies included stress management, education, strengthening functional communication among family members and nursing management. The major concepts were family burden, family stress and coping, and family experience. CONCLUSION: It is necessary that research on the family-as-a-client be more focused and that the results of family related research be applied to the family as a unit. Development of research instruments to measure the phenomena of Korean families of patients with chronic disease is also needed.