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Background: Experiences of living with and seeking care for multimorbidity is a relatively under-researched field. By analysing experiences of people with multimorbidity, caregivers and care professionals, we can better understand the complex care needs of those with multimorbidity and identify improvements to care management. This paper reports findings from research that elicited the views of key stakeholders to inform future care practice and policy. Aim: To elicit care recipient and care provider views to understand the care needs of those living with and seeking care for multimorbidity. Method: A qualitative interview study using purposive sampling of those living with and providing care in multimorbidity. Results: Increased support to those with multimorbidity and caregivers to navigate care systems was advocated. Establishing trusting care relationships featured prominently in participants accounts. Fragmented care, inadequate coordination and poor communication between care providers, were identified as system-wide challenges. There was agreement that integrated care models were needed, which delivered personalised care, such as shared decision-making, choice in care options and accessing services, and individualised care plans. Conclusion: We found significant agreement among stakeholders on care need and management in multimorbidity. Understanding the experiences of those with multimorbidity, caregivers and care professionals, can inform future improvements in care management.
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Background: Multimorbidity is a major challenge to health and social care systems around the world. There is limited research exploring the wider contextual determinants that are important to improving care for this cohort. In this study, we aimed to elicit and prioritise determinants of improved care in people with multiple conditions. Methods: A three-round online Delphi study was conducted in England with health and social care professionals, data scientists, researchers, people living with multimorbidity and their carers. Results: Our findings suggest a care system which is still predominantly single condition focused. 'Person-centred and holistic care' and 'coordinated and joined up care', were highly rated determinants in relation to improved care for multimorbidity. We further identified a range of non-medical determinants that are important to providing holistic care for this cohort. Conclusions: Further progress towards a holistic and patient-centred model is needed to ensure that care more effectively addresses the complex range of medical and non-medical needs of people living with multimorbidity. This requires a move from a single condition focused biomedical model to a person-based biopsychosocial approach, which has yet to be achieved.
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Abstract Objective: To analyze the associations between posterior tooth loss and masticatory performance, nutrition intake, and nutritional status in the elderly. Material and Methods: A total of 158 subjects aged 60 years and older from Depok, West Java, Indonesia were enrolled in this cross-sectional study. Posterior teeth contacts were assessed and the subjects were divided into two groups based on Eichner Index; group A2-B3 and group B4-C3. The masticatory performance test was conducted using color-changeable chewing gum. A semi-quantitative food-frequency questionnaire was used to measure nutritional intake in the form of total calories, and the Mini-Nutritional Assessment-Short Form was used to measure nutritional status. Mann Whitney U test was used to determine differences in masticatory performance, nutrition intake, and nutritional status between the two groups Results: Seventy-four percent of participants were female, and 26% were male. A significant difference in the mean masticatory performance score (p<0.001) was noted between Eichner group A2-B3 (5.66 ± 1.80) and B4-C3 (3.20 ± 1.25). However, no statistically significant difference in nutritional status and calorie intake were found between the two groups (p>0.05) Conclusion: Despite the adequacy of nutrition intake and nutrition status in this population, tooth replacement is necessary to improve masticatory performance in both groups.
