Functional Impairments Associated With Patient Activation Among Community-Dwelling Older Adults. Am J Phys Med Rehabil 2018 Nov;97(11):839-847
Date
06/13/2018Pubmed ID
29894313Pubmed Central ID
PMC6193847DOI
10.1097/PHM.0000000000000979Scopus ID
2-s2.0-85055072818 (requires institutional sign-in at Scopus site) 2 CitationsAbstract
OBJECTIVES: Activity of daily living stages and instrumental activity of daily living stages demonstrated ordered associations with mortality, risk of hospitalization, and receipt of recommended care. This article explores the associations of stages with the following three dimensions of patient activation: self-care efficacy, patient-doctor communication, and health-information seeking. We hypothesized that higher activity of daily living and instrumental activity of daily living stages (greater limitation) are associated with a lower level of patient activation.
METHODS: Patient activation factors were derived from the 2004 and 2009 Medicare Current Beneficiary Survey. In this cross-sectional study (N = 8981), the associations of activity limitation stages with patient activation factors were assessed in latent factor models.
RESULTS: Greater activity limitation was in general inversely associated with self-efficacy, patient-doctor communication, and health information seeking, even after adjusting for sociodemographic and clinical characteristics. For instance, the mean of self-care efficacy across activity of daily living stages I-IV (mild, moderate, severe, and complete limitation) compared with stage 0 (no limitation) decreased significantly by 0.17, 0.29, 0.34, and 0.60, respectively. Covariates associated with suboptimal patient activation were also identified.
DISCUSSION: Our study identified multiple opportunities to improve patient activation, including providing support for older adults with physical impairments, at socioeconomic disadvantages, or with psychological or cognitive impairment.
Author List
Na L, Kwong PL, Xie D, Pezzin LE, Kurichi JE, Streim JEAuthor
Liliana Pezzin PhD, JD Professor in the Institute for Health and Equity department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Activities of Daily LivingAged
Aged, 80 and over
Cross-Sectional Studies
Disability Evaluation
Female
Humans
Independent Living
Information Seeking Behavior
Male
Medicare
Patient Participation
Physician-Patient Relations
Risk Factors
Self Care
Self Efficacy
United States
