Biomedical subjects

Julie Hicks Patrick

Publications and source records attributed to Julie Hicks Patrick.

4 recordsLinked to original sources

PubMed2006

Quality of life, health status and clinical outcomes in Type 2 diabetes patients.

This study examines relationships between patient reported outcomes (PROs) and clinical outcomes in Type 2 diabetes mellitus (T2DM). Patients at the outpatient clinics of a university hospital completed measures of generic health status (SF-12), diabetes-specific quality of life (Audit of Diabetes Dependent Quality of Life - ADDQoL), and depressive symptoms (Center for Epidemiologic Studies Depression - CES-D). Patient reported data were merged with a retrospective collection of clinical and utilization data, including HbA1C, from electronic medical records. A Charlson comorbidity score, diabetes complications score, BMI, and total number of ER and hospital visits were calculated. Usable response rate was 44.3% (n = 385). Patients were dichotomized into glycemic control levels based on the ADA recommended A1C level < 7.0, vs. >or= 7.0. The ADDQoL, PCS-12, and MCS-12 scores were separately examined as dependent variables using hierarchical regression models, with glycemic control as the primary explanatory variable, and controlling for demographics and clinical variables including comorbidities and complications. Glycemic control was not a significant predictor in any regression model. Obesity was a significant predictor leading to poorer PCS-12 and MCS-12 scores, while depressive symptoms significantly resulted in lower PCS-12, MCS-12 and ADDQoL scores. These and other factors related to self-management behaviors may contribute to a greater understanding of how to intervene with patients with T2DM. The use of such PROs alongside biomedical measures such as A1C is recommended.

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PubMed2005

Self-rated health among vulnerable older adults in rural Appalachia.

CONTEXT: Self-rated health (SRH) predicts service use, morbidity, and mortality. Additionally, SRH has been associated with indices of psychological well-being. PURPOSE: The main focus of the study was to investigate important differences among the lower spectrum of SRH (ie, fair and poor) on indices of well-being. METHODS: In-person interviews collected data from 207 (M age = 75.8) older rural adults. Data were used to examine differences between those reporting poor, fair, and good or excellent SRH on measures of demographics, and physical and psychological health. RESULTS: Significant differences emerged between levels of SRH in relation to measures of physical and psychological health. Specifically, individuals with poor SRH were significantly more likely to have (1) illnesses, (2) problems with basic and cognitive tasks of daily living, and (3) depressed affect than individuals reporting good or excellent health. Individuals with poor SRH were significantly more likely to have problems with basic and cognitive tasks of daily living than individuals with fair SRH. No significant differences were found between people reporting fair and good or excellent SRH on illnesses and depressed affect. CONCLUSIONS: Results suggest that future research should investigate the expansion of the lower-end of the SRH measure to more accurately assess SRH among vulnerable, rural older adults. Such efforts would better inform health care providers, practitioners, and policy makers in rural areas as to how SRH affects the well-being of vulnerable older adults.

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PubMed2004

The effects of depressed affect on functional disability among rural older adults.

This study investigates functional disability among some of the nation's most vulnerable older adults: rural Medicaid recipients. Data were provided by 221 older adults (mean age = 75.9 years; 82% women) who were receiving community-based long-term care services through Medicaid. Participants self-reported functional ability involving the completion of six basic activities of daily living (BADLs), three cognitive instrumental activities of daily living (IADLS), and four physical IADLs. Self-reports of depressed affect and the number of physical health conditions were also obtained. Path analysis was used to examine all of the associations among age, gender, number of chronic health conditions, depressed affect and functional disability. The tested model was significant [chi2 (DF = 3, n = 221) = 5.052, p = 0.168; TLI = 0.945; CFI = 0.992; RMSEA = 0.056] and explained 45.1% of the variance in BADL disability. Depressed affect significantly predicted disability in cognitive IADLs and physical IADLs, which predicted disability in BADLs. Age and gender had indirect effects on BADL, through their association with cognitive IADLs and physical IADLs. The number of chronic health conditions exerted both indirect and direct effects on BADL disability. Results are discussed within the context of the growing literature that suggests the importance of psychological variables as predictors of functional disability. Moreover, we discuss whether community-based long-term care is appropriate for older adults with high levels of functional disability.

Activities of Daily Living↗

PubMed2003

Collaborative everyday problem solving: interpersonal relationships and problem dimensions.

Older adults' preferred partners for collaborative everyday problem solving and the types of everyday problems solved alone and with others were examined in a sample of community dwelling older adults (N = 112, M age = 71.86 yrs., SD = 5.92 yrs.). Family members (i.e., spouses, adult children) were the most frequently nominated partners for collaborative everyday problem solving, but friends, neighbors, and church members also were nominated. Older adults reported that they solved numerous types of problems, including finance, house repair, and health, in collaboration with others. These problems were also prominent when older adults reported the problems that they consulted others for advice on how to solve and the problems they solved alone. Together the results suggest new directions for research on collaborative everyday problem solving in terms of the types of interpersonal relationships and problems to be investigated. Implications of the findings for researchers and practitioners are discussed in terms of how to best understand and promote successful aging.

Activities of Daily Living↗