Health work by older people with chronic illness: how much time does it take?

Yen, Laurann; McRae, Ian; Jowsey, Tanisha; Gillespie, James; Dugdale, Paul; Banfield, Michelle; Matthews, Paul; Kljakovic, Marjan

doi:10.1177/1742395313476720

Cited by 22 publications

(30 citation statements)

References 15 publications

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“…In doing so, we take the case of people with chronic obstructive pulmonary disease (COPD). Drawing on the findings from a time use survey we conducted in Australia in 2011,3 we have established that people with arthritis spend approximately 7.8 hours (median) per month on health practices. We also identified that people with COPD spent more time overall on health practices than those with arthritis or other chronic illnesses 3.…”

Section: Introductionmentioning

confidence: 99%

“…Drawing on the findings from a time use survey we conducted in Australia in 2011,3 we have established that people with arthritis spend approximately 7.8 hours (median) per month on health practices. We also identified that people with COPD spent more time overall on health practices than those with arthritis or other chronic illnesses 3. Returning to Bury’s study,1 and combining his findings with our own, if people with arthritis spend about 7.8 hours each month on health practices, and they experience this time as contributing to a sense of disruption, then people with COPD – an illness associated with a higher magnitude of time use – may experience the same, or even a greater sense, of disruption.…”

Section: Introductionmentioning

confidence: 99%

“…We undertook a national time use survey of older adults to establish the amount of time they spent on health work, and found that people with COPD reported spending the highest amount of time on health-related activities 3,20. Here, we analyze which of a selected group of tasks people spend most of their time on, and suggest that the total amount of time spent on health practices may indeed contribute to a person’s sense that his or her daily biography (and indeed, their life course) has been disrupted by chronic illness.…”

Section: Introductionmentioning

confidence: 99%

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Time spent by people managing chronic obstructive pulmonary disease indicates biographical disruption

Jowsey¹,

Yen²,

Bagheri³

et al. 2014

COPD

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Since Bury’s 1982 proposal that chronic illness creates biographical disruption for those who are living with it, there has been no effort to quantitatively measure such disruption. “Biographical disruption” refers to the substantial and directive influence that chronic illness can have over the course of a person’s life. Qualitative research and time use studies have demonstrated that people with chronic illnesses spend considerable amounts of time managing their health, and that these demands may change over time. This study was designed to measure the time that older people with chronic illnesses spend on selected health practices as one indicator of biographical disruption. We look specifically at the time use of people with chronic obstructive pulmonary disease (COPD). As part of a larger time use survey, a recall questionnaire was mailed to 3,100 members of Lung Foundation Australia in 2011. A total of 681 responses were received (22.0% response rate), 611 of which were from people with COPD. Descriptive analyses were undertaken on the amount of time spent on selected health-related activities including personal care, nonclinical health-related care, and activity relating to health services. Almost all people with COPD report spending some time each day on personal or home-based health-related tasks, with a median time of 15 minutes per day spent on these activities. At the median, people also report spending about 30 minutes per day exercising, 2.2 hours per month (the equivalent of 4.4 minutes per day) on nonclinical health-related activities, and 4.1 hours per month (equivalent to 8.2 minutes per day) on clinical activities. Excluding exercise, the median total time spent on health-related activities was 17.8 hours per month (or 35.6 minutes per day). For people in the top 10% of time use, the total amount of time was more than 64.6 hours per month (or 2.2 hours per day) excluding exercise, and 104 hours per month (or 3.5 hours per day) including exercise. The amount of time spent on health-related activity, such as engaging in personal care tasks, may be regular and predictable. The execution of these tasks generally takes relatively small amounts of time, and might be incorporated into daily life (biography) without causing significant disruption. Other activities may require large blocks of time, and they may be disruptive in a practical way that almost inevitably disrupts biography. The amount of time required does not appear to alter in relation to the time since diagnosis. The scale of time needed to manage one’s health could easily be interpreted as disruptive, and for some people, even overwhelming.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Time spent by people managing chronic obstructive pulmonary disease indicates biographical disruption

Jowsey¹,

Yen²,

Bagheri³

et al. 2014

COPD

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“…The survey was tested twice, first by 18 members of a local health care consumer group, and, following modifications, by 29 respondents to a previous survey who had indicated their willingness to assist in future research. Full details of the survey development and conduct have been described elsewhere (Yen et al (2013) [13]).…”

Section: Methodsmentioning

confidence: 99%

Time spent on health related activity by older Australians with diabetes

Yen

McRae

Jowsey

et al. 2013

J Diabetes Metab Disord

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AimsThere is little information available about what people do to look after their health, or how long people spend on health activities. This study identifies key health related activities and time taken as part of self management by people with diabetes. Management planning often lacks information that this study provides that would help clinicians and patients to create manageable and do-able plans that patients can follow.MethodsData were collected in 2010 using a national survey of people aged 50 years the National Diabetes Services Scheme. Respondents provided recall data on time used for personal health care, non-clinical health activity; and health service interactions. Data were analysed using Stata 12 and SPSS 19.ResultsWhile most people with diabetes spend on average less than 30 minutes a day on health-related activities (excluding exercise), the highest decile of respondents averaged over 100 minutes. Time spent increased with the number of co-existent conditions. Taking medication and sitting in waiting rooms were the most frequently reported activities. The greatest amount of time was spent on daily personal health care activities.ConclusionThe time demands of diabetes for older people can be substantial. Better patient engagement in self management might result from a better match in care planning between the illness demands and the patient time availability, with potential to reduce admissions for hospital care.

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“…Time demands are particularly heavy for the elderly, those with diabetes, and those with poor health and multiple chronic conditions. Self-management of chronic conditions, crucial to good health, can be particularly time consuming (Jonas et al, 2011;Yen et al, 2013). For example, diabetic adults must spend 2 hours a day to meet recommendations of the American Diabetes Association for self care (Safford et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

Risk factors for family time burdens providing and arranging health care for children with special health care needs: Lessons from nonproportional odds models

Miller

Nugent

Russell

2015

Social Science Research

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Health work by older people with chronic illness: how much time does it take?

Abstract: For a minority of people with chronic illness, time demands for health-related activities can be so great that other activities must be affected. Some time demands are amenable to system interventions that would result in a more patient-centered organisation of care.

Cited by 22 publications

References 15 publications

Time spent by people managing chronic obstructive pulmonary disease indicates biographical disruption

Time spent by people managing chronic obstructive pulmonary disease indicates biographical disruption

Time spent on health related activity by older Australians with diabetes

Risk factors for family time burdens providing and arranging health care for children with special health care needs: Lessons from nonproportional odds models

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