Associations of patient health-related problem solving with disease control, Emergency Department visits, and hospitalizations in HIV and diabetes clinic samples

Felicia Hill-Briggs, Leigh Gemmell, Babul Kulkarni, Brendan Klick, Frederick L. Brancati

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Patient problem solving and decision making are recognized as essential to effective self-management across multiple chronic diseases. However, a health-related problem-solving instrument that demonstrates sensitivity to disease control parameters in multiple diseases has not been established. OBJECTIVES: To determine, in two disease samples, internal consistency and associations with disease control of the Health Problem-Solving Scale (HPSS), a 50-item measure with 7 subscales assessing effective and ineffective problem-solving approaches, learning from past experiences, and motivation/orientation. DESIGN: Cross-sectional study. PARTICIPANTS: Outpatients from university-affiliated medical center HIV (N=111) and diabetes mellitus (DM, N=78) clinics. MEASUREMENTS: HPSS, CD4, hemoglobin A1c (HbA1c), and number of hospitalizations in the previous year and Emergency Department (ED) visits in the previous 6 months. RESULTS: Administration time for the HPSS ranged from 5 to 10 minutes. Cronbach's alpha for the total HPSS was 0.86 and 0.89 for HIV and DM, respectively. Higher total scores (better problem solving) were associated with higher CD4 and fewer hospitalizations in HIV and lower HbA1c and fewer ED visits in DM. Health Problem-Solving Scale subscales representing negative problem-solving approaches were consistently associated with more hospitalizations (HIV, DM) and ED visits (DM). CONCLUSIONS: The HPSS may identify problem-solving difficulties with disease self-management and assess effectiveness of interventions targeting patient decision making in self-care.

Original languageEnglish (US)
Pages (from-to)649-654
Number of pages6
JournalJournal of general internal medicine
Volume22
Issue number5
DOIs
StatePublished - May 1 2007

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Keywords

  • Chronic disease
  • Decision making
  • Disease control
  • Measure development
  • Minority populations
  • Problem solving

ASJC Scopus subject areas

  • Internal Medicine

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