PMID- 24134436
OWN - NLM
STAT- MEDLINE
DCOM- 20150604
LR  - 20151119
IS  - 1468-3083 (Electronic)
IS  - 0926-9959 (Linking)
VI  - 28
IP  - 10
DP  - 2014 Oct
TI  - Chronic disease influences over 40 major life-changing decisions (MLCDs): a 
      qualitative study in dermatology and general medicine.
PG  - 1344-55
LID - 10.1111/jdv.12289 [doi]
AB  - BACKGROUND: Chronic disease not only impairs patients' psycho-social well-being 
      but also influences major life-changing decisions (MLCDs). There is little 
      information about the types of MLCDs affected and the long-term consequences. 
      OBJECTIVES: The aims were to identify the MLCDs influenced by chronic disease, to 
      define 'MLCD' and to suggest support strategies for patients taking MLCDs. 
      METHODS: Adult dermatology patients explained how their chronic disease had 
      influenced MLCDs in individual interviews. Adult patients from other medical 
      specialities gave similar information by postal survey. NVivo8 software was used 
      for qualitative analysis of data. Themes were categorized through a 
      coding-recoding iterative process. RESULTS: There were 308 evaluable responses 
      (male 55.2%; mean age = 51.8 years, mean disease duration = 19 years) from the 
      365 (55.7%) responses to the 655 patient invitations. These were used to generate 
      themes to conceptualize 'MLCDs'. The most frequently reported MLCDs in the 
      dermatology interviews concerned career choice (66%), job (58%), choice of 
      clothing (54%), relationships (52%), education (44%), stopping swimming (34%), 
      moving abroad (32%), not socializing (34%), wearing make-up (22%) and having 
      children (22%). In the postal survey early retirement (40.6%), impact on job 
      (29.4%), having children (24.8%), career choice (22.4%) and relationships (15.5%) 
      were most commonly reported. The number of MLCDs reported by individuals was 
      inversely related to age. Forty-one affected MLCD themes were grouped into 18 
      MLCD categories. A definition of MLCD was developed and strategies suggested to 
      support patients. CONCLUSIONS: Chronic diseases influence a wide range of MLCDs. 
      MLCDs are a novel domain in disease burden assessment. Clinicians' knowledge 
      about this is important in patient management.
CI  - (c) 2013 European Academy of Dermatology and Venereology.
FAU - Bhatti, Z U
AU  - Bhatti ZU
AD  - Centre for Socioeconomic Research, Cardiff School of Pharmacy and Pharmaceutical 
      Sciences, Cardiff University, Cardiff, UK; Department of Dermatology and Wound 
      Healing, School of Medicine, Cardiff University, Cardiff, UK.
FAU - Finlay, A Y
AU  - Finlay AY
FAU - Bolton, C E
AU  - Bolton CE
FAU - George, L
AU  - George L
FAU - Halcox, J P
AU  - Halcox JP
FAU - Jones, S M
AU  - Jones SM
FAU - Ketchell, R I
AU  - Ketchell RI
FAU - Moore, R H
AU  - Moore RH
FAU - Salek, M S
AU  - Salek MS
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20131018
PL  - England
TA  - J Eur Acad Dermatol Venereol
JT  - Journal of the European Academy of Dermatology and Venereology : JEADV
JID - 9216037
SB  - IM
MH  - Adaptation, Psychological
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Chronic Disease/*psychology
MH  - Decision Making
MH  - Dermatology
MH  - Female
MH  - General Practice
MH  - Humans
MH  - *Life Change Events
MH  - Life Style
MH  - Male
MH  - Middle Aged
MH  - Skin Diseases/*psychology
MH  - Surveys and Questionnaires
MH  - Young Adult
EDAT- 2013/10/19 06:00
MHDA- 2015/06/05 06:00
CRDT- 2013/10/19 06:00
PHST- 2012/11/05 00:00 [received]
PHST- 2013/09/16 00:00 [accepted]
PHST- 2013/10/19 06:00 [entrez]
PHST- 2013/10/19 06:00 [pubmed]
PHST- 2015/06/05 06:00 [medline]
AID - 10.1111/jdv.12289 [doi]
PST - ppublish
SO  - J Eur Acad Dermatol Venereol. 2014 Oct;28(10):1344-55. doi: 10.1111/jdv.12289. 
      Epub 2013 Oct 18.