5 results on '"Perzynski, Adam T."'
Search Results
2. Behavioral stage of change and dialysis decision-making.
- Author
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Prakash S, McGrail A, Lewis SA, Schold J, Lawless ME, Sehgal AR, and Perzynski AT
- Subjects
- Adult, Aged, Attitude of Health Personnel, Communication, Cross-Sectional Studies, Female, Health Care Surveys, Health Literacy, Humans, Intention, Interviews as Topic, Logistic Models, Male, Middle Aged, Multivariate Analysis, Odds Ratio, Physicians psychology, Qualitative Research, Renal Insufficiency, Chronic diagnosis, Surveys and Questionnaires, Algorithms, Choice Behavior, Health Behavior, Health Knowledge, Attitudes, Practice, Patient Participation, Patients psychology, Renal Dialysis methods, Renal Insufficiency, Chronic psychology, Renal Insufficiency, Chronic therapy
- Abstract
Background and Objectives: Behavioral stage of change (SoC) algorithms classify patients' readiness for medical treatment decision-making. In the precontemplation stage, patients have no intention to take action within 6 months. In the contemplation stage, action is intended within 6 months. In the preparation stage, patients intend to take action within 30 days. In the action stage, the change has been made. This study examines the influence of SoC on dialysis modality decision-making., Design, Setting, Participants, & Measurements: SoC and relevant covariates were measured, and associations with dialysis decision-making were determined. In-depth interviews were conducted with 16 patients on dialysis to elicit experiences. Qualitative interview data informed the survey design. Surveys were administered to adults with CKD (eGFR≤25 ml/min/1.73 m(2)) from August, 2012 to June, 2013. Multivariable logistic regression modeled dialysis decision-making with predictors: SoC, provider connection, and dialysis knowledge score., Results: Fifty-five patients completed the survey (71% women, 39% white, and 59% black), and median annual income was $17,500. In total, 65% of patients were in the precontemplation/contemplation (thinking) and 35% of patients were in the preparation/maintenance (acting) SoC; 62% of patients had made dialysis modality decisions. Doctors explaining modality options, higher dialysis knowledge scores, and fewer lifestyle barriers were associated with acting versus thinking SoC (all P<0.02). Patients making modality decisions had doctors who explained dialysis options (76% versus 43%), were in the acting versus the thinking SoC (50% versus 10%), had higher dialysis knowledge scores (1.4 versus 0.5), and had lower eGFR (13.9 versus 16.8 ml/min/1.73 m(2); all P<0.05). In adjusted analyses, dialysis knowledge was significantly associated with decision-making (odds ratio, 4.2; 95% confidence interval, 1.4 to 12.9; P=0.01), and SoC was of borderline significance (odds ratio, 5.8; 95% confidence interval, 1.0 to 32.6; P=0.05). The model C statistic was 0.87., Conclusions: Dialysis decision-making was associated with SoC, dialysis knowledge, and physicians discussing treatment options. Future studies determining ways to assist patients with CKD in making satisfying modality decisions are warranted., (Copyright © 2015 by the American Society of Nephrology.)
- Published
- 2015
- Full Text
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3. Playing the Numbers: How Hepatitis C Patients Use Their Medical Test Results.
- Author
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Perzynski, Adam T., Terchek, Joshua J., Stoller, Eleanor P., Blixen, Carol E., Dawson, Neal V., Kanuch, Stephanie W., and McCormick, Richard C.
- Subjects
HEPATITIS C ,BIOCHEMISTRY ,HEALTH behavior ,SELF-management (Psychology) ,VIRAL hepatitis - Abstract
The perspectives of hepatitis C patients are an important concern that has not been given much attention. Illness narratives from 307 individuals infected with hepatitis C were collected from the Internet and analyzed qualitatively. Hepatitis C patients are required to have periodic blood draws for laboratory testing. Lab results are presented numerically and compared with physicians? repertoires of experience and established biochemical standards. Treatment decisions are often measured against how well patient lab values match accepted standards. HCV patients? knowledge and interpretation of test results may have important consequences for their health behavior choices and their medical outcomes. In their stories, patients described decisions to begin, delay or stop treatment. Patients also explained changes in test results by referring to self management behaviors like diet, exercise, and alternative medicine approaches like vitamins and acupuncture. For those with hepatitis C, test results are powerful signifiers, capable of altering the course of their illness, their lives, and their stories. Patients are ?playing the numbers,? and making calculated decisions about their health. [ABSTRACT FROM AUTHOR]
- Published
- 2004
- Full Text
- View/download PDF
4. Lay Management of Chronic Disease: A Qualitative Study of Living with Hepatitis C Infection.
- Author
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Stoller, Eleanor Palo, Webster, Noah J., Blixen, Carol E., McCormick, Richard A., Perzynski, Adam T., Kanuch, Stephanie W., and Dawson, Neal V.
- Subjects
CHRONIC diseases ,HEPATITIS C ,HEALTH self-care ,HEALTH behavior ,LAY analysis (Psychoanalysis) ,MEDICAL care research - Abstract
Objectives: To examine management strategies and goals reported by people diagnosed with chronic hepatitis C. Methods: We analyzed data from semistructured interviews (N=42) and from electronic sources [illness narratives (N=79) and Internet threaded discussions (N=264)]. Line-by-line coding, comparisons, and team discussions generated catalogs of lay management strategies and goals. We analyzed code-based files to identify informants' selection of specific strategies for each goal. Results: We classified lay management strategies into 3 categories: medical self-care, behavior change, and coping. These strategies were used selectively In addressing multiple goals, categorized as fighting the virus, strengthening the body, and managing consequences. Conclusions: Results underscore the diversity of strategies for living with a disease characterized by uncertain prognosis and variable expression of symptoms. [ABSTRACT FROM AUTHOR]
- Published
- 2009
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5. A Targeted Self-Management Approach for Reducing Stroke Risk Factors in African American Men Who Have Had a Stroke or Transient Ischemic Attack.
- Author
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Sajatovic, Martha, Tatsuoka, Curtis, Welter, Elisabeth, Colon-Zimmermann, Kari, Blixen, Carol, Perzynski, Adam T., Amato, Shelly, Cage, Jamie, Sams, Johnny, Moore, Shirley M., Pundik, Svetlana, Sundararajan, Sophia, Modlin, Charles, and Sila, Cathy
- Subjects
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SELF-management (Psychology) , *AFRICAN American men , *CORONARY disease , *CLINICAL trials , *HEALTH , *STROKE prevention , *BLACK people , *BLOOD pressure , *COMPARATIVE studies , *MENTAL depression , *DRUGS , *HEALTH behavior , *LIPIDS , *LONGITUDINAL method , *RESEARCH methodology , *MEDICAL cooperation , *PATIENT compliance , *PATIENT education , *QUALITY of life , *RESEARCH , *STATISTICAL sampling , *SOILS , *STROKE , *TRANSIENT ischemic attack , *EVALUATION research , *RANDOMIZED controlled trials ,STROKE risk factors - Abstract
Purpose: This study compared a novel self-management (TargetEd MAnageMent Intervention [TEAM]) versus treatment as usual (TAU) to reduce stroke risk in African American (AA) men.Design: Six-month prospective randomized controlled trial with outcomes evaluated at baseline, 3 months, and 6 months.Setting: Academic health center.Participants: Thirty-eight (age < 65) AA men who had a stroke or transient ischemic attack and a Barthel index score of >60 were randomly assigned to TEAM (n = 19) or TAU (n = 19).Intervention: Self-management training, delivered in 1 individual and 4 group sessions (over 3 months).Measures: Blood pressure, glycosylated hemoglobin (HbA1c), lipids, medication adherence, weight, and standardized measures of health behaviors (diet, exercise, smoking, substances), depression, and quality of life. Qualitative assessments evaluated the perspectives of TEAM participants.Analysis: T tests for paired differences and nonparametric tests. Thematic content qualitative analysis.Results: Mean age was 52.1 (standard deviation [SD] = 7.4) and mean body mass index was 31.4 (SD = 7.4). Compared to TAU, TEAM participants had significantly lower mean systolic blood pressure by 24 weeks, and there was also improvement in HbA1c and high-density lipoprotein cholesterol ( P = .03). Other biomarker and health behaviors were similar between groups. Qualitative results suggested improved awareness of risk factors as well as positive effects of group support. [ABSTRACT FROM AUTHOR]- Published
- 2018
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