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20 North Lincoln Street . Batavia, IL 60510
p. 630.761.4427 f. 630.761.4430
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Integrated Health Advocacy Program
 

Research

Articles | Presentations

Published Articles

Krause, C.M., Kuhn, M.E. J., & Wolfe, K. (2008). A brief description of the limitations of the current health care system in the United States, and a program response to the complex issues of many individuals who are confronted with multiple, chronic conditions. In L.A. Klein & E.L. Neumann (Eds.) Integrated Health Care Delivery, (pp. 1-17) New York: Nova Science Publishers.

This article describes an innovative, theory-driven, multidisciplinary intervention program designed to a) improve the health and healthcare of individuals who are dealing with multiple chronic health conditions, and b) help these individuals learn to manage their healthcare by means of an empowerment process through modeling, education, and decision support by a collaborative, multidisciplinary team. The focus of the intervention is to empower participants to be responsible for their healthcare through a gradual process of increasing personal involvement in the healthcare decision-making process. Another goal of the program is the effective use of healthcare dollars. The literature review explains the reasoning behind the goals of this program. A description of information learned through the research data collection process is described, and conclusions are presented.
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Krause, C.M., & Kuhn, M.E.J. (2007). Help for the caring: The stress, value, and the perceptions of informal caregivers. Annuals of the American Psychotherapy Association, 10(1), 32-37.

This study consisted of reviewing empirical literature concerning the effects of being an informal caregiver. Additionally, a study of caregivers was conducted to examine their level of health and level of personal control over their health issues. The results indicate that informal caregivers do rate their level of health lower than adults who are not informal caregivers. Furthermore, adults who believe that they have more personal control over different aspects of their lives believe that their health is better than adults who do not perceive themselves as having as much personal control. The results suggest the need for psychosocial interventions to teach stress-management strategies in order to increase caregivers’ perceptions of personal control, and their perceptions of their level of health. 
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Krause, C.M., Jones, C.S., Kuhn, M.E.J., Joyce, S., Curtin, K., Murphy, L. P., Krause, C.M.J., Boan, B. K., & Lucas, D. R. (2006). The impact of a multi-disciplinary approach in improving health and quality of care for individuals dealing with multiple, chronic conditions. American Journal of Orthopsychiatry, 76(1), 109-114.

This study examined the effects of using a multidisciplinary, integrated, whole-person, team advocate approach to educate and empower participants with multiple chronic illnesses and to coordinate, monitor, and support their healthcare process. Individuals (n=39) from Midwest hospitals participated and completed self-report instruments. Changes in participants' functioning were also measured with diagnostic measures completed by the team advocates. The results indicate that the participants' perceptions of physical functioning, physical well-being, control, self-efficacy, and life satisfaction increased. Additionally, health-related behavior changes were reported, and short-term costs were significantly lower than projected costs. Finally, the participants rated their healthcare services in the program as more effective than their previous healthcare services.
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Invited Addresses, Papers, and Poster Presentations at Professional Conferences:

Krause C.M. & Kuhn, M.E.J. (2010, October 23). Better Care? What do the patients think? Presented at the 12th Annual Collaborative Family Healthcare Association Conference, Louisville, Kentucky.

As healthcare costs are escalating, there is also a growing concern regarding how to address the complex issues related to the care of individuals with multiple chronic conditions. These individuals often require specialized, long term and expensive treatments. Furthermore, the number of individuals who are dealing with chronic conditions is expected to increase steadily in the future. An integrated approach is a possible solution to some of the identified problems that exist in the current healthcare system. This presentation reported the patients' views of this integrated care approach, as compared to their views regarding their experiences in traditional healthcare. The patients reported significantly more satisfaction with the integrated healthcare approach, as compared to their level of satisfaction with traditional healthcare services.

Lokken, C., Kuhn, M.E.J., & Krause, C.M. (2010, October 22). The reflections of psychosocial professionals working on multidisciplinary healthcare teams. Presented at the 12th Annual Collaborative Family Healthcare Association Conference, Louisville, Kentucky.

This presentation described the unique expertise that each team member offers to a multidisciplinary team intervention process. In this team process, decisions were made to address the clinical needs of the participants by using a consensus approach. Various unique options of funding multidisciplinary teams to address chronic illnesses were also presented.

Krause, C.M., & Kuhn, M.E.J. (2010, July 29-August 1). Who will care for the caregivers? Presentation at the Batten Disease Support and Research Association 22nd Annual International Family Conference, Oak Brook, IL. Invited keynote presentation.

One of the effects of caring for individuals with multiple, chronic health conditions is that caregivers often become patients themselves. This study examined the perceptions of informal (unpaid) caregivers of children with a terminal genetic disease, informal caregivers of adults with multiple chronic conditions, and adults who are not caregivers. Participants' ratings of their own level of health indicated that the two groups of informal caregivers rated their health significantly lower than adults who were not informal caregivers. Additionally, a positive relationship was found between individuals' ratings of their level of health and their level of personal control over their health issues and their friendships.

Kuhn, M.E.J., Krause, C.M., & Andriopoulos, K. (2010, July 8-10). Critiquing existing alcohol screening forms for a unique population. Poster presented at the Summer Institute on Evidence-Based Practice: University of Texas Health Science Center, San Antonio, Texas.

This project examined the widely used screening forms on alcohol used to determine if any of these forms are “sensitive”(able to correctly identify whether individuals have an alcohol related problem), and also to determine if they are appropriate to use with individuals with multiple health conditions. A comprehensive literature review was conducted to assess the quality and reliability of the three most widely used short-form questionnaires on alcohol use. The criteria used in the various screening instruments was applied to data regarding 384 individuals with multiple, chronic conditions (mean= 4.7 health conditions, mean= 7 prescribed medications). It was determined that none of these popular short-form instruments are appropriate to use with individuals who have multiple chronic illnesses and are taking prescription medications.

Kuhn, M.E.J. & Krause, C.M. (2007, April 19th). Invited Talk: An interdisciplinary approach to whole-person health in the rural Midwest. Presentation at the 18th Annual Rural Health Hospital Association Conference, Effingham, Illinois.

This interactive session describes an intervention process that addresses the health issues of people living in rural Midwestern areas. This session described the process used to identify people dealing with chronic conditions, and explained a comprehensive assessment process to determine appropriate treatment.

Krause, C.M., Kuhn, M.E.J., & Jones, C. S. (2006, November 17th). Multiple chronic health conditions and trauma: Is there a connection? Paper presented at the 2006 National Rural Women’s Health Conference, San Antonio, Texas.

Prior to conducting this study a literature review was conducted to examine the effects of trauma on individuals. Previously, researchers found that experiences of trauma are related to an increased utilization of healthcare services, depression, substance abuse, psychiatric disorders, and severe social and occupational impairment. In this study 93 participants in a chronic disease intervention program completed a series of three questionnaires. The results indicate that 93% of the female participants and 83% of the male participants reported a traumatic event; these percentages of traumatic events are significantly higher than found in the general population (50% to 60%). This difference in traumatic experiences needs to be explored further; research in this area is important as a possible explanation for the life-long health struggles of some individuals.

Krause, C.M., Jones, C.S., & Kuhn, M.E.J. (2005, May 6th). Hope for Individuals with Multiple, Chronic Illnesses: A Medical and Psychological Pathway to Increasing Self-confidence and Life Satisfaction. Poster presented at the 77th Annual Meeting of the Midwestern Psychological Association, Chicago, Illinois.

The purpose of this study was to assess the psychological impact of a multi-discipline integrated treatment approach on the health of individuals dealing with multiple, chronic illnesses. The results indicate that using a collaborative approach for the treatment of individuals with multiple chronic illnesses has a positive impact on their psychological well-being. Participants reported an increase in their confidence in being able to manage their health issues and an increase in their life satisfaction while participating in this intervention program.

Krause, C.M., Kuhn, M.E.J., Jones, C.S., Murphy, L.P., Lucas, D.R., & Joyce, S. (2003, June 29). The Impact of a Multidisciplinary Approach on Improving the Quality of Care, Increasing Access to Care, and Controlling Healthcare Costs for Individuals Dealing With Multiple-Chronic Illnesses. Paper presented at the 20th Annual Research Meeting of the Academy of Health. Nashville, Tennessee.

The purpose of this study was to assess the financial and behavioral outcomes, and level of client satisfaction, for participants in an intervention program (Integrated Health Advocacy Program℠ [IHAP®]). The results indicate that IHAP has a positive financial impact on the short-term costs and projected long-term liabilities (Healthcare Cost and Utilization Project [HCUP-3]—Most Frequent Diagnoses and Procedures DRGs by Insurance Status, 1997) for multiple, chronically ill participants; specifically, the actual healthcare costs for the participants were significantly less than predicted healthcare costs. Furthermore, participants rated their level of satisfaction with the integrated services significantly higher than with traditional healthcare and participants increased their confidence in their ability to decrease their use of emergency healthcare system.

 

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