What Role Can Trained Volunteers Add to Chronic Disease Care of Immigrants?
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ORIGINAL PAPER
What Role Can Trained Volunteers Add to Chronic Disease Care of Immigrants? Ellen Rosenberg1,2 · Tamara Carver1 · Nina Mamishi1 · Gillian Bartlett1 Accepted: 5 September 2020 © The Author(s) 2020
Abstract To help primary care teams improve patient-centered care, we elicited health and life goals of immigrants with a chronic disease. We conducted an exploratory study of the (1) acceptability of home visits by volunteers to collect health information and (2) content of health and life goals within a primary care program for immigrants with chronic disease. Pairs of trained community volunteers visited 23 patients in their homes and asked them to identify three life goals and three health goals. We conducted content analyses of written notes. Health goals were related to disease prevention and symptom control, family well-being, own quality of life, own or family members’ work and/or financial situation. Life goals concerned family well-being, their own quality of life, work/financial situation and health. Given the limited time health professionals have with their patients, trained community volunteers could be important members of primary care teams caring for immigrants. Keywords Health goals · Immigrants · Life goals · Volunteers
Background Chronic diseases are one of the most important health care issues affecting Canadians today [1]. To improve the health of people with chronic diseases, professionals have developed disease care guidelines that include treatment goals. Setting goals with patients can improve goal attainment in areas including physical activity, stress management [2, 3], well-being [4], and meeting of targets for chronic conditions, e.g. blood glucose, blood pressure and asthma control [5]. Goals of care for chronic diseases are traditionally set in terms of disease-specific outcomes such as biomarkers and symptoms chosen by health professionals. Both life and health goals, however, are important to patients [6]. For example, the reported goals of patients with low back pain were idiosyncratic to the individual and not necessarily aligned with standard clinical outcome measures [7]. The literature, however, provides evidence of the importance of the integration of life goals into treatment plans. Two studies
* Ellen Rosenberg [email protected] 1
Department of Family Medicine, McGill University, Montreal, QC, Canada
Westmount, Canada
2
found that, to be successful in heart failure care, one needed to address patient priority goals first, whether or not they were related to the disease [8, 9]. The potential impact of both health and life goal setting is particularly relevant for immigrants. Many migrant groups of non-Caucasian origins have higher prevalence of Type 2 diabetes mellitus (DM) and cardiovascular disease (CVD) than the host populations in the United Kingdom, Europe, Canada, United States and Singapore [10–12], and lower than average rates of disease control [10, 13]. In addition, migrants have important life goals in their new country such as educ
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