Outcome Evaluation of an Interdisciplinary Care Model for Children with Cystic Fibrosis
Review TypeNone: Degree-based Submission
Review StatusNot Applicable (See Review Type)
Repository Posting Date2019-05-06T19:27:38Z
Author(s)Pawlak, Roberta P.
Author DetailsRoberta P. Pawlak, PhD, RN, NEA-BC
Lead Author Sigma AffliationBeta Eta at-Large
Level of EvidenceOther
Research ApproachQuantitative Research
KeywordsChildren with Cystic Fibrosis; Cross-discipline Communication; Interdisciplinary Care Model
CINAHL HeadingsCystic Fibrosis -- Therapy; Multidisciplinary Care Team; Practice Guidelines; Cystic Fibrosis
Cystic Fibrosis (CF) is a life-limiting, autosomal recessive inherited disease that affects approximately 30,000 individuals in the United States. Health problems of children with CF tend to be complex, requiring specialty health services. Often children with CF are cared for in CF Care Centers, where an interdisciplinary care team addresses these needs. The Cystic Fibrosis Foundation (CFF) recommends specific Clinical Practice Guidelines be applied to all patients with CF. A major gap in the CF literature is evidence of guideline application results on health outcomes. The purpose of this study was to examine the influence of an interdisciplinary care model and CFF Care Guideline application on clinical outcomes for children with CF. The theoretical foundation for this research was The Chronic Care Model (Wagener, 2001) which is an organizing framework for improving chronic illness care. The model is based on the assumption that quality care requires an approach that takes into account patient, provider and system level interventions. This was a longitudinal cohort study using applied program evaluation methods. A secondary analysis was done of a subset of the Cystic Fibrosis Foundation (CFF) Patient Registry data for YRs 2006 and 2007 (children ages 6-17). Cases were matched by unique patient ID between years. Descriptive, exploratory and multiple regression modeling were done to identify influences on the clinical outcomes of Forced Expiratory Volume percent predicted (FEV 1 % predicted) and Body Mass Index (BMI). Predictors (application of Annual Care Guidelines and distinct discipline contacts) from YR 2006 were compared to clinical outcomes from YR 2007 on matched cases. Sample size n= 5726. The results showed that identified subjects who were most likely to receive annual care guidelines, and those most likely to receive more distinct discipline contacts, showed poorer clinical outcomes, even when controlling for acuity. Recommendations for future studies include investigating evidence for CFF Consensus Guidelines, as well as patient acuity measures on clinical outcomes. Further, interdisciplinary care processes need to be studied to examine the full impact of this care model.
DescriptionThis dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 3501178; ProQuest document ID: 929136526. The author still retains copyright.
Advisor(s)Murray, Mary Ellen
Degree GrantorThe University of Wisconsin - Madison
NotesThis item has not gone through this repository's peer-review process, but has been accepted by the indicated university or college in partial fulfillment of the requirements for the specified degree.
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