#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Discharge care quality in hospitalised elderly patients: Extended validation of the Discharge Care Experiences Survey


Autoři: Ranveig Marie Boge aff001;  Arvid Steinar Haugen aff003;  Roy Miodini Nilsen aff004;  Frøydis Bruvik aff006;  Stig Harthug aff001
Působiště autorů: Department of Clinical Sciences, University of Bergen, Bergen, Norway aff001;  Department of Medicine, Haukeland University Hospital, Bergen, Norway aff002;  Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway aff003;  Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway aff004;  Department of Research and Development, Haukeland University Hospital, Bergen, Norway aff005;  Haraldsplass Deaconess Hospital, Bergen, Norway aff006;  Department of Global Public Health and Primary Care, Bergen, Norway aff007
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0223150

Souhrn

Background

The Discharge Care Experiences Survey (DICARES) was previously developed to measure quality of discharge care in elderly patients (≥ 65 years). The objective of this study was to test the factorial validity of responses of the DICARES, and to investigate its association with existing quality indicators.

Methods

We conducted a cross-sectional study at two hospitals in Bergen, Western Norway. A survey, including DICARES, was sent by postal mail to 1,418 patients 30 days after discharge from hospital. To test the previously identified three-factor structure of the DICARES we applied a first order confirmatory factor analysis with corresponding fit indices and reliability measures. Spearman’s correlation coefficients, and linear regression, was used to investigate the association of DICARES scores with the quality indicators Nordic Patient Experiences Questionnaire and emergency readmission within 30 days.

Results

A total of 493 (35%) patients completed the survey. The mean age of the respondents was 79 years (SD = 8) and 52% were women. The confirmatory factor analysis showed acceptable fit. Cronbach’s α between items within factors was 0.82 (Coping after discharge), 0.71 (Adherence to treatment), and 0.66 (Participation in discharge planning). DICARES was moderately correlated with the Nordic Patient Experiences Questionnaire (rho = 0.49, P < 0.001). DICARES overall score was higher in patients with no readmissions compared to those who were emergency readmitted within 30 days (P < 0.001), indicating that more positive experiences were associated with fewer readmissions.

Conclusions

DICARES appears to be a feasible instrument for measuring quality of discharge care in elderly patients (≥ 65 years). This brief questionnaire seems to be sensitive with regard to readmission, and independent of comorbidity. Further studies of patients’ experiences are warranted to identify elements that impact on discharge care in other patient groups.

Klíčová slova:

Critical care and emergency medicine – Elderly – Factor analysis – Geriatric depression – Geriatrics – Hospitals – Patients – Surveys


Zdroje

1. Leez L. The key principles of effective discharge planning. Nurs. Times. 2013; 109(3):18–19. 23431715

2. Fitzgerald Miller J, Piacentine LB, Weiss M. Coping difficulties after hospitalization. Clinical nursing research. 2008. doi: 10.1177/1054773808325226 18927261

3. U.S. Department of Health and Human Services. Readmissions and Adverse Events After Discharge. 2019. [cited September 8 2019]. Avalible from: https://psnet.ahrq.gov/primers/primer/11/Readmissions-and-Adverse-Events-After-Discharge

4. Alper E, O'Malley T. Greenwald J. Hospital discharge and readmission: UpToDate. 2019. [cited September 8 2019]. Avalible from: https://www.uptodate.com/contents/hospital-discharge-and-readmission.

5. Waring J, Marshall F, Bishop S, Sahota O, Walker M, Currie G, et al. An ethnographic study of knowledge sharing across the boundaries between care processes, services and organisations: the contributions to ‘safe’ hospital discharge. HS&DR, No. 2.29. Editor: Queen’s Printer and Controller of HMSO. 2014. [cited 11 August 2019]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK259989/ doi: 10.3310/hsdr02290 25642570

6. Perry W, Lacritz L, Roebuck-Spencer T, Silver C, Denney RL, Meyers J, et al. Population Health Solutions for Assessing Cognitive Impairment in Geriatric Patients. 2018. Innov Aging. 2018. doi: 10.1093/geroni/igy025 30480142

7. Forster AJ, Clark H, Menard A, Dupuis N, Chernish R, Chandok N, Khan A, van Walraven C. Adverse events among medical patients after discharge from hospital. CMAJ. 2004 Feb 3;170(3):345–9. 14757670

8. Wolinsky FD, Bentler SE, Liu L, Obrizan M, Cook EA, Wright KB, et al. Recent hospitalization and the risk of hip fracture among older Americans. J Gerontol A Biol Sci Med Sci. 2009. doi: 10.1093/gerona/gln027 19196641

9. Grimmer K. Experiences of elderly patients regarding independent community living after discharge from hospital: a longitudinal study. Int J Qual Health C. 2004; 16(6):465–72.

10. Albrecht JS, Gruber-Baldini AL, Hirshon JM, Brown CH, Goldberg R, Rosenberg JH, et al. Depressive symptoms and hospital readmission in older adults. J Am Geriatr Soc. 2014. doi: 10.1111/jgs.12686 24512099

11. Laugaland K, Aase K, Barach P. Interventions to improve patient safety in transitional care—a review of the evidence. Work (Reading, Mass). 2012. doi: 10.3233/WOR-2012-0544-2915 22317162

12. Kripalani S, LeFevre F, Phillips CO, Williams MV, Basaviah P, Baker DW. Deficits in communication and information transfer between hospital-based and primary care physicians: implications for patient safety and continuity of care. JAMA. 2007; 297(8):831–41. doi: 10.1001/jama.297.8.831 17327525

13. England UK: National Health Services. Involving people in their own care. 2019. [cited September 8 2019]. Available from: https://www.england.nhs.uk/ourwork/patient-participation/.

14. Frank C, Asp M, Fridlund B, Baigi A. Questionnaire for patient participation in emergency departments: development and psychometric testing. J Adv Nurs. 2011. doi: 10.1111/j.1365-2648.2010.05472.x 21166838

15. Vahdat S, Hamzehgardeshi L, Hessam S, Hamzehgardeshi Z. Patient involvement in health care decision making: a review. Iran Red Crescent Med J. 2014. doi: 10.5812/ircmj.12454 24719703

16. Oikonomou E, Chatburn E, Higham HM, J., Lawton R, Vincent C. Developing a measure to assess the quality of care transitions for older people. BMC Health Serv Res. 2019. [cited September 8 2019]. Available from: https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-019-4306-8

17. Rodrigue N, Laizner AM, Tze N, Sewitch M. Experiences of Older Adult Trauma Patients Discharged Home From a Level I Trauma Center. JTN. 2017. doi: 10.1097/JTN.0000000000000288 28486325

18. Foss C, Hofoss D. Elderly persons' experiences of participation in hospital discharge process. Patient Educ Couns. 2011. doi: 10.1016/j.pec.2010.08.025 20884160

19. Perry MA, Hudson S, Ardis K. "If I didn't have anybody, what would I have done?": Experiences of older adults and their discharge home after lower limb orthopaedic surgery. J Rehabil Med. 2011. doi: 10.2340/16501977-0874 21915586

20. Wressle E, Eriksson L, Fahlander A, Rasmusson IM, Tedemalm U, Tangmark K. Patient perspective on quality of geriatric care and rehabilitation—development and psychometric testing of a questionnaire. Scand. J. Caring Sci. 2006;20(2):135–42. doi: 10.1111/j.1471-6712.2006.00390.x 16756518

21. Kilshaw MF. Implementing an effective quality assurance program. In: Gelman D, editor. Medical Administration in Canadian Hospitals. Chapter F1. Ottawa: Canadian Medical Association; 1992.

22. Donze J, Lipsitz S, Bates DW, Schnipper JL. Causes and patterns of readmissions in patients with common comorbidities: retrospective cohort study. BMJ 2013. doi: 10.1136/bmj.f7171 347:f7171. 24342737

23. Lee EA, Gibbs NE, Fahey L, Whiffen TL. Making hospitals safer for older adults: updating quality metrics by understanding hospital-acquired delirium and its link to falls. The Perm J. 2013;17(4): 32–36. doi: 10.7812/TPP/13-065 24361018

24. Jenkinson C, Coulter A, Bruster S, Richards N, Chandola T. Patients' experiences and satisfaction with health care: results of a questionnaire study of specific aspects of care. Qual Saf Health Care. 2002;11(4):335–9. doi: 10.1136/qhc.11.4.335 12468693

25. Wolf JN, V, Marshburn DL, SL. Defining Patient experience. Patient Exp J. 2014;1(1):7–9.

26. Beattie M, Murphy DJ, Atherton I, Lauder W. Instruments to measure patient experience of healthcare quality in hospitals: a systematic review. Syst Rev. 2015. doi: 10.1186/s13643-015-0089-0 26202326

27. England, UK: Department of Health. High quality care for all: NHS Next Stage Review final report. 2008. [cited September 8 2019]. Available from: https://www.gov.uk/government/publications/high-quality-care-for-all-nhs-next-stage-review-final-report.

28. Doyle C, Lennox L, Bell D. A systematic review of evidence on the links between patient experience and clinical safety and effectiveness. BMJ Open. 2013. doi: 10.1136/bmjopen-2012-001570 23293244

29. Ware J Jr, Sherbourne C: The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Medical care. 1992;30(6):473–83. 1593914

30. Eriksen HR: A scoring system for subjective health complaints (SHC). Scand J Public Health. 1999;27(1):63–72. 10847674

31. Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40(5):373–83. doi: 10.1016/0021-9681(87)90171-8 3558716

32. Hesselink G, Schoonhoven L, Plas M, Wollersheim H, Vernooij-Dassen M. Quality and safety of hospital discharge: a study on experiences and perceptions of patients, relatives and care providers. Int J Qual Health Care. 2013. doi: 10.1093/intqhc/mzs066 23184652

33. Merten H, van Galen LS, Wagner C. Safe Handover. BMJ. 2017. doi: 10.1136/bmj.j4328 28993308

34. Kangovi S, Grande D, Meehan P, Mitra N, Shannon R, Long JA. Perceptions of readmitted patients on the transition from hospital to home. J Hosp Med. 2012. doi: 10.1002/jhm.1966 23212980

35. Coleman EA, Mahoney E, Parry C. Assessing the quality of preparation for posthospital care from the patient's perspective: the care transitions measure. Med Care. 2005 Mar;43(3):246–55. doi: 10.1097/00005650-200503000-00007 15725981

36. Boge RM, Haugen AS, Nilsen RM, Harthug S. Elderly patients' (≥65 years) experiences associated with discharge; Development, validity and reliability of the Discharge Care Experiences Survey. PLoS One. 2018. doi: 10.1371/journal.pone.0206904 30403738

37. Aronson JK. Compliance, concordance, adherence. Br J Clin Pharmacol. 2007. doi: 10.1111/j.1365-2125.2007.02893.x 17378797

38. Oltedal S, Garratt A, Bjertnaes O, Bjornsdottir M, Freil M, Sachs M. The NORPEQ patient experiences questionnaire: data quality, internal consistency and validity following a Norwegian inpatient survey. Scand J Public Health. 2007.

39. Skudal KE, Garratt AM, Eriksson B, Leinonen T, Simonsen J, Bjertnaes OA. The Nordic Patient Experiences Questionnaire (NORPEQ): cross-national comparison of data quality, internal consistency and validity in four Nordic countries. BMJ Open. 2012. doi: 10.1136/bmjopen-2012-000864 22649175

40. Likert RA Technique for the Measurement of Attitudes. Archives of Psychology. 1932;140:1–55. doi: 10.1080/14034940701291724

41. Fischer C, Lingsma HF, Marang-van de Mheen PJ, Kringos DS, Klazinga NS, Steyerber EW. Is the Readmission Rate a Valid Quality Indicator? A Review of the Evidence. PLoS One. 2014. doi: 10.1371/journal.pone.0112282 25379675

42. World Health Organization (WHO). International Statistical Classification of Diseases and Related Health Problems 10th Revision 2016. [cited September 8 2019]. Available from: http://www.who.int/classifications/icd/en/.

43. Siddiqui OI. Methods for Computing Missing Item Response in Psychometric Scale Construction. Am J Biostat, 2015. doi: 10.3844/amjbsp.2015.1.6

44. Byrne B. Structural Equation Modelling with Amos. New York: Taylor & Francis Group, LLC; 2010.

45. Kline RB. Principles and practice of structural equation modelling. New York: Guilford Press; 1998.

46. Schreiber JB, Nora A, Stage F, Barlow E, King J. Reporting Structural Equation Modelling and Confirmatory Factor Analysis; A review. J. Educ. Res. 2006;99(06):333–337.

47. Cohen J, Cohen P., West S. G., & Aiken LS. Applied multiple regression/correlation analysis for the behavioural sciences. Mahwah, New Jersey; Lawrence Erlbaum Associates; 2003.

48. Smirnova A, Lombarts K, Arah OA, van der Vleuten CPM. Closing the patient experience chasm: A two-level validation of the Consumer Quality Index Inpatient Hospital Care. Health Expect. 2017. doi: 10.1111/hex.12545 28218984

49. Gjestsen MT, Bronnick K, Testad I. Characteristics and predictors for hospitalizations of home-dwelling older persons receiving community care: a cohort study from Norway. BMC Geriatr. 2018. doi: 10.1186/s12877-018-0887-z 30176794

50. Bezold C. The future of patient-centered care: scenarios, visions, and audacious goals. J Altern Complement Med. 2005. Available from: https://doi.org/10.1089/acm.2005.11.s-77

51. Aligning Forces for Quality. Good for health good for business. The case for measuring patient experience of care. 2015. [cited September 8 2019]. Available from: http://forces4quality.org/.

52. Tsang S, Royse CF, Terkawi AS. Guidelines for developing, translating, and validating a questionnaire in perioperative and pain medicine. Saudi J Anaesth. 2017. doi: 10.4103/sja.SJA_203_1711 28616007

53. Manary MP, Boulding W, Staelin R, Glickman SW. The patient experience and health outcomes. N Engl J Med. 2013. doi: 10.1177/1062860614539994

54. World Health Organization. Adherence to long-term therapies: Evidence for action. 2003. [cited September 8 2019]. Available from: http://www.who.int/chp/knowledge/publications/adherence_report/en/.

55. England, UK: National Health Services. Supporting Self-mangement/self care. 2018. [cited September 8 2019]. Available from: https://www.england.nhs.uk/ourwork/patient-participation/self-care/.

56. Felix HC, Seaberg B, Bursac Z, Thostenson J, Stewart MK. Why do patients keep coming back? Results of a readmitted patient survey. Soc Work Health Care. 2015. doi: 10.1080/00981389.2014.966881 25588093

57. Mulhem E, Lick D, Varughese J, Barton E, Ripley T, Haveman J. Adherence to medications after hospital discharge in the elderly. Int J Family Med. 2013. doi: 10.1155/2013/901845 23589775

58. Musich S, Wang SS, Hawkins K, Yeh CS. Homebound older adults: Prevalence, characteristics, health care utilization and quality of care. Geriatr Nurs. 2015. doi: 10.1016/j.gerinurse.2015.06.013 26254815

59. Rustad EC, Furnes B, Cronfalk BS, Dysvik E. Older patients' experiences during care transition. Patient preference and adherence. 2016. doi: 10.2147/ppa.s97570 27274204

60. Hvalvik S, Dale B. The Transition from Hospital to Home: Older People’s Experiences. Open J Nurs. 2015. Available from; http://dx.doi.org/10.4236/ojn.2015.57066.

61. Bell SP, Vasilevskis EE, Saraf AA, Jacobsen JM, Kripalani S, Mixon AS, et al. Geriatric Syndromes in Hospitalized Older Adults Discharged to Skilled Nursing Facilities. J Am Geriatr Soc. 2016. doi: 10.1111/jgs.14035 27059831

62. Loewenthal KM. An introduction to psychological tests and scales. 2nd ed. New York: Psychology Press Ltd; 2001.

63. Hardy SE, Allore H, Studenski SA: Missing data: a special challenge in aging research. J Am Geriatr Soc. 2009. doi: 10.1111/j.1532-5415.2008.02168


Článek vyšel v časopise

PLOS One


2019 Číslo 9
Nejčtenější tento týden
Nejčtenější v tomto čísle
Kurzy

Zvyšte si kvalifikaci online z pohodlí domova

plice
INSIGHTS from European Respiratory Congress
nový kurz

Současné pohledy na riziko v parodontologii
Autoři: MUDr. Ladislav Korábek, CSc., MBA

Svět praktické medicíny 3/2024 (znalostní test z časopisu)

Kardiologické projevy hypereozinofilií
Autoři: prof. MUDr. Petr Němec, Ph.D.

Střevní příprava před kolonoskopií
Autoři: MUDr. Klára Kmochová, Ph.D.

Všechny kurzy
Kurzy Podcasty Doporučená témata Časopisy
Přihlášení
Zapomenuté heslo

Zadejte e-mailovou adresu, se kterou jste vytvářel(a) účet, budou Vám na ni zaslány informace k nastavení nového hesla.

Přihlášení

Nemáte účet?  Registrujte se

#ADS_BOTTOM_SCRIPTS#