Nursing workload predictors in Catalonia (Spain): a home care cohort study

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• 作者：Joan Gené ; Badia^a ; ^b ; ^c ; ^d ; ^{jgene@clinic.ub.es} ; Al&#237 ; cia Borrà ; s Santos^d ; Joan Carles Contel Segura^b ; Ma Dolors Camprub&#237 ; Casellas^b ; Francisco Cegri Lombardo^b ; Antonio Heras Tebar^b ; Ramó ; n Noguera Rodr&#237 ; guez^e ; Susana Gonzá ; lez Mart&#237 ; nez^f ; Anna Oliver Olius^g ; Martiñ ; o Piñ ; eiro Gonzá ; lez^c ; Teresa Montanuy Baró ; ^b ; Esther Limó ; n Ram&#237 ; rez^b ; Antonio Aranzana Mart&#237 ; nez^b ; Roser Pedret Llaberia^b ; Manuel Borrell Muñ ; oz^h ; Antonio Hidalgo Garc&#237 ; a^d
• 关键词：Nursing workload ; Home care ; Elderly ; Primary care
• 刊名：Gaceta Sanitaria
• 出版年：2011
• 期刊代码：pca166_02139111
• 类别：med
• 出版时间：July-August 2011
• 卷：25
• 期：4
• 页码：308-313
• 文件大小：99 K

摘要

ass="h4">Objective

To identify the characteristics of chronic patients and their environment in order to predict the nursing workload required 1 year after their inclusion in a home care program.

ass="h4">Methods

A longitudinal study was carried out in 72 primary health care teams in Catalonia (Spain) with a 1-year follow-up of 1,068 home care patients over 64 years old. The variables collected from each patient included data on health and social status (Charlson and Barthel indexes and the Pfeiffer, Braden and Gijon scales), carer overburden (Zarit scale), hospital admissions, use of emergency services, self-perceived health (SF-12) and the number of health worker visits.

ass="h4">Results

Patients received 7.2 (SD 10.4) visits per year from their nurse-in-charge, out of a total of 8.7 (SD 13.1) nursing visits per year. Risk factors for receiving more nursing visits at home were male gender (IRR = 1.42, 95%CI: 1.20-1.67), dependency for daily activities (IRR = 1.65, 95%CI: 1.29-2.13), decubitus ulcers (IRR = 4.03, 95%CI: 2.27-7.14) and receiving emergency medical care at home (IRR = 1.65, 95%CI: 1.31-2.07). In contrast, patients with major cognitive impairment (IRR = 0.78, 95%CI: 0.63-0.98) had a lower probability of receiving nursing visits at home.

ass="h4">Conclusions

Workload can be predicted by patients鈥?clinical characteristics. The positive correlation of workload with variables related to disease severity and the negative correlation with variables related to cognitive impairment show that home care nursing in Catalonia is basically demand-oriented.