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Study Evaluating the Effect of Person-centred Care for Patients Admitted for Inpatient Care at an Internal Medicine Unit

29 ottobre 2018 aggiornato da: Göteborg University

Person-centred Inpatient Care - a Quasi-experimental Study Within an Internal Medicine Context

Patients admitted to internal medicine care environments have complex care needs and must be treated as persons with resources and responsibilities. Person-centred care is defined as care in which the caregiver aims to get to know the patient as a person, and the care comprises a holistic approach to assess patients' needs and resources. There is strong motivation for future health care to transform into an approach that acknowledges and endorses every patient's resources, interests and needs. There is limited existing research on the benefit of implementing person-centred care in internal medicine care environments for all patients regardless of diagnosis or care pathway. Little is known about the effects of person-centred inpatient care on patients' satisfaction with care. This study includes adult patients admitted to an internal medicine inpatient unit regardless of reason for admission. The aim of the study is to evaluate effects of person-centred inpatient care on care processes, in terms of satisfaction with care and person-centred content in medical records and to evaluate effects on self-reported health and self-efficacy.

Panoramica dello studio

Stato

Completato

Condizioni

Intervento / Trattamento

Tipo di studio

Interventistico

Iscrizione (Effettivo)

177

Fase

  • Non applicabile

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Luoghi di studio

  • Svezia
      • Gothenburg, Svezia, 41345
        • Department of Medicine, Sahlgrenska University Hospital

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

18 anni e precedenti (Adulto, Adulto più anziano)

Accetta volontari sani

No

Sessi ammissibili allo studio

Tutto

Descrizione

Inclusion Criteria:

  • acute or elective admission with a minimum projected in-hospital stay of 24 hours
  • age ≥ 18 years
  • conscious and alert, with no delay in response.

Exclusion Criteria:

  • cognitive impairment or a judgment by the caregivers that inclusion was not in the best interests of the patient (e.g. end of life care, impaired psychological wellbeing).

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Ricerca sui servizi sanitari
  • Assegnazione: N / A
  • Modello interventistico: Assegnazione di gruppo singolo
  • Mascheramento: Nessuno (etichetta aperta)

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Sperimentale: Person-centred inpatient care
Altro: Person-centred inpatient care

The intervention comprises three sequential steps in the care process. The first two steps follow one after the other in conjunction with admission to the ward: 1) person-centred assessment, and 2) creation of a person-centred health plan. Persistent person-centred inpatient care, the third step, is practiced throughout the hospital stay, and is a component of the quality and patient safety program.

The model is systematically applied to all patients admitted to the unit. All staff are trained in PCC before implementation of the intervention.

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Satisfaction with care comprise patients' evaluations of caregivers' identity-oriented approach and the sociocultural atmosphere at the ward.
Lasso di tempo: From date of admission until the date of discharge, up to 60 days of hospitalization.
The outcome is assessed with the questionnaire Quality from the Patient Perspective. The questionnaire comprises four dimension of with two dimensions is used: Identity-oriented approach (13 items) and the sociocultural atmosphere (5 items). One item from the medical competence subscale (effective pain relief) and one additional item on provision of information about medications is also used. Two kinds of assessments are being made at each item: whether things were being done (perceived reality) and whether the right things were being done (subjective significance). For the primary outcome only the assessments of perceived reality are being used. Items are rated on a four-point response scale ranging from 1 (do not agree at all) to 4 (completely agree). Each item also has a response option of "not applicable". Subscales can be reported item by item or combined in a subscale score (average of all responses within the subscale).
From date of admission until the date of discharge, up to 60 days of hospitalization.
Person-centred content in medical records
Lasso di tempo: From date of admission until the date of discharge, up to 60 days of hospitalization.
Degree of person-centredness in medical records
From date of admission until the date of discharge, up to 60 days of hospitalization.

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Self-reported health assessed with EQ-5D-5L
Lasso di tempo: at the date of discharge, an average of 5 days after inclusion
Self-reported health is measured with the EuroQual-5Dimensions-5Levels questionnaire (EQ- 5D- 5L). The questionnaire comprises 1 item per dimension. The dimensions of importance for health which are included are; mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Patients rate each item on a scale ranging from 1 (no problems) to 5 (extreme problems/unable to). A unique health state is defined by combining 1 level from each of the 5 dimensions. The questionnaire also includes EQ-VAS, in which the patients grade their current health status on an analogue scale from 0 (worst health) to 100 (best health).
at the date of discharge, an average of 5 days after inclusion
Physical and psychological wellbeing assessed with the Quality from the Patient Perspective questionnaire
Lasso di tempo: at the date of discharge, an average of 5 days after inclusion
Patients rated their physical and psychological wellbeing on two separate five-point Likert scales ranging from "very good" (5) to "very bad" (1). These two items are included in the Quality from the Patient Perspective questionnaire as two separate questions.
at the date of discharge, an average of 5 days after inclusion
Level of general self-efficacy assessed with the General Self-Efficacy scale
Lasso di tempo: at the date of discharge, an average of 5 days after inclusion
General self-efficacy measures confidence in one's ability to handle difficult challenges in life. It includes 10 items, which are rated on a four- point Likert scale giving a summary score of 40 for the total scale (10-40).
at the date of discharge, an average of 5 days after inclusion
Quality of care measured with ratings of Medical-technical competence and physical conditions at the ward assessed with the questionnaire Quality from the Patient Perspective.
Lasso di tempo: From date of admission until the date of discharge, up to 60 days of hospitalization.
The questionnaire comprises four dimension of with the two rational dimensions was used for this specific aim: medical- technical competence (4 items) and physical-technical condition (3 items). Two kinds of assessments are being made at each item: whether things were being done (perceived reality) and whether the right things were being done (subjective significance). For this secondary outcome the assessments of perceived reality is being used. A four-point response scale ranging from 1 (do not agree at all) to 4 (completely agree) forms the basis of ratings, each item also had a response option of "not applicable". Subscales can be reported item by item or combined in a subscale score (average of all responses within the subscale).
From date of admission until the date of discharge, up to 60 days of hospitalization.
Clinical observations of pulse rate
Lasso di tempo: From date of admission until the date of discharge, up to 60 days of hospitalization.
Frequency of documented pulse rate during hospitalization. The medical records are reviewed retrospectively.
From date of admission until the date of discharge, up to 60 days of hospitalization.
Quality of care assessed as documented information in medical records on current medication at a daily basis and at discharge
Lasso di tempo: From date of admission until the date of the discharge, up to 60 days of hospitalization.
All information in the medical records during hospitalization are reviewed retrospectively. Rating is made regarding the presence (yes or no) of information on current medication at a daily basis and at discharge.
From date of admission until the date of the discharge, up to 60 days of hospitalization.
Quality of care assessed as documented information in medical records on planned medical care at discharge.
Lasso di tempo: From date of admission until the date of discharge, up to 60 days of hospitalization.
All information in the medical records during hospitalization are reviewed retrospectively. Rating is made regarding the presence (yes or no) of information on planned medical care at discharge.
From date of admission until the date of discharge, up to 60 days of hospitalization.
Clinical observations of weight
Lasso di tempo: From date of admission until date of discharge, up to 60 days of hospitalization.
Frequency of documented clinical observations of weight (kg) during hospitalization. The medical records are reviewed retrospectively.
From date of admission until date of discharge, up to 60 days of hospitalization.
Clinical observations of blood pressure
Lasso di tempo: From date of admission until the date of discharge, up to 60 days of hospitalization.
Frequency of documented clinical observations of systolic and diastolic blood pressure during hospitalization. The medical records are reviewed retrospectively.
From date of admission until the date of discharge, up to 60 days of hospitalization.
Clinical observations of respiratory rate
Lasso di tempo: From date of admission until the date of discharge, up to 60 days of hospitalization.
Frequency of documented clinical observations of respiratory rate during hospitalization. The medical records are reviewed retrospectively.
From date of admission until the date of discharge, up to 60 days of hospitalization.
Body temperature
Lasso di tempo: From date of admission until the date of discharge, up to 60 days of hospitalization.
Frequency of documented clinical observations of body temperature (degrees celsius) during hospitalization. The medical records are reviewed retrospectively.
From date of admission until the date of discharge, up to 60 days of hospitalization.

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Göteborg University

Investigatori

  • Investigatore principale: Eva Jakobsson Ung, Associate professor, Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden and Institute of Health and Care Sciences, Sahlgrenska Academy at the University of Gothenburg

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Effettivo)

9 novembre 2015

Completamento primario (Effettivo)

30 giugno 2016

Completamento dello studio (Effettivo)

30 giugno 2016

Date di iscrizione allo studio

Primo inviato

16 ottobre 2018

Primo inviato che soddisfa i criteri di controllo qualità

29 ottobre 2018

Primo Inserito (Effettivo)

31 ottobre 2018

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

31 ottobre 2018

Ultimo aggiornamento inviato che soddisfa i criteri QC

29 ottobre 2018

Ultimo verificato

1 ottobre 2018

Maggiori informazioni

Termini relativi a questo studio

Parole chiave

Termini MeSH pertinenti aggiuntivi

Altri numeri di identificazione dello studio

  • Person-centred care

Piano per i dati dei singoli partecipanti (IPD)

Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?

NO

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

No

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .

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