Study Evaluating the Effect of Person-centred Care for Patients Admitted for Inpatient Care at an Internal Medicine Unit
2018년 10월 29일 업데이트: 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.
연구 개요
연구 유형
중재적
등록 (실제)
177
단계
- 해당 없음
연락처 및 위치
이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.
연구 장소
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Gothenburg, 스웨덴, 41345
- Department of Medicine, Sahlgrenska University Hospital
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참여기준
연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.
자격 기준
공부할 수 있는 나이
18년 이상 (성인, 고령자)
건강한 자원 봉사자를 받아들입니다
아니
연구 대상 성별
모두
설명
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).
공부 계획
이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 건강 서비스 연구
- 할당: 해당 없음
- 중재 모델: 단일 그룹 할당
- 마스킹: 없음(오픈 라벨)
무기와 개입
참가자 그룹 / 팔 |
개입 / 치료 |
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실험적: Person-centred inpatient care
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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. |
연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
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Satisfaction with care comprise patients' evaluations of caregivers' identity-oriented approach and the sociocultural atmosphere at the ward.
기간: From date of admission until the date of discharge, up to 60 days of hospitalization.
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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).
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From date of admission until the date of discharge, up to 60 days of hospitalization.
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Person-centred content in medical records
기간: From date of admission until the date of discharge, up to 60 days of hospitalization.
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Degree of person-centredness in medical records
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From date of admission until the date of discharge, up to 60 days of hospitalization.
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2차 결과 측정
결과 측정 |
측정값 설명 |
기간 |
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Self-reported health assessed with EQ-5D-5L
기간: at the date of discharge, an average of 5 days after inclusion
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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).
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at the date of discharge, an average of 5 days after inclusion
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Physical and psychological wellbeing assessed with the Quality from the Patient Perspective questionnaire
기간: at the date of discharge, an average of 5 days after inclusion
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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.
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at the date of discharge, an average of 5 days after inclusion
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Level of general self-efficacy assessed with the General Self-Efficacy scale
기간: at the date of discharge, an average of 5 days after inclusion
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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).
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at the date of discharge, an average of 5 days after inclusion
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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.
기간: From date of admission until the date of discharge, up to 60 days of hospitalization.
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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).
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From date of admission until the date of discharge, up to 60 days of hospitalization.
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Clinical observations of pulse rate
기간: From date of admission until the date of discharge, up to 60 days of hospitalization.
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Frequency of documented pulse rate during hospitalization.
The medical records are reviewed retrospectively.
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From date of admission until the date of discharge, up to 60 days of hospitalization.
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Quality of care assessed as documented information in medical records on current medication at a daily basis and at discharge
기간: From date of admission until the date of the discharge, up to 60 days of hospitalization.
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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.
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From date of admission until the date of the discharge, up to 60 days of hospitalization.
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Quality of care assessed as documented information in medical records on planned medical care at discharge.
기간: From date of admission until the date of discharge, up to 60 days of hospitalization.
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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.
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From date of admission until the date of discharge, up to 60 days of hospitalization.
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Clinical observations of weight
기간: From date of admission until date of discharge, up to 60 days of hospitalization.
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Frequency of documented clinical observations of weight (kg) during hospitalization.
The medical records are reviewed retrospectively.
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From date of admission until date of discharge, up to 60 days of hospitalization.
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Clinical observations of blood pressure
기간: From date of admission until the date of discharge, up to 60 days of hospitalization.
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Frequency of documented clinical observations of systolic and diastolic blood pressure during hospitalization.
The medical records are reviewed retrospectively.
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From date of admission until the date of discharge, up to 60 days of hospitalization.
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Clinical observations of respiratory rate
기간: From date of admission until the date of discharge, up to 60 days of hospitalization.
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Frequency of documented clinical observations of respiratory rate during hospitalization.
The medical records are reviewed retrospectively.
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From date of admission until the date of discharge, up to 60 days of hospitalization.
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Body temperature
기간: From date of admission until the date of discharge, up to 60 days of hospitalization.
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Frequency of documented clinical observations of body temperature (degrees celsius) during hospitalization.
The medical records are reviewed retrospectively.
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From date of admission until the date of discharge, up to 60 days of hospitalization.
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공동 작업자 및 조사자
여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.
수사관
- 수석 연구원: 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
연구 기록 날짜
이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.
연구 주요 날짜
연구 시작 (실제)
2015년 11월 9일
기본 완료 (실제)
2016년 6월 30일
연구 완료 (실제)
2016년 6월 30일
연구 등록 날짜
최초 제출
2018년 10월 16일
QC 기준을 충족하는 최초 제출
2018년 10월 29일
처음 게시됨 (실제)
2018년 10월 31일
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
2018년 10월 31일
QC 기준을 충족하는 마지막 업데이트 제출
2018년 10월 29일
마지막으로 확인됨
2018년 10월 1일
추가 정보
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