Care transition of patients with chronic diseases from the discharge of the emergency service to their homes

Acosta, Aline Marques; Lima, Maria Alice Dias da Silva; Pinto, Ione Carvalho; Weber, Luciana Andressa Feil

doi:10.1590/1983-1447.2020.20190155

Brasil

home Sumário navigate_before Anterior Atual Seguinte navigate_next

home Sumário

Original Article • Rev. Gaúcha Enferm. 41 (spe) • 2020 • https://doi.org/10.1590/1983-1447.2020.20190155 linkcopy

Care transition of patients with chronic diseases from the discharge of the emergency service to their homes

Transición del cuidado de pacientes con enfermedades crónicas desde el alta del servicio de emergencia hasta el domicilio

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective: To evaluate the quality of the care transition for patients with chronic non-communicable diseases discharged from the emergency department to home.

Method: A cross-sectional observational and epidemiological study conducted at an emergency department in the South of Brazil with 117 patients and 81 caregivers. The Care Transitions Measure was applied by phone to collect data. A descriptive and analytical statistical analysis was performed.

Results: The quality of the care transition’s total score was close to satisfactory (69.5). The “Self-Management Training” factor had the highest score (70.6), while “Understanding medications” had the lowest (68.3). Items related to understanding medications and confidence in carrying out care after discharge obtained lower scores.

Conclusions: A moderate quality of the care transition was evidenced, as well as the need to adopt strategies to improve the emergency department discharge process and the continuity of the care of patients with chronic diseases.

Keywords: Patient discharge; Continuity of patient care; Chronic disease; Non-communicable diseases; Emergency nursing

CTM-15* Score	Mean ± Standard Deviation	Cronbach’s Alpha
Total	69.5 ± 19.7	0.922
Per factor
Factor 1 -Management Preparation	70.6 ± 23.3	0.918
Factor 2 - Understanding Medications	68.3 ± 22.5	0.647
Factor 3 - Preferences Imported	68.4 ± 22.7	0.787
Factor 4 - Care Plan	68.8 ± 26.9	0.641

Item No.	Factor	CTM-15*	Mean ± Standard Deviation
14	2	Understand how to take medications, including quantity and times.	81.52±21.47
9	1	Understand health care responsibilities.	75.42±24.94
5	1	Understand how to manage health.	73.23±28.23
13	2	Understand medications’ purpose.	73.23±27.48
4	1	Had information needed for self-cafe.	72.25±28.31
6	1	Understand warning signs and symptoms.	71.04±28.35
1	3	Agreed with the health care team on health goals and means.	70.87±24.20
7	4	Had a written care plan.	70.49±27.44
10	1	Confident knew what to do to manage care.	68.87±29.56
12	4	Had a written list of appointments or exams for the next weeks.	68.71±33.27
8	1	Understand what makes the health condition better or worse.	67.86±30.07
2	3	Preferences considered when deciding health needs.	67.34±27.34
3	3	Preferences considered when deciding where health needs are met.	67.01±29.81
11	1	Confident could do what needed to take care of health.	66.16±28.34
15	2	Understand medications’ side effects.	50.09±37.60

Item	Strongly Disagree	Disagree	Agree	Strongly Agree	Don’t know/Not applicable
1	8 (4.0%)	17 (8.6%)	115 (58.1%)	58 (29.3%)	0 (0.0%)
2	12 (6.1%)	28 (14.1%)	101 (51.0%)	56 (28.3%)	1 (0.5%)
3	19 (9.6%)	20 (10.1%)	97 (49.0%)	60 (30.3%)	2 (1.0%)
4	12 (6.1%)	21 (10.6%)	86 (43.4%)	78 (39.4%)	1 (0.5%)
5	11 (5.6%)	22 (11.1%)	82 (41.4%)	83 (41.9%)	0 (0.0%)
6	13 (6.6%)	21 (10.6%)	91 (46.0%)	73 (36.9%)	0 (0.0%)
7	11 (5.6%)	22 (11.1%)	93 (47.0%)	66 (33.3%)	6 (3.0%)
8	17 (8.6%)	25 (12.6%)	88 (44.4%)	66 (33.3%)	2 (1.0%)
9	8 (4.0%)	12 (6.1%)	98 (49.5%)	80 (40.4%)	0 (0.0%)
10	16 (8.1%)	23 (11.6%)	90 (45.5%)	68 (34.3%)	1 (0.5%)
11	12 (6.1%)	36 (18.2%)	91 (46.0%)	57 (28.8%)	2 (1.0%)
12	20 (10.1%)	16 (8.1%)	61 (30.8%)	66 (33.3%)	35 (17.7%)
13	12 (6.1%)	14 (7.1%)	91 (46.0%)	76 (38.4%)	5 (2.5%)
14	4 (2.0%)	4 (2.0%)	87 (43.9%)	98 (49.5%)	5 (2.5%)
15	54 (27.3%)	30 (15.2%)	64 (32.3%)	43 (21.7%)	7 (3.5%)

Variables	Total	Factor 1	Factor 2	Factor 3	Factor 4
Who answered*
Patient	68.0±19.3	68.9±24.3	66.8±20.6	67.2±21.4	68.0±27.2
Caregiver	71.6±20.3	73.0±21.8	70.5±25.0	70.1±24.6	69.9±26.7
p^‡	0.213	0.229	0.271	0.385	0.612
Gender*
Male	70.7±22.6	71.6±25.9	70.6±22.7	68.5±26.0	70.8±28.2
Female	68.4±16.8	69.7±20.9	66.3±22.3	68.4±19.5	66.9±25.8
p^‡	0.417	0.570	0.195	0.976	0.326
Age (years old) ^†	-0.033	-0.052	-0.048	0.082	-0.087
p^§	0.649	0.469	0.508	0.252	0.225
Schooling level ^†	-0.105	-0.111	-0.069	-0.102	0.059
p^\|\|	0.157	0.132	0.360	0.170	0.432
Risk rating ^†	0.078	0.070	0.061	0.019	0.138
p^\|\|	0.277	0.332	0.404	0.789	0.054
Length of stay (days) ^†	0.095	0.098	0.092	0.093	0.032
p^\|\|	0.183	0.168	0.201	0.195	0.653
Shift of discharge*
Morning	63.6±17.5	66.2±19.5	61.3±22.5	63.1±26.6	59.5±27.4
Afternoon	72.0±19.7	72.5±24.2	70.7±21.6	71.6±20.6	73.5±25.3
Evening	67.6±20.5	69.3±23.7	68.2±24.2	64.4±23.7	64.4±28.7
p^¶	0.062	0.324	0.087	0.056	0.010
Day of discharge*
Weekday	69.2±19.8	70.2±23.5	67.8±22.9	68.6±23.2	68.9±25.9
Weekend	70.5±19.4	72.2±22.8	70.5±20.9	67.5±20.8	68.4±31.2
p^¶	0.708	0.639	0.511	0.787	0.925
No. of previous hospital visits ^†	0.147^‡	0.170^‡	0.112	0.089	0.062
p^\|\|	0.039	0.017	0.121	0.214	0.389
Emergency readmission*
Yes	70.7±20.5	72.7±23.1	68.2±24.4	68.9±23.6	70.2±27.8
No	68.9±19.4	69.6±23.4	68.4±21.6	68.2±22.4	68.1±26.6
p^‡	0.543	0.383	0.964	0.845	0.603
Hospital admission after discharge from emergency department*
Yes	74.9±17.2	76.7±18.8	70.4±25.6	74.6±17.4	77.6±19.4^§
No	68.3±20.1	69.3±24.0	67.9±21.9	67.1±23.6	66.9±28.0
p^‡	0.072	0.087	0.564	0.075	0.032

vertical_align_top file_download show_chart

more_horizclose
- image
- translate
- link
- article
- vertical_align_top
- file_download
- show_chart
- image
- translate
- link
- article

location_on

Universidade Federal do Rio Grande do Sul. Escola de Enfermagem Rua São Manoel, 963 -Campus da Saúde , 90.620-110 - Porto Alegre - RS - Brasil, Fone: (55 51) 3308-5242 / Fax: (55 51) 3308-5436 - Porto Alegre - RS - Brazil
E-mail: revista@enf.ufrgs.br

rss_feed Acompanhe os números deste periódico no seu leitor de RSS

Acessibilidade / Reportar erro

[TFN1] Source: Research data, 2015.