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Dependency, subjective health and care experience among patients hospitalised in internal medicine

Authors Axel Wolf
Lars-Eric Olsson
Karl Swedberg
Inger Ekman
Published in European Journal of Cardiovascular Nursing
Volume 10
Pages S22
Publication year 2011
Published at University of Gothenburg Centre for person-centred care (GPCC)
Institute of Medicine, Department of Emergeny and Cardiovascular Medicine
Institute of Health and Care Sciences
Pages S22
Language en
Subject categories Nursing


Dependency, subjective health and care experience among patients hospitalised in internal medicine A. Wolf1, L.E. Olsson1, K. Swedberg2, I. Ekman1 1University of Gothenburg, The Sahlgrenska Academy, Institute of Health and Care Sciences, Gothenburg, Sweden; 2Sahlgrenska University Hospital/Ostra, Institute of Medicine/Dpt Emergency & Cardiovascular Medicine, Gothenburg, Sweden Background: Hospitalised frailed patients are at risk of a downward trajectory in their physical state and general health status. Limited information is available about how subjective health and physical status impact on patients’ care experience with a potential impact on hospital readmission. Objectives: Explore whether subjective health and physical dependence affect the care experiences of patients, and analyse how patients report communication during their hospitalisation. Design: A Swedish adapted version of The Picker Institute “In patient” survey was used. Instrument items relate to how the patient perceives specific areas of care rather than general satisfaction with care. The study population was divided into two groups: frail-dependent and non-frail and independent, analysing how self-rated health and physical dependency impacts the care satisfaction. Setting: Patients discharged from internal, medicine wards at six regional and university hospitals in different parts of Sweden during the period 2008–2009. Results: The survey was sent to 6,034 patients and 3,813 patients responded (63.2%). Good, self-rated health and physical independence were significant predictors of a more positive care experience in areas important for decreasing the frequency of hospital readmission. Of the frail patients with low self-rated health and high physical dependence, 35% reported acceptable participation in decision making compared with 64% in the non-frail group (good health and independence) (p ≤ 0.05). Conclusion: Our findings indicate a care paradox: conventional care delivered by healthcare professionals in Swedish internal medicine wards provides communication and patient participation that to an higher extend acknowledge the need and resources of the non-frail patients (i.e. those in good health), resulting in a care which does not correspond enough to the well-being of frail patients.

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