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Health status and most distressing concerns at admission and discharge reported by patients cared for at an internal medical care ward

Journal article
Authors Sofie Jakobsson
Eva Jakobsson Ung
Marie Lindström
Björn Eliasson
Gisela Ringström
Published in Scandinavian Journal of Caring Sciences
Volume 32
Issue 3
Pages 1168-1178
ISSN 0283-9318
Publication year 2018
Published at University of Gothenburg Centre for person-centred care (GPCC)
Institute of Medicine, Department of Internal Medicine and Clinical Nutrition
Institute of Health and Care Sciences
Institute of Medicine, Department of Molecular and Clinical Medicine
Pages 1168-1178
Language en
Links dx.doi.org/10.1111/scs.12562
Keywords inpatient care, self-reported health, symptoms, distressing concerns, internal medicine, chronic heart-failure, person-centered care, point prevalence survey, self-rated health, hospitalized-patients, mortality, symptoms, adults, Nursing
Subject categories Clinical Medicine

Abstract

BackgroundTo promote patients' ability to regain health during hospitalisation, care should not only focus on disease but also on how patients perceive health. There is a lack of studies on how patients admitted for inpatients care perceive their health. AimTo investigate self-reported health at admission and discharge perceived by patients admitted to an internal medicine ward; and, further, to explore the most distressing concerns at admission and discharge and the factors that influence low health status at discharge. Designs and methodsOne hundred and forty-seven patients completed EQ-5D and an open-ended question What concerns distress you the most?' at admission and discharge. Descriptive, parametric and nonparametric analyses were used. Subset analyses were performed between three groups based on health change. Factors influencing low health status at discharge were tested in a logistic regression. To analyse most distressing concerns, an inductive content analysis was performed. ResultsThere was a significant increase in self-rated health for patients with gastrointestinal disorders. At discharge, 50% was identified with improved and 30% with unaltered health. Twenty per cent reported a significant deterioration of health and had the highest frequency of severe problems in all EQ-5D dimensions. Several patients left hospital with distressing symptoms, uncertainty and concerns that had persisted throughout their hospitalisation. Vulnerable patients were characterised by an acute admission, unemployment and longer hospitalisation. Low EQ VAS at admission predicted poor health at discharge. ConclusionsMany patients had low health status at admission. For some, this did not improve during hospital stay, and for some, it got worse. Our findings highlight a group, whose care can be improved, through information, support and follow-up routines within and outside the hospital. Identifying these patients, efforts to better support patients in their self-care, including relief of pain and worries, at discharge can be established.

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