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Effects of person-centred care in patients with chronic heart failure: the PCC-HF study

Artikel i vetenskaplig tidskrift
Författare Inger Ekman
Axel Wolf
Lars-Eric Olsson
Charles Taft
Kerstin Dudas
Maria Schaufelberger
Karl Swedberg
Publicerad i European Heart Journal
Volym 33
Nummer/häfte 9
Sidor 1112-1119
ISSN 1522-9645
Publiceringsår 2012
Publicerad vid Centrum för personcentrerad vård vid Göteborgs universitet (GPCC)
Institutionen för vårdvetenskap och hälsa
Institutionen för medicin, avdelningen för molekylär och klinisk medicin
Sidor 1112-1119
Språk en
Länkar dx.doi.org/10.1093/eurheartj/ehr306
Ämnesord Person-centred care, Patient-centred care, Chronic heart failure, Disease management programs, Person-centered medicine, Person-centered care
Ämneskategorier Medicin och Hälsovetenskap, Omvårdnad

Sammanfattning

Aims: Person-centred care (PCC), emphasizes a partnership in care between patients and health care professionals and is advocated by WHO as a key component of quality health care. We evaluated outcomes of PCC in hospitalized patients with chronic heart failure (CHF) with respect to length of hospital stay (LOS), activities of daily living (ADL), health-related quality of life (HRQL) and 6-month readmission rate. Methods and results: During 2008-2010, 248 consecutive patients hospitalized for symptoms of worsening CHF were enrolled in a controlled before and after designed study. A Usual care group (n=123) was recruited according to pre-defined criteria to map usual CHF care and assess outcomes at 5 designated hospital wards. Based on the mapping, a panel of in-house clinicians and researchers developed measures aimed at aligning usual care with basic PCC principles. These measures were incorporated into a study protocol to guide care procedures at the same 5 wards. PCC was then implemented at these wards and evaluated in 125 patients. LOS and 6-month readmission were extracted from patient records. ADL was evaluated at baseline and discharge and HRQL at baseline and after three months. In the analysis of all patients, LOS was reduced by one day (p=0.16) while retaining ADL (p=0.07). When PCC was fully implemented (per protocol analysis), LOS was reduced by 2.5 days (p=0.01) and ADL level better preserved (p=0.04). HRQL and time-to-first readmission did not differ. Conclusions: In this proof-of-concept study, our findings suggest that a fully implemented PCC approach shortens hospital stay and maintains functional performance in patients hospitalized for worsening CHF, without increasing risk for readmission or jeopardizing patients’ HRQL.

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