The Effects of a Health-social Partnership Program for Discharged Non-frail Older Adults
- Conditions
- Partner CommunicationTransition
- Interventions
- Other: Usual careOther: Complex interventions
- Registration Number
- NCT04434742
- Lead Sponsor
- The Hong Kong Polytechnic University
- Brief Summary
Previous studies supporting discharged patients are hospital-based which admission criteria tend to include mainly those with complex needs and/or specific disease conditions. This study captured the service gap where these non-frail older patients might have no specific medical problem upon discharge but they might encounter residual health and social issues when returning home.
- Detailed Description
Objective: To compare the effect of a community-based health-social partnership program with usual care for discharged community-dwelling non-frail older adults on their health-related quality of life, activities of daily living, depressive symptoms, and use of health services.
Design: A randomized controlled trial. Participants: Discharged community-dwelling non-frail older adults from an emergency medical ward in an intervention (n=37) and a control (n=38) group.
Interventions: Discharged older adults were randomized to receive usual care or complex interventions, including structured assessment, health education, goal empowerment, and care coordination supported by a health-social team.
Main measures: The outcomes were measured at pre-intervention (T1) and at three months post-intervention (T2) using the Medical Outcomes Study 12-item Short Form, the Modified Barthel Index and the Geriatric Depression Scale.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 75
- resided in the service areas of the study hospital,
- were aged 60 or over,
- were cognitively competent with a score greater than 26 in the Montreal Cognitive Assessment Hong Kong version,
- were living at home before and after discharge from the hospital,
- had scores of <5 on the Clinical Frailty Scale (Note: a patient is considered to be non-frail if they have a score less than 5), and
- were fit for medical discharge
- were not able to communicate,
- could not be reached by phone,
- were bed-bound,
- had active psychiatric problems,
- were already engaged in other structured health or social programs, and
- would not be staying in Hong Kong for the three months of the study
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Control group Usual care The control group received usual discharge care and community resources that were made available to them as appropriate. A monthly social call was made to each client in the control group in order to exclude social effects. The contents of the social call, such as asking about entertainment and clients' hobbies, were set in the protocol. Intervention group Complex interventions The subjects in this group receive complex interventions, including structured assessment, health education, goal empowerment, and care coordination supported by a health-social team.
- Primary Outcome Measures
Name Time Method Change from baseline Health-related quality of life: SF-12 at 3 months At baseline pre-intervention and at three months when the interventions were completed. The goal for this program was to enable older adults to live with optimum quality of life in their own environment through receiving support from the collaboration of nurse case managers and social workers. Quality of life was measured by SF-12, which has been shown to be useful in Chinese elderly patients. The questionnaire has 12 items organized into eight categories (physical functioning, role limitation due to emotional and physical problems, mental health scale, general health, bodily pain, social functioning, and vitality), and has been validated in numerous studies.
- Secondary Outcome Measures
Name Time Method Change from baseline Activity of daily living at 3 months At baseline pre-intervention and at three months when the interventions were completed. Use Modified Barthel index to measure the subjects' ability to do basic activity of daily livings such as grooming, eating, and walking. The score is from 0-100, with higher scores representing better activity of daily living.
Change from baseline Presence of depressive symptoms at 3 months At baseline pre-intervention and at three months when the interventions were completed. The presence of depressive symptoms was measured by the Geriatric Depression Scale. The scores from each item are summed up. The maximum score is 15, with higher scores representing higher severity of depressive symptoms. Good validity and reliability have been reported in this scale, with criterion-related validity 0.95 and test-retest reliability 0.85 among the older Chinese population.
Change from Total number of unplanned outpatient department, general practitioner, and emergency department visits, hospital admissions and total number of health service attendances at 3 months At baseline pre-intervention and at three months when the interventions were completed. This information was collected from the subjective reports of participants. They were asked about the number of attendances within the last three months prior to both T1 and T2 data collection.
Trial Locations
- Locations (1)
Queen Elizabeth Hospital
ðŸ‡ðŸ‡°Kowloon, Hong Kong