Person-centred Inpatient Care - a Quasi-experimental Study Within an Internal Medicine Context
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Endocrine System Diseases
- Sponsor
- Göteborg University
- Enrollment
- 177
- Locations
- 1
- Primary Endpoint
- Person-centred content in medical records
- Status
- Completed
- Last Updated
- 7 years ago
Overview
Brief Summary
Patients admitted to internal medicine care environments have complex care needs and must be treated as persons with resources and responsibilities. Person-centred care is defined as care in which the caregiver aims to get to know the patient as a person, and the care comprises a holistic approach to assess patients' needs and resources. There is strong motivation for future health care to transform into an approach that acknowledges and endorses every patient's resources, interests and needs. There is limited existing research on the benefit of implementing person-centred care in internal medicine care environments for all patients regardless of diagnosis or care pathway. Little is known about the effects of person-centred inpatient care on patients' satisfaction with care. This study includes adult patients admitted to an internal medicine inpatient unit regardless of reason for admission. The aim of the study is to evaluate effects of person-centred inpatient care on care processes, in terms of satisfaction with care and person-centred content in medical records and to evaluate effects on self-reported health and self-efficacy.
Investigators
Eligibility Criteria
Inclusion Criteria
- •acute or elective admission with a minimum projected in-hospital stay of 24 hours
- •age ≥ 18 years
- •conscious and alert, with no delay in response.
Exclusion Criteria
- •cognitive impairment or a judgment by the caregivers that inclusion was not in the best interests of the patient (e.g. end of life care, impaired psychological wellbeing).
Outcomes
Primary Outcomes
Person-centred content in medical records
Time Frame: From date of admission until the date of discharge, up to 60 days of hospitalization.
Degree of person-centredness in medical records
Satisfaction with care comprise patients' evaluations of caregivers' identity-oriented approach and the sociocultural atmosphere at the ward.
Time Frame: From date of admission until the date of discharge, up to 60 days of hospitalization.
The outcome is assessed with the questionnaire Quality from the Patient Perspective. The questionnaire comprises four dimension of with two dimensions is used: Identity-oriented approach (13 items) and the sociocultural atmosphere (5 items). One item from the medical competence subscale (effective pain relief) and one additional item on provision of information about medications is also used. Two kinds of assessments are being made at each item: whether things were being done (perceived reality) and whether the right things were being done (subjective significance). For the primary outcome only the assessments of perceived reality are being used. Items are rated on a four-point response scale ranging from 1 (do not agree at all) to 4 (completely agree). Each item also has a response option of "not applicable". Subscales can be reported item by item or combined in a subscale score (average of all responses within the subscale).
Secondary Outcomes
- Self-reported health assessed with EQ-5D-5L(at the date of discharge, an average of 5 days after inclusion)
- Clinical observations of pulse rate(From date of admission until the date of discharge, up to 60 days of hospitalization.)
- Clinical observations of weight(From date of admission until date of discharge, up to 60 days of hospitalization.)
- Clinical observations of respiratory rate(From date of admission until the date of discharge, up to 60 days of hospitalization.)
- Level of general self-efficacy assessed with the General Self-Efficacy scale(at the date of discharge, an average of 5 days after inclusion)
- Body temperature(From date of admission until the date of discharge, up to 60 days of hospitalization.)
- Quality of care assessed as documented information in medical records on current medication at a daily basis and at discharge(From date of admission until the date of the discharge, up to 60 days of hospitalization.)
- Quality of care assessed as documented information in medical records on planned medical care at discharge.(From date of admission until the date of discharge, up to 60 days of hospitalization.)
- Clinical observations of blood pressure(From date of admission until the date of discharge, up to 60 days of hospitalization.)
- Physical and psychological wellbeing assessed with the Quality from the Patient Perspective questionnaire(at the date of discharge, an average of 5 days after inclusion)
- Quality of care measured with ratings of Medical-technical competence and physical conditions at the ward assessed with the questionnaire Quality from the Patient Perspective.(From date of admission until the date of discharge, up to 60 days of hospitalization.)