Valoración Geriátrica Integral
- Predictors of Functional Decline in Nursing Home Residents: The Shelter Project
- DIVERT-Collaboration Action Research and Evaluation (CARE) Trial Protocol: a multiprovincial pragmatic cluster randomised trial of cardiorespiratory management in home care | BMJ Open
- Moving Towards Common Data Elements and Core Outcome Measures in Frailty Research
- A frailty index derived from a standardized comprehensive geriatric assessment predicts mortality and aged residential care admission
- Appropriateness of transferring nursing home residents to emergency departments: a systematic review | BMC Geriatrics | Full Text
- febrero 2020
- enero 2020
- enero 2019
- julio 2018
- marzo 2018
- febrero 2018
- enero 2018
- octubre 2017
- septiembre 2017
- noviembre 2016
- marzo 2016
- febrero 2016
- enero 2016
- diciembre 2015
- octubre 2015
- agosto 2015
- julio 2015
- junio 2015
- mayo 2015
- abril 2015
- marzo 2015
- febrero 2015
- diciembre 2014
- noviembre 2014
- octubre 2014
- septiembre 2014
- julio 2014
- junio 2014
Archivo mensual: julio 2014
Hospitals are considered a setting ill-prepared for end of life issues; therefore, use of such acute care services has to be considered an indicator of poor quality end of life care. This study examines predictors of ERVH prior to death among HPC home care clients.
Methods: A retrospective cohort study of a sample of 764 HPC home care clients who received services from a community care access centre (CCAC) in southern Ontario, Canada.
All clients were assessed using the Resident Assessment Instrument for Palliative Care (interRAI PC) as part of normal clinical practice between April 2008 and July 2010. The Andersen-Newman framework for health service utilization was used as a conceptual model for the basis of this study.
Logistic regression and Cox regression analyses were carried out to identify predictors of ERVH.
Results: Half of the HPC clients had at least one or more ERVH (n = 399, 52.2%). Wish to die at home (OR = 0.54) and advanced care directives (OR = 0.39) were protective against ERVH.
Unstable health (OR = 0.70) was also associated with reduced probability, while infections such as prior urinary tract infections (OR = 2.54) increased the likelihood of ERVH. Clients with increased use of formal services had reduced probability of ERVH (OR = 0.55).
Conclusions: Findings of this study suggest that predisposing characteristics are nearly as important as need variables in determining ERVH among HPC clients, which challenges the assumption that need variables are the most important determinants of ERVH.
Ongoing assessment of HPC clients is essential in reducing ERVH, as reassessments at specified intervals will allow care and service plans to be adjusted with clients’changing health needs and end of life preferences.
Author: Lialoma Salam-WhiteJohn P HirdesJeffrey W PossJane Blums
Source: BMC Palliative Care 2014, 13:35