Nursing Model and Health Outcomes of Elderly People with Multimorbidity: a Quasi-experimental Study

NCT ID: NCT06702150

Last Updated: 2024-11-22

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 206 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2022-04-18
• Study Completion Date: 2023-08-31

Brief Summary

The goal of this quasi-experimental study is to analyze the effect of organizing nursing care according to the primary nursing model on therapeutic self-care and satisfaction with nursing care for elderly people with multimorbidity in hospital. Participants were patients of both sexes aged over 65 years with at least two chronic diseases admitted to an acute hospital ward. The main questions it aims to answer are:

• Does the use of the primary nursing model increase participants' perceived ability for therapeutic self-care?
• Does the use of the primary care model increase participants' satisfaction with nursing care? The researchers are comparing whether implementing the primary nursing model with the usual care model increases patients' capacity for therapeutic self-care.

Participants:

• Complete a self-care skills questionnaire on admission to the inpatient unit;
• Complete the same self-care questionnaire on discharge from hospital;
• Complete the same self-care questionnaire by telephone one month after discharge from hospital
• Complete a nursing care satisfaction questionnaire on discharge from hospital;

Detailed Description

The self-care skills questionnaire used was the Therapeutic Self-care Scale (TSC), translated and validated for the Portuguese population.

The questionnaire used to assess satisfaction with care was the Scale of Citizen Satisfaction with Care (ESCCE), validated for the Portuguese population.

Conditions

Multimorbidity; Aged; Patient Outcome Assessment

Study Design

• Allocation Method: NON_RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: HEALTH_SERVICES_RESEARCH
• Blinding Strategy: NONE

Study Groups

Changing the nursing care model to the primary nursing model

Inpatient unit where the primary nursing model has been implemented.

Group Type: EXPERIMENTAL

Changing the nursing care model to the primary nursing model

Intervention Type: BEHAVIORAL

The nurses received training in primary nursing care before the start of the intervention. The model was tested and implemented in early April 2022. Since then, all patients admitted to the unit have been assigned to a primary nurse within the first 48 hours. This nurse is responsible for developing and monitoring the patient's care plan, assessing care needs, implementing the care plan and evaluating the outcomes. This nurse is also responsible for coordinating care needs and discharge planning with other healthcare professionals. When the primary nurse is not working, another nurse from his or her team continues the care plan that he or she has defined. All patients admitted to the unit who met the selection criteria were informed about the study and, if they agreed to take part, completed a self-care competence questionnaire at admission (baseline), at discharge and one month after discharge. They also completed a questionnaire on satisfaction with nursing care at discharge.

Standard of care

In this unit there was no change in the model of nursing care; the model used was the individualized care model. In this model, each nurse is responsible for the whole care of a group of patients on one working day and may or may not be given responsibility for the same patients on subsequent days. The patients who agreed to participate in the study completed the same questionnaires and at the same frequency as the patients in the intervention unit.

Group Type: NO_INTERVENTION

No interventions assigned to this group

Interventions

Changing the nursing care model to the primary nursing model

The nurses received training in primary nursing care before the start of the intervention. The model was tested and implemented in early April 2022. Since then, all patients admitted to the unit have been assigned to a primary nurse within the first 48 hours. This nurse is responsible for developing and monitoring the patient's care plan, assessing care needs, implementing the care plan and evaluating the outcomes. This nurse is also responsible for coordinating care needs and discharge planning with other healthcare professionals. When the primary nurse is not working, another nurse from his or her team continues the care plan that he or she has defined. All patients admitted to the unit who met the selection criteria were informed about the study and, if they agreed to take part, completed a self-care competence questionnaire at admission (baseline), at discharge and one month after discharge. They also completed a questionnaire on satisfaction with nursing care at discharge.

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

• Have at least two chronic diseases
• Have at least one disease classified in the International Classification of Diseases, Ninth Revision (ICD9) and belonging to one of the following groups: cardiovascular disease, cancer, chronic obstructive pulmonary disease and diabetes;
• Expect to be hospitalised for more than 48 hours;
• Have the cognitive ability to read, write and understand the information provided;
• Speak, read and write Portuguese.

Exclusion Criteria

• Transfer to other levels of care within the organisation
• Discharged to other care units outside the organisation
• Episodes of readmission within 30 days of leaving hospital, as this made the last moment of data collection impossible.

• Minimum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Universidade Católica Portuguesa

OTHER

Sponsor Role: collaborator

Hospital da Luz, Portugal

OTHER

Sponsor Role: lead

Responsible Party

Isabel Gonçalves

Head of nursing

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Elvio Jesus, Professor

Role: STUDY_DIRECTOR

Universidade Católica Portuguesa

Elisabete Nunes, Professor

Role: STUDY_CHAIR

Nursing School of Lisbon

Locations

Hospital da LUz

Lisbon, , Portugal

Countries

Portugal

References

Goncalves I, Almeida S, Jesus E, Nunes E. Effect of the Primary Nursing Model on Self-Care Skills of Hospitalized Older Patients with Multimorbidity: A Quasi-Experimental Study. Healthcare (Basel). 2025 Sep 27;13(19):2457. doi: 10.3390/healthcare13192457.

Reference Type: DERIVED

PMID: 41095543 (View on PubMed)

Other Identifiers

CES/01/2022/ME

Identifier Type: -

Identifier Source: org_study_id