Health status and most distressing concerns at admission and discharge reported by patients cared for at an internal medical care ward

Jakobsson, Sofie; Ung, Eva Jakobsson; Lindström, Marie; Eliasson, Björn; Ringström, Gisela

doi:10.1111/scs.12562

Cited by 7 publications

(8 citation statements)

References 32 publications

(47 reference statements)

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“…To date few data are available about the perception of health from in-patients admitted to internal medicine wards. [ 11 ] Different studies showed that chronic medical conditions affect physical functioning and reduced quality of life. [ 19 , 20 ] Particularly, gastrointestinal diseases, cerebrovascular conditions, musculoskeletal and renal diseases determined poorer quality of life.…”

Section: Resultsmentioning

confidence: 99%

GDS score as screening tool to assess the risk of impact of chronic conditions and depression on quality of life in hospitalized elderly patients in internal medicine wards

Argano¹,

Catalano²,

Natoli³

et al. 2021

Medicine

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Aging of population is characterized by multiple chronic conditions in the same individual. Health-related quality of life (HR-QOL) reflects the multidimensional impact of chronic disease on population and it is increasingly analysed as outcomes. The aim of this study was the evaluation of the predictors of quality of life among elderly patients hospitalized in internal medicine ward, investigating the effect of comorbidities on health-related quality of life. Data collected in this cross-sectional study were analysed. Socio-demographic, clinical characteristics, disease distribution and quality of life by the 12-Item Short Form Health Survey (SF-12) were evaluated. Of 240 inpatients, subjects with Barthel Index (BI)≤40 were 23.7%, 55% had a Geriatric Depression Scale (GDS)≥2. After categorizing mental component score (MCS) and physical component score (PCS) in five classes, we found that diabetics and patients with cancer were more frequent in the first class of MCS while patients with NYHA III-IV are significantly more frequent in the first class of PCS. When we classified patients according to GDS≥2 or < 2, subjects with GDS≥2 had BI and MCS significantly lower. In the multivariate analysis GDS score ≥2 was independently associated with first MCS class [16.32 (3.77–70.68)] while NYHA III-IV class and claudicatio intermittents were strong predictors of the worst PCS class [9.54 (1.97–47.40), 2.53 (1.16–5.49), respectively]. Liver disease was independently associated with GDS≥2 [5.26 (1.13–24.39)]. Our study highlighted the impact of chronic diseases on health-related quality of life in elderly subjects hospitalized in an internal medicine ward pointing out the importance of taking into account patient's needs and perception and the setting up of a personalised health-care. Patients with diabetes and liver disease along with persons affected by cancer need psychological support to improve their quality of life. A GDS score ≥ 2 is a strong predictor of poor quality of life and should trigger an in-depth assessment of mental health in this kind of patients.

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Section: Resultsmentioning

confidence: 99%

GDS score as screening tool to assess the risk of impact of chronic conditions and depression on quality of life in hospitalized elderly patients in internal medicine wards

Argano¹,

Catalano²,

Natoli³

et al. 2021

Medicine

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“…Nevertheless, information derived from self-reported health status, HRQoL, anxiety, depression, and symptom burden can help identify those patients at risk of future readmission. It is likely that, if medical staff were to provide the person-centered approach, patient's expectations, worries, thoughts, and resources can be more readily identified and support to patients in their self-care at discharge can be better established [8].…”

Section: Discussionmentioning

confidence: 99%

“…When used in reference to health care, QoL means health-related quality of life (HRQoL) and can be defined as a functional effect on medical conditions and/or its treatment upon a patient's physical, social, and emotional well-being [7]. In healthy and chronically ill community-dwelling elderly people, higher HRQoL is associated with longer survival and lower admission rates [8][9][10][11][12][13][14]. For the acutely hospitalized patients, HRQoL at admission predicts subsequent risk of mortality and functional decline [9].…”

Section: Introductionmentioning

confidence: 99%

Health-Related Quality of Life Measured by EQ-5D in Relation to Hospital Stay and Readmission in Elderly Patients Hospitalized for Acute Illness

Lin

Huang

et al. 2020

IJERPH

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We evaluated the predictability of self-reported Health-related quality of life (HRQoL) assessed by the 3-level 5-dimensional Euro-Quality of Life tool (EQ-5D-3L) and the EQ-Visual Analog Scale (EQ-VAS) on clinical outcomes of elderly patients who were admitted to an acute geriatric ward. A total of 102 participants (56.9% men) with a median age of 81.0 years (interquartile range or IQR: 76.0–85.3 years) were studied. The age-adjusted Charlson comorbidity index was 5.0 (IQR: 4.0–6.0) with a median length of stay (LOS) of 9.0 days (IQR: 7.0–15.0 days). No death occurred during hospitalization, and within 30 days after discharge, 15 patients were readmitted. During hospitalization, the EQ-5D-3L index was 0.440 at admission and that improved to 0.648 at discharge (p < 0.001). EQ-VAS scores also improved similarly from 60 to 70 (p < 0.001). Physical, cognitive function, frailty parameters (hand grip strength and walking speed), and nutritional status at admission all improved significantly during hospitalization and were related to EQ-5D-3L index or EQ-VAS scores at discharge. After controlling for relevant factors, EQ-5D-3L index at admission was found to be associated with LOS. In addition, EQ-VAS was marginally related to readmission. HRQoL assessment during hospitalization could be useful to guide clinical practice and to improve outcome.

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“…Forthcoming surgery and its sequelae are often sources of distress among inpatients in general where major concerns are worries about not being able to fully recover and return to full health (21). Existential concerns about health and what the future would be like for oneself and loved ones are common (21, 22). Further, the fear of recurrence during recovery was evident in this study and has previously been highlighted as a central aspect of quality of life among patients treated for pituitary tumour (15, 16).…”

Section: Discussionmentioning

confidence: 99%

The pre- and postoperative illness trajectory in patients with pituitary tumours

Ung

Olofsson

Björkman

et al. 2019

Endocrine Connections

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Objective Experiences and need of support during surgery and start of replacement therapy in patients with pituitary tumours are highly unknown. This study aimed at exploring patient experiences during pre- and postoperative care and recovery after pituitary surgery in patients with a pituitary tumour. Methods Within a qualitative study design, 16 consecutive patients who underwent surgery for pituitary tumours were repeatedly interviewed. In total, 42 interviews were performed before and after surgery. Analysis was performed using qualitative interpretation. Results Suffering a pituitary tumour was overwhelming for many patients and struggling with existential issues was common. Patients expressed loneliness and vulnerability before and after surgery. How professionals handled information in connection with diagnosis greatly affected the patients. Other patients with the same diagnosis were experienced as the greatest support. Normalisation of bodily symptoms and relationships with others were reported during postoperative recovery. However, a fear that the tumour would return was present. Conclusions Patients with pituitary tumours need structured support, including peer support, which acknowledges physical, cognitive as well as emotional and existential concerns. Information related to diagnosis and surgery should be adapted in relation to the loneliness and the existential seriousness of the situation. Care and support for patients with pituitary tumours should preferably be organised based on continuity and an unbroken care pathway from the first pre-operative evaluation through to postoperative care and the start of a life-long endocrine treatment and tumour surveillance.

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Health status and most distressing concerns at admission and discharge reported by patients cared for at an internal medical care ward

Cited by 7 publications

References 32 publications

GDS score as screening tool to assess the risk of impact of chronic conditions and depression on quality of life in hospitalized elderly patients in internal medicine wards

GDS score as screening tool to assess the risk of impact of chronic conditions and depression on quality of life in hospitalized elderly patients in internal medicine wards

Health-Related Quality of Life Measured by EQ-5D in Relation to Hospital Stay and Readmission in Elderly Patients Hospitalized for Acute Illness

The pre- and postoperative illness trajectory in patients with pituitary tumours

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