Patient preference and satisfaction in hospital-at-home and usual hospital care for COPD exacerbations: Results of a randomised controlled trial
Patient preference and satisfaction in hospital-at-home and usual hospital care for COPD exacerbations: Results of a randomised controlled trial
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DOI：
10.1016/j.ijnurstu.2013.03.006
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发表时间：
2013-11-01
影响因子：
8.1
通讯作者：
Smeenk, Frank W. J. M.
中科院分区：
文献类型：
--
作者：
Utens, Cecile M. A.;Goossens, Lucas M. A.;Smeenk, Frank W. J. M.
背景资料：由于在家住院计划和常规医院护理之间的有效性和成本效益没有明显差异，患者偏好发挥着重要作用。本研究探讨了患者的偏好治疗的地方，相关因素和患者的满意度与社区为基础的医院在家里的计划为COPD acquisitions.Methods：这项研究是一个更大的随机对照试验的一部分。患者随机接受常规医院护理或早期辅助出院，包括第4天出院和家庭护理护士访视，直至治疗第7天（T + 4天）。医院护理组照常接受护理，并于第7天出院。患者随访90天（T+90天）。在T + 4天和T + 90天时，使用问卷定量和定性评估患者对治疗地点的偏好和患者满意度（总体和每项）。在早期协助出院group.Results：139例患者进行了随机化与患者的偏好相关的因素进行了分析。总体满意度无差异。在T + 4天时，早期辅助出院组的患者对夜间护理的满意度较低，并且恢复正常日常活动的能力较差。在T + 90天时，单独项目无差异。在T + 4天时，医院护理组和早期协助出院组的患者对家庭治疗的偏好分别为42%和86%，在T+90天时分别为35%和59%。患者的精神状态与preference.Conclusion：结果支持更广泛地实施早期辅助出院COPD急性加重，这种治疗选择应提供给选定的患者，喜欢家庭治疗。(C)2013爱思唯尔有限公司保留所有权利。
Background: In the absence of clear differences in effectiveness and cost-effectiveness between hospital-at-home schemes and usual hospital care, patient preference plays an important role. This study investigates patient preference for treatment place, associated factors and patient satisfaction with a community-based hospital-at-home scheme for COPD exacerbations.Methods: The study is part of a larger randomised controlled trial. Patients were randomised to usual hospital care or early assisted discharge which incorporated discharge at day 4 and visits by a home care nurse until day 7 of treatment (T + 4 days). The hospital care group received care as usual and was discharged from hospital at day 7. Patients were followed for 90 days (T+90 days). Patient preference for treatment place and patient satisfaction (overall and per item) were assessed quantitatively and qualitatively using questionnaires at T + 4 days and T + 90 days. Factors associated with patient preference were analysed in the early assisted discharge group.Results: 139 patients were randomised. No difference was found in overall satisfaction. At T + 4 days, patients in the early assisted discharge group were less satisfied with care at night and were less able to resume normal daily activities. At T + 90 days there were no differences for the separate items. Patient preference for home treatment at T + 4 days was 42% in the hospital care group and 86% in the early assisted discharge group and 35% and 59% at T+90 days. Patients' mental state was associated with preference.Conclusion: Results support the wider implementation of early assisted discharge for COPD exacerbations and this treatment option should be offered to selected patients that prefer home treatment. (C) 2013 Elsevier Ltd. All rights reserved.