20
views
0
recommends
+1 Recommend
1 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Biopsychosocial aspects and the complexity of care of hospitalized elderly Translated title: Aspectos biopsicossociais e a complexidade assistencial de idosos hospitalizados

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Objective To investigate the biopsychosocial aspects and aspects of the health system of hospitalized elderly and to classify their degree of care complexity. Methods This was a quantitative study whose convenience sample consisted of 279 elderly. The Interdisciplinary Medicine Instrument (INTERMED) method was used, a tool that identified biopsychosocial aspects and conditions of the health system and classified the complexity of the patient. The data were submitted to descriptive analysis. Results The prevailing profile was of elderly women, retired, white, with low educational levels, married and satisfied with their life conditions. The mean age was 72.3 years. The biological domain was the most compromised. As for the complexity of care, 34.8% of the patients required multiprofessional care. Conclusion The elderly had high care complexity, with the biological and health system domains being the most compromised.

          Translated abstract

          Objetivo Conhecer os aspectos biopsicossociais e as condições do sistema de saúde de idosos hospitalizados e classificar o grau de complexidade assistencial. Métodos Trata-se de estudo quantitativo, cuja amostra por conveniência foi constituída por 279 idosos. Utilizou-se o método Interdisciplinary Medicine Instrument (INTERMED), ferramenta que identifica aspectos biopsicossociais e condições do sistema de saúde e classifica a complexidade do paciente. Os dados foram submetidos à análise descritiva. Resultados Predominou idosos do gênero feminino, aposentados, de cor branca, baixa escolaridade, casados e satisfeitos com as condições de saúde. A média de idade foi 72,3 anos. O domínio biológico foi o mais comprometido. Quanto à complexidade assistencial, 34,8 % dos pacientes requerem assistência multiprofissional. Conclusão Os idosos apresentaram elevada complexidade assistencial, com maior comprometimento nos domínios biológico e sistema de saúde.

          Related collections

          Most cited references33

          • Record: found
          • Abstract: found
          • Article: not found

          Reliable integrative assessment of health care needs in elderly persons: the INTERMED for the Elderly (IM-E).

          With the increasing prevalence of multiple conditions in older age, the high prevalence of mental disorders, and the many social challenges facing elderly people, a high-risk patient group in need of interdisciplinary (biological, psychological, and social) care is emerging. The INTERMED interview is an integrative assessment method that identifies patients with complex health care needs. The aim of this study was to develop and evaluate the INTERMED for the Elderly (IM-E), specifically for use in populations of elderly persons. In focus groups conducted with the authors of the original INTERMED, the variables and anchor points that had to be adjusted to the needs and situation of the elderly and to the demands of a population-based study were discussed and altered. The final version of the IM-E was conducted with 42 elderly persons. Participants were doubly scored by two trained raters; the interrater reliability [intraclass correlation coefficient (ICC) (2,1)] was calculated. The IM-E was well accepted by the elderly persons interviewed. ICCs for the various domains of the IM-E ranged between .87 and .95, while the ICC for the sum score was .95. Regarding the cutoff point of 20/21 for patients with complex health care needs, a κ of .75 was achieved. The IM-E is a reliable integrative assessment instrument. It is well suited for epidemiological settings to adequately describe the percentage of elderly patients with complex health care needs. In clinical settings, it can be used to identify elderly patients in need of interdisciplinary care. Copyright © 2011 Elsevier Inc. All rights reserved.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Gaps in continuity of care at the interface between primary care and specialized care: general practitioners’ experiences and expectations

            Introduction Discontinuity of care at the interface between inpatient and outpatient management can lead to increased morbidity and mortality. Appropriate communication and flow of information is indispensable to ensure continuity of care. Consequently, the aim of this study was to assess general practitioners’ (GPs) experiences of cooperation with a university hospital, as well as their needs and obvious barriers regarding an optimized information flow. Methods A qualitative study was performed. In March 2011, 300 GPs from the Zurich Canton were invited to participate in two focus group meetings. Based on a review of the literature, an interview guide was created addressing two main issues. In the first part, experiences and barriers regarding cooperation with the university were explored. In the second part, needs and suggestions to improve cooperation were addressed. Results Fifteen GPs participated in two focus groups. GPs complained that they have often not been adequately informed about ongoing treatments or appointments for their patients. GPs feel responsible for the continuity of care and wish to be more involved, especially in long-term treatment decisions or at the end of life. By not involving them, they stated, important information concerning patients’ medical history and social setting was not taken into account. Improvements are also required at discharge: GPs often do not receive important information about treatments in the hospital and further requirements within a reasonable time. Conclusion Exchange of information between the hospital and the GP at admission and discharge is essential. However, at present, involvement during hospitalization of the patient is lacking. This includes the exchange of information after an unexpected clinical procedure and input from GPs when difficult clinical decisions are made, such as at the beginning or termination of long-term therapies.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: found
              Is Open Access

              Integrative care for the management of low back pain: use of a clinical care pathway

              Background For the treatment of chronic back pain, it has been theorized that integrative care plans can lead to better outcomes than those achieved by monodisciplinary care alone, especially when using a collaborative, interdisciplinary, and non-hierarchical team approach. This paper describes the use of a care pathway designed to guide treatment by an integrative group of providers within a randomized controlled trial. Methods A clinical care pathway was used by a multidisciplinary group of providers, which included acupuncturists, chiropractors, cognitive behavioral therapists, exercise therapists, massage therapists and primary care physicians. Treatment recommendations were based on an evidence-informed practice model, and reached by group consensus. Research study participants were empowered to select one of the treatment recommendations proposed by the integrative group. Common principles and benchmarks were established to guide treatment management throughout the study. Results Thirteen providers representing 5 healthcare professions collaborated to provide integrative care to study participants. On average, 3 to 4 treatment plans, each consisting of 2 to 3 modalities, were recommended to study participants. Exercise, massage, and acupuncture were both most commonly recommended by the team and selected by study participants. Changes to care commonly incorporated cognitive behavioral therapy into treatment plans. Conclusion This clinical care pathway was a useful tool for the consistent application of evidence-based care for low back pain in the context of an integrative setting. Trial registration ClinicalTrials.gov NCT00567333
                Bookmark

                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Journal
                ape
                Acta Paulista de Enfermagem
                Acta paul. enferm.
                Escola Paulista de Enfermagem, Universidade Federal de São Paulo (São Paulo )
                1982-0194
                October 2014
                : 27
                : 5
                : 427-433
                Affiliations
                [1 ] Universidade de São Paulo Brazil
                [2 ] Universidade de São Paulo Brazil
                [3 ] Universidade de Brasília Brazil
                Article
                S0103-21002014000500007
                10.1590/19820194201400071
                ed5f0504-68eb-4a27-ba2d-efdf7e504505

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0103-2100&lng=en
                Categories
                NURSING

                Nursing
                Nursing care,Geriatric nursing,Nursing service,Hospital,Aged,Cuidados de Enfermagem,Enfermagem geriátrica,Serviço hospitalar de enfermagem,Idoso

                Comments

                Comment on this article