Nursing Care Ethical Implications Regarding Chronic Patients at Hospital Discharge
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Setting
2.2. Analysis
2.3. Ethical Consideration
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
- Thorpe, K.E.; Allen, L.; Joski, P. The role of chronic disease, obesity, and improved treatment and detection in accounting for the rise in healthcare spending between 1987 and 2011. Appl. Health Econ. Health Policy 2015, 13, 381–387. [Google Scholar] [CrossRef] [PubMed]
- Ministerio de Sanidad, Servicios Sociales e Igualdad. Informe anual del Sistema Nacional de Salud. 2015. Available online: http://www.msssi.gob.es/estadEstudios/estadisticas/sisInfSanSNS/tablasEstadisticas/InfAnSNS.htm (accessed on 10 June 2020).
- De Oliveira Brito, L.V.; Maranhao Neto, G.A.; Moraes, H.; Emerick, R.F.; Deslandes, A.C. Relationship between level of independence in activities of daily living and estimated cardiovascular capacity in elderly women. Arch. Gerontol. Geriatr. 2014, 59, 367–371. [Google Scholar] [CrossRef] [PubMed]
- Chen, S.; Zheng, J.; Chen, C.; Xing, Y.; Cui, Y.; Ding, Y.; Li, X. Unmet needs of activities of daily living among a community-based sample of disabled elderly people in Eastern China: A cross-sectional study. BMC Geriatr. 2018, 18, 160. [Google Scholar] [CrossRef] [PubMed]
- Unidad de Pacientes Pluripatológicos Estándares y Recomendaciones. Available online: https://www.mscbs.gob.es/organizacion/sns/planCalidadSNS/docs/EyR_UPP.pdf (accessed on 10 June 2020).
- Diederichs, C.; Berger, K.; Bartels, D.B. The measure ment of multiple chronic diseases: A systematic review on existing multimorbidity indices. J. Gerontol. A Biol. Sci. Med. Sci. 2011, 66, 301–311. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Aguilar Guisado, M.; Ramírez Duque, N.; Romero Carmona, S.; Ollero Baturone, M.; Limpo, P.; Cuello-Contreras, J.A.; Bernabéu Wittel, M.; García-Morillo, J.S.; González de la Puente, M.A. Incidencia y características clínicas de los pacientes con pluripatología ingresados en una unidad de medicina interna. Med. Clin. (Barc.) 2005, 125, 5–9. [Google Scholar]
- García-Morillo, J.S.; Bernabeu-Witte, M.; Ollero-Baturone, M.; González de la Puente, M.A.; Cuello-Contreras, J.A. Risk factors associated to mortality and functional deterioration in pluripathologic patients with heart failure. Rev. Clin. Esp. 2007, 207, 1–5. [Google Scholar] [CrossRef] [PubMed]
- Ramírez Duque, N.; García Morillo, S.; Nieto Guindo, M.; Rincón, M.; Bernabéu Wittel, M.; Yerro Páez, V.; Ollero Baturone, M. Mapa de interacciones medicamentosas con relevancia clínica tras entrevista domiciliaria, en una cohorte de pluripatológicos y polimedicados del área de Sevilla. In Libro De Resúmenes of the XXVII Congreso Nacional de la Sociedad Española de Medicina Interna. Rev. Clin. Esp. 2006, 206. [Google Scholar]
- Galindo-Ocaña, J.; Gil-Navarro, M.V.; García-Morillo, J.S.; Bernabéu-Wittel, M.; Ollero-Baturone, M.; Ortiz-Camúñez, M.A. Interacciones medicamentosas en pacientes pluripatológicos. Rev. Clin. Esp. 2010, 210, 270–278. [Google Scholar]
- Ramírez-Duque, N.; Ollero-Baturone, M.; Bernabeu-Wittel, M.; Rincón-Gomez, M.; Ortiz-Camúnez, M.A.; García-Morillo, S. Clinical, functional, mental and socio familiar features in pluripathological patients. One-year prospective study in primary health care. Rev. Clin. Esp. 2008, 208, 4–11. [Google Scholar] [CrossRef] [Green Version]
- Keleher, H.; Parker, R.; Abdulwadud, O.; Francis, K. Systematic review of the effectiveness of primary care nursing. Int. J. Nurs. Pract. 2009, 15, 16–24. [Google Scholar] [CrossRef]
- Pena, V.; Watson, A.J.; Kvedar, J.C.; Grant, R.W. Mobile phone technology for children with type 1 and type 2 diabetes: A parent survey. J. Diabetes Sci. Technol. 2009, 3, 1481–1489. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Locsin, R.C. The co-existence of technology and caring in the theory of technological competency as caring in nursing. J. Med. Investig. 2017, 64, 160–164. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Polisena, J.; Tran, K.; Cimon, K.; Hutton, B.; McGill, S.; Palmer, K. Home telehealth for diabetes management: A systematic review and meta-analysis. Diabetes Obes. Metab. 2009, 11, 913–930. [Google Scholar] [CrossRef]
- Rabiee, P. Exploring the relationships between choice and independence: Experiences of disabled and older persons. Brit. J. Soc. Work 2013, 43, 872–888. [Google Scholar] [CrossRef]
- Committee on Quality of Health Care in America. Crossing the Quality Chasm: A New Health System for the 21st Century; National Academies Press: Washington, DC, USA, 2001. [Google Scholar]
- Entwistle, V.A.; Watt, I.S. A capabilities approach to person-centered care: Response to open peer commentaries on “Treating patients as persons: A capabilities approach to support delivery of person-centered care”. Am. J. Bioeth. 2013, 13, W1–W4. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Walker, M. Moral Understandings: A Feminist Study in Ethics; Oxford University Press: Oxford, UK, 2007. [Google Scholar]
- Jacobs, G. Patient autonomy in home care: Nurses' relational practices of responsibility. Nurs. Ethics 2019, 26, 1638–1653. [Google Scholar] [CrossRef]
- Gibert, S.H.; DeGrazia, D.; Danis, M. Ethics of patient activation: Exploring its relation to personal responsibility, autonomy and health disparities. J. Med. Ethics 2017, 43, 670–675. [Google Scholar] [CrossRef]
- Alarcon, M.T.; González, J.I. La escala socio familiar de Gijón, instrumento útil en el hospital general. Rev. Esp. Geriatr. Gerontol. 1998, 33, 175–179. [Google Scholar]
- Mahoney, F.I.; Barthel, D.W. Functional evaluation: The Barthel Index. Md. State Med. J. 1965, 71, 61–65. [Google Scholar]
- Martínez de la Iglesia, J.; Dueñas Herrero, R.; Onís Vilches, M.C.; Aguado Taberné, C.; Albert Colomer, C.; Luque, R. Spanish language adaptation and validation of the Pfeiffer’s questionnaire (SPMSQ) to detect cognitive deterioration in people over 65 years of age. Med. Clin. (Barc.) 2001, 117, 129–134. [Google Scholar]
- Huesa Andrade, M.; Calvo-Gallego, J.L.; Pedregal González, M.Á.; Bohórquez Colombo, P. Differences between institutionalized patients and those included in a home care program in Seville. Aten. Primaria 2020. [Google Scholar] [CrossRef]
- Colombo, P.B.; Nieto Martín, M.D.; Pascual de la Pisa, B.; García Lozano, M.; Ortiz Camúñez, M.; Wittel, M.B. Validation of a prognostic model for polypathological patients (PP) in Primary Health Care: “PROFUND STUDY-AP”. Aten Primaria 2014, 46, 41–48. [Google Scholar] [CrossRef] [Green Version]
- Seoane, J.A. Las autonomías del paciente. Dilemata 2010, 3, 61–75. [Google Scholar]
- Friesen-Storms, J.H.; Bours, G.J.; van der Weijden, T.; Beurskens, A.J. Shared decision making in chronic care in the context of evidence-based practice in nursing. Int. J. Nurs. Stud. 2015, 52, 393–402. [Google Scholar] [CrossRef] [Green Version]
- Pasricha, A.; Deinstadt, R.T.; Moher, D.; Killoran, A.; Rourke, S.B.; Kendall, C.E. Chronic care model decision support and clinical information systems interventions for people living with HIV: A systematic review. J. Gen. Intern. Med. 2013, 28, 127–135. [Google Scholar] [CrossRef] [Green Version]
- Stellefson, M.; Dipnarine, K.; Stopka, C. The chronic care model and diabetes management in us primary care settings: A systematic review. Prev. Chronic Dis. 2013, 10, E26. [Google Scholar] [CrossRef] [Green Version]
- Kang, H.G.; Mahoney, D.F.; Hoenig, H.; Hirth, V.A.; Bonato, P.; Hajjar, I.; Lipsitz, L.A. In situ monitoring of health in older adults: Technologies and issues. J. Am. Geriatr. Soc. 2010, 58, 1579–1586. [Google Scholar] [CrossRef]
- Dwarswaard, J.; Van de Bovenkamp, L. Self-management support: A qualitative study of ethical dilemmas experienced by nurses. Patient Educ. Couns. 2015, 98, 1131–1136. [Google Scholar] [CrossRef] [Green Version]
- Freedman, A.; Nicolle, J. Social isolation and loneliness: The new geriatric giants: Approach for primary care. Can. Fam. Physician 2020, 66, 176–182. [Google Scholar]
- Shaw, S.; Rosen, R.; Rumbold, B. What Is Integrated Care? A Research Report; Nuffield Trust: London, UK, 2011. [Google Scholar]
- Rosen, R.; Ham, C. Integrated Care: Lessons from Evidence and Experience. Available online: https://www.nuffieldtrust.org.uk/files/2017-01/integrated-care-lessons-from-evidence-experience-web-final.pdf (accessed on 10 June 2020).
- Martínez-González, N.A.; Berchtold, P.; Ullman, K.; Busato, A.; Egger, M. Integrated care programmes for adults with chronic conditions: A meta-review. Int. J. Qual. Health Care 2014, 26, 561–570. [Google Scholar] [CrossRef]
- Solomon, R.; Orridge, C. Defining health equity. HealthcarePapers 2014, 14, 62–65. [Google Scholar] [CrossRef] [PubMed]
- Olmedo Vega, V.; Aguilar Idáñez, M.J.; Arenillas Lara, J.F. Análisis de factores asociados a la recuperación integral de pacientes de ictus al alta de hospital de agudos. Rev. Esp. Salud Publica 2019, 93, e201910103. [Google Scholar] [PubMed]
- Conill, J. Eficiencia y justicia en la empresa sanitaria. Veritas 2006, 1, 209–222. [Google Scholar]
- Epstein, R.M.; Street, R.L., Jr. The values and value of patient-centered care. Ann. Fam. Med. 2011, 9, 100–103. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Hedberg, C.; Lynøe, N. What is meant by patient-centredness being value-based? Scand. J. Prim. Health Care 2013, 31, 188–189. [Google Scholar] [CrossRef] [PubMed] [Green Version]
Sex, men | (%) 56.8 |
Medication, Mean | (SD) 9.1 (3.1) |
Functional situation (Barthel index) | n (%) |
Independent | 7 (6.3) |
Moderate dependence | 35 (31.5) |
Severe dependence | 47 (42.3) |
Total dependence | 22 (19.8) |
Social risk (Gijón scale) | n (%) |
Social problem | 61 (56.5) |
Social risk | 38 (35.2) |
Good social situation | 9 (8.3) |
Cognitive impairment (Pfeiffer) | n (%) |
No impairment | 69 (62.2) |
Cognitive impairment established | 41 (36.9) |
Cognitive Impairment n (%) | Yes | No | p |
---|---|---|---|
Loneliness | 0.038 | ||
Lives alone | 4 (10.3) | 18 (27.3) | |
Lives accompanied | 35 (89.7) | 48 (72.7) | |
Social risk | 0.001 | ||
Positive social situation | 1 (2.6) | 8 (11.8) | |
Social risk exists | 7 (17.9) | 31 (45.6) | |
Social problem exists | 31 (79.5) | 29 (42.6) |
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Coronado-Vázquez, V.; Canet-Fajas, C.; Ramírez-Durán, M.V.; Gómez-Salgado, J.; Robles-Romero, J.M.; Fagundo-Rivera, J.; Romero-Martín, M. Nursing Care Ethical Implications Regarding Chronic Patients at Hospital Discharge. Healthcare 2020, 8, 167. https://doi.org/10.3390/healthcare8020167
Coronado-Vázquez V, Canet-Fajas C, Ramírez-Durán MV, Gómez-Salgado J, Robles-Romero JM, Fagundo-Rivera J, Romero-Martín M. Nursing Care Ethical Implications Regarding Chronic Patients at Hospital Discharge. Healthcare. 2020; 8(2):167. https://doi.org/10.3390/healthcare8020167
Chicago/Turabian StyleCoronado-Vázquez, Valle, Carlota Canet-Fajas, María Valle Ramírez-Durán, Juan Gómez-Salgado, José Miguel Robles-Romero, Javier Fagundo-Rivera, and Macarena Romero-Martín. 2020. "Nursing Care Ethical Implications Regarding Chronic Patients at Hospital Discharge" Healthcare 8, no. 2: 167. https://doi.org/10.3390/healthcare8020167