Cucinotta D, Savorani G, Piscaglia F, Galletti L, Petazzoni E, Bolondi L
Department of Internal Medicine and Aging, S. Orsola-Malpighi University Hospital, I-40138 Bologna, Italy.
Arch Gerontol Geriatr Suppl. 2004(9):103-8. doi: 10.1016/j.archger.2004.04.017.
This controlled study evaluated various outcomes in a group of 127 chronically ill and frail elderly patients when discharged from a hospital ward, and cared at home, enrolled during 12 months starting from September 2001. The observation of patients is programmed to be of two years from enrollment, with a scheduled program of follow up at baseline,6, 12, and 24 months. Patients (of both sexes) were randomly assigned to one of two groups: (i) Control group (61 patients: mean age 85.2 years) having a usual home care program of assistance, guaranteed by the Social Health Care Service. (ii) Intervention group (66 patients: mean age 83.2 years), for whom the program of care mentioned above was integrated providing collaboration of a home care attendant. This was a lay-working person who has attended a specializing course about care of the elderly and of the very frail. The home attendance was provided for 4-10 hrs daily, according to a program established by a Geriatric Evaluation Unit. The team evaluated the patients at their home,deciding the amount of hours of attendance in the presence of the caregiver. The financial cost of the additional home care attendance was sponsored, totally or in part, according to the financial situation of the patient's family, by the "Fondazione del Monte di Bologna e di Ravenna". This report takes into consideration only few preliminary data, coming from the first 6 months of observation of all the patients included. The two groups were homogeneous when compared statistically at baseline. Data coming form laboratory and biological analysis will be available only at the end of the project as they are recorded in a blind methodology. A lower degree of mortality and of dropouts in the intervention group was observed,compared to the control group, already at 6 months. These outcomes can be considered favorable, and perhaps can be related to the various benefits gained by additional program of home attendance.
这项对照研究评估了2001年9月起的12个月内,从医院病房出院并在家中接受护理的127名慢性病体弱老年患者的各项结果。对患者的观察计划为期两年,从入组开始,在基线、6个月、12个月和24个月进行定期随访。患者(男女皆有)被随机分为两组:(i)对照组(61名患者:平均年龄85.2岁),接受社会医疗服务保障的常规家庭护理援助计划。(ii)干预组(66名患者:平均年龄83.2岁),上述护理计划在此基础上整合了家庭护理员的协作。护理员为参加过老年及极度体弱患者护理专业课程的非专业人员。根据老年评估单位制定的计划,每天提供4至10小时的上门护理服务。该团队在患者家中对其进行评估,并在有护理人员在场的情况下确定护理时长。额外上门护理服务的财务成本全部或部分由“博洛尼亚和拉文纳储蓄银行基金会”根据患者家庭的财务状况提供资助。本报告仅考虑了所有纳入患者前6个月观察期的少量初步数据。两组在基线时进行统计学比较时具有同质性。实验室和生物学分析的数据只有在项目结束时才会获得,因为这些数据是以盲法记录的。在6个月时就观察到,与对照组相比,干预组的死亡率和退出率较低。这些结果可以被认为是有利的,可能与额外的上门护理计划所带来的各种益处有关。