Gené Badia Joan, Borràs Santos Alícia, Carles Contel Segura Joan, Camprubí Casellas M A Dolors, Cegri Lombardo Francisco, Heras Tebar Antonio, Noguera Rodríguez Ramón, González Martínez Susana, Oliver Olius Anna, Piñeiro González Martiño, Montanuy Baró Teresa, Limón Ramírez Esther, Aranzana Martínez Antonio, Pedret Llaberia Roser, Borrell Muñoz Manuel, Hidalgo García Antonio
Consorci d'Atenció Primària de Salut de l'Eixample (CAPSE), Barcelona, España.
Gac Sanit. 2011 Jul-Aug;25(4):308-13. doi: 10.1016/j.gaceta.2010.12.011. Epub 2011 Apr 13.
To identify the characteristics of chronic patients and their environment in order to predict the nursing workload required 1 year after their inclusion in a home care program.
A longitudinal study was carried out in 72 primary health care teams in Catalonia (Spain) with a 1-year follow-up of 1,068 home care patients over 64 years old. The variables collected from each patient included data on health and social status (Charlson and Barthel indexes and the Pfeiffer, Braden and Gijon scales), carer overburden (Zarit scale), hospital admissions, use of emergency services, self-perceived health (SF-12) and the number of health worker visits.
Patients received 7.2 (SD 10.4) visits per year from their nurse-in-charge, out of a total of 8.7 (SD 13.1) nursing visits per year. Risk factors for receiving more nursing visits at home were male gender (IRR=1.42, 95%CI: 1.20-1.67), dependency for daily activities (IRR=1.65, 95%CI: 1.29-2.13), decubitus ulcers (IRR=4.03, 95%CI: 2.27-7.14) and receiving emergency medical care at home (IRR=1.65, 95%CI: 1.31-2.07). In contrast, patients with major cognitive impairment (IRR=0.78, 95%CI: 0.63-0.98) had a lower probability of receiving nursing visits at home.
Workload can be predicted by patients' clinical characteristics. The positive correlation of workload with variables related to disease severity and the negative correlation with variables related to cognitive impairment show that home care nursing in Catalonia is basically demand-oriented.
识别慢性病患者及其环境的特征，以便预测他们纳入家庭护理计划1年后所需的护理工作量。
在西班牙加泰罗尼亚的72个初级卫生保健团队中开展了一项纵向研究，对1068名64岁以上的家庭护理患者进行了为期1年的随访。从每位患者收集的变量包括健康和社会状况数据（查尔森指数和巴塞尔指数以及 Pfeiffer、Braden 和希洪量表）、照顾者负担（Zarit 量表）、住院次数、急诊服务使用情况、自我感知健康状况（SF-12）以及医护人员家访次数。
患者每年从其主管护士处接受7.2次（标准差10.4）家访，而每年总的护理家访次数为8.7次（标准差13.1）。在家接受更多护理家访的危险因素包括男性（风险比=1.42，95%置信区间：1.20 - 1.67）、日常生活依赖（风险比=1.65，95%置信区间：1.29 - 2.13）、压疮（风险比=4.03，95%置信区间：2.
