Naylor Mary D, Hirschman Karen B, Hanlon Alexandra L, Bowles Kathryn H, Bradway Christine, McCauley Kathleen M, Pauly Mark V
New Courtland Center for Transitions & Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA.
University of Pennsylvania School of Nursing, 418 Curie Boulevard, Philadelphia, PA 19104, USA.
J Comp Eff Res. 2016 May;5(3):259-72. doi: 10.2217/cer-2015-0009. Epub 2016 May 5.
Compare within site effects of three interventions designed to enhance outcomes of hospitalized cognitively impaired elders.
Prospective, nonrandomized, confirmatory phased study. In Phase I, 183 patients received one of three interventions: augmented standard care (ASC), resource nurse care (RNC) or Transitional Care Model (TCM). In Phase II, 205 patients received the TCM.
Time to first rehospitalization or death was longer for the TCM versus ASC group (p = 0.017). Rates for total all-cause rehospitalizations and days were significantly reduced in the TCM versus ASC group (p < 0.001, both). No differences were observed between RNC versus TCM.
Findings suggest the TCM is more effective than ASC. However, potential effects of the RNC relative to the TCM warrant further study.
比较三种旨在改善住院认知障碍老年人预后的干预措施在同一地点的效果。
前瞻性、非随机、验证性分阶段研究。在第一阶段,183名患者接受了三种干预措施之一:强化标准护理(ASC)、资源护士护理(RNC)或过渡护理模式(TCM)。在第二阶段,205名患者接受了TCM。
与ASC组相比,TCM组首次再住院或死亡的时间更长(p = 0.017)。与ASC组相比,TCM组全因再住院率和天数显著降低(两者p < 0.001)。RNC组与TCM组之间未观察到差异。
研究结果表明TCM比ASC更有效。然而,RNC相对于TCM的潜在效果值得进一步研究。