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社会心理因素能否预测老年糖尿病患者的再入院情况?

Do Psychosocial Factors Predict Readmission among Diabetic Elderly Patients?

作者信息

Alavi Mousa, Baharlooei Omeleila, AdelMehraban Marzieh

机构信息

Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.

Student Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

Iran J Nurs Midwifery Res. 2017 Nov-Dec;22(6):460-464. doi: 10.4103/ijnmr.IJNMR_138_16.

Abstract

BACKGROUND

Despite advances in diabetes treatment, the rate of readmission is still relatively high among these patients, especially in older population. Various factors may predict readmission in these patients; hence, the aim of this study was to assess the role of psychosocial factors in predicting readmission among diabetic elderly hospitalized in selected hospitals of Isfahan.

MATERIALS AND METHODS

In this cross-sectional study conducted from January to September 2016, 150 diabetic elderly hospitalized in selected hospitals affiliated with Isfahan University of medical sciences were chosen using a convenient sampling method. The initial information was collected by a three-part questionnaire consisting of (a) demographic characteristics, (b) 21-item depression, anxiety, and stress scale (DASS-21), and (c) multidimensional scale of perceived social support (MSPSS). Further information about readmission was gathered 3 months after completing the questionnaires through a phone call follow-up. Descriptive and inferential statistics (discriminant function analysis test) were used to analyze the data.

RESULTS

During 3 months after discharge, 44% of hospitalized diabetic elderly were readmitted. Analytical model predicted the readmission status of 109 individuals (of total 150 persons) in the studied units (success rate of 72.2%). Among predicting factors, depression and social support had the most and the least important roles in predicting readmission rate, respectively.

CONCLUSIONS

Interventions to improve mental status (i.e., decreasing levels of depression, anxiety, and stress) and develop social support are suggested to reduce the risk of readmission among diabetic elderly patients. Nevertheless, future studies are needed to verify the value of such interventions.

摘要

背景

尽管糖尿病治疗取得了进展,但这些患者的再入院率仍然相对较高,尤其是在老年人群中。多种因素可能预测这些患者的再入院情况;因此,本研究的目的是评估心理社会因素在预测伊斯法罕选定医院住院的糖尿病老年人再入院中的作用。

材料与方法

在这项于2016年1月至9月进行的横断面研究中,采用方便抽样方法选取了150名在伊斯法罕医科大学附属选定医院住院的糖尿病老年人。初始信息通过一份由三部分组成的问卷收集,包括(a)人口统计学特征,(b)21项抑郁、焦虑和压力量表(DASS - 21),以及(c)感知社会支持多维量表(MSPSS)。在完成问卷3个月后,通过电话随访收集有关再入院的进一步信息。使用描述性和推断性统计(判别函数分析测试)来分析数据。

结果

出院后的3个月内,44%的住院糖尿病老年人再次入院。分析模型预测了研究单位中109名个体(总共150人)的再入院状态(成功率为72.2%)。在预测因素中,抑郁和社会支持在预测再入院率方面分别具有最重要和最不重要的作用。

结论

建议采取干预措施改善心理状态(即降低抑郁、焦虑和压力水平)并发展社会支持,以降低糖尿病老年患者再入院的风险。然而,需要未来的研究来验证此类干预措施的价值。

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Hospital readmission of patients with diabetes.糖尿病患者的医院再入院情况。
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Risk factors for hospital readmission of elderly patients.老年患者住院再入院的风险因素。
Eur J Intern Med. 2013 Jan;24(1):45-51. doi: 10.1016/j.ejim.2012.10.005. Epub 2012 Nov 8.
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