PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Transitional Care”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 559 records · Page 31Linked to original sources
PubMed1991

Transitions of older adults to home care.

To discover the process of admission and transition of older adults to home care following hospital discharge, or during periods of illness, ethnographic methodology was used to explore the experience of 65 participants in the "culture" of home care: patients, families, nurses, home care staff, and discharge planners. Two themes resulting from ethnographic analysis are presented: identification of patients and needs, and transfer of information. Support from family and friends was an essential addition to referral by discharge planners, physicians, and casefinding in facilitating transition to home care. Accurate, timely patient information was found to expedite home nursing assessment and insure continuity of care.

Aged↗
PubMedDate not supplied

Living in the community while waiting for an admission in long-term care: satisfaction with a transitional nursing home project.

This qualitative study took place in Quebec City, Quebec, Canada. The main objective was to evaluate satisfaction with a transitional program aimed at keeping seniors in the community while waiting for admission to a public long-term care facility. Semistructured interviews were conducted with 4 types of informants: seniors, family members, facility managers, and hospital or community care coordinators. Results show that satisfaction varies according to groups of informants but seniors are the most satisfied of all.

Aged↗
PubMed1999

Problems of transition from tax-based system of health care finance to mandatory health insurance model in Russia.

This article examines three problems burdening the Russian system of health care finance in transition period: (a) unrealistic government promise to cover health care coverage too wide to be achieved with available resources; (b) inefficient management of health care delivery systems; and (c) lack in evidence of actual positive changes effected by the new players: mandatory health insurance carriers and funds. Radical reshaping of the health benefits promised by the government and introduction of patient co-payments are considered as a way to normalize public health sector finance and operations. Two alternative approaches to the reform of the existing eclectic system of health care management are available. Institutional preconditions for operational effectiveness of third-party purchasers of health services in public-financed health sector are defined.

Delivery of Health Care↗
PubMedDate not supplied

Establishing a home care protocol for early discharge of patients with hip and knee arthroplasties.

Joint arthroplasty procedures are significant in number and cost. Discharging hip and knee arthroplasty patients early from the hospital to a transitional home care program has the potential to reduce costs, while maintaining quality. A retrospective review of hospital records of hip and knee arthroplasty patients quantified patient problems during postoperative days 3 through 12 and analyzed them by age, gender, and joint type. The pilot study also allowed the development of a protocol for transitional home care after hip and knee arthroplasty.

Adult↗
PubMed2004

Reduced vision in older adults with age related macular degeneration interferes with ability to care for self and impairs role as carer.

AIM: To study the relation between visual impairment and ability to care for oneself or a dependant in older people with age related macular degeneration (AMD). METHOD: Cross sectional study of older people with visual impairment due to AMD in a specialised retinal service clinic. 199 subjects who underwent visual function assessment (fully corrected distance and near acuity and contrast sensitivity in both eyes), followed by completion of a package of questionnaires dealing with general health status (SF36), visual functioning (Daily Living Tasks Dependent on Vision, DLTV) and ability to care for self or provide care to others. The outcome measure was self reported ability to care for self and others. Three levels of self reported ability to care were identified--inability to care for self (level 1), ability to care for self but not others (level 2), and ability to care for self and others (level 3). RESULTS: People who reported good general health status and visual functioning (that is, had high scores on SF36 and DLTV) were more likely to state that they were able to care for self and others. Similarly people with good vision in the better seeing eye were more likely to report ability to care for self and others. People with a distance visual acuity (DVA) worse than 0.4 logMAR (Snellen 6/15) had less than 50% probability of assigning themselves to care level 3 and those with DVA worse than 1.0 logMAR (Snellen 6/60) had a probability of greater than 50% or for assigning themselves to care level 1. Regression analyses with level of care as the dependent variable and demographic factors, DLTV subscales, and SF36 dimensions as the explanatory variables confirmed that the DLTV subscale 1 was the most important variable in the transition from care level 3 to care level 2. The regression analyses also confirmed that the DLTV subscale 2 was the most important in the transition from care level 3 to care level 1. CONCLUSIONS: Ability to care for self and dependants has a strong relation with self reported visual functioning and quality of life and is adversely influenced by visual impairment. The acuity at which the balance of probability shifts in the direction of diminished ability to care for self or others is lower than the level set by social care agencies for provision of support. These findings have implications for those involved with visual rehabilitation and for studies of the cost effectiveness of interventions in AMD.

Activities of Daily Living↗
PubMed2006

In sickness and in health: transition of cancer-related care for older adolescents and young adults.

With nearly 80% of childhood cancer patients achieving cure, there are more adult survivors living now than at any other time in history. Because they are at risk for developing complications of treatment years later, it is recommended that survivors undergo systematic, regular monitoring into young adulthood and beyond. Occasionally, older adolescents and young adults are diagnosed with a relapsed, secondary or primary malignancy that requires urgent care. How best to manage each of these situations is a major challenge. A review of literature and clinical experience was performed. The medical, developmental, and psychosocial characteristics of older adolescents and young adults argue for a planned transition of care from a pediatric to more appropriate adult setting at that age. The 'health-oriented transition' involves the relatively healthy survivor, where an adult-oriented provider must be identified and supplied with a comprehensive treatment history, problem list, and monitoring plan. Continuity of medical insurance coverage must be preserved. The 2 basic models for this type of transition are either institution- or community-based. Each has relative advantages and disadvantages. In both, education and empowerment of the survivor are fundamental. The 'crisis-oriented transition' involves the older adolescent or young adult who is diagnosed in the pediatric setting with relapsed, secondary or primary cancer and is rapidly moved into the adult setting to begin treatment. With minimal time for preparation, this transition requires collaborative efforts by the pediatric and adult oncology teams. Having the capability to address both types of transition should be a central goal of any pediatric and adolescent oncology program.

Adolescent↗
PubMed2005

Integrating palliative care into heart failure care.

Heart failure is a condition for which both palliative care and hospice care can be appropriate. The disease's increasing prevalence and predilection for elderly patients with significant comorbidity underscore the need to integrate these modes of care with the acute care approach that has dominated heart failure treatment. We propose integration of a palliative care approach early in the course of heart failure treatment and a tiered process for selecting patients for hospice care. A transition of the focus to palliative care rather than mortality reduction should occur over time, when clinical status deteriorates and advanced therapeutic options become inappropriate or ineffective. Failure to respond to the need for palliative care puts at risk the mandate to treat the patient with heart failure during the entire course of illness.

Aged↗
PubMed1998

Prevalence of subacute patients in acute care: results of a study of VA hospitals.

Subacute care is a transitional level of care for medically stable patients who no longer require daily diagnostic/invasive care but require more intensive care than is typical in a skilled care facility. A Congressionally mandated study was undertaken to determine the number of VA patients with subacute needs being cared for in acute care. InterQual, Inc. subacute care criteria were retrospectively applied to 858 medical and surgical admissions from 43 VA hospitals. Over one-third contained at least one subacute day; with an average length of stay (LOS) of 12.7 days (SD = 12.4); of which 6.8 days were subacute. Patients with these admissions had significantly longer LOSs, were older, and were more likely to die or to be discharged to a nursing home. Diagnoses with subacute days included COPD, pneumonia, joint replacement, and cellulitis. Future studies should develop clinical pathways to prospectively manage admissions with subacute needs and then evaluate their effectiveness.

Age Factors↗
PubMed2001

The end of the survival journey.

OBJECTIVES: To review the problems encountered by cancer survivors who face the end of their cancer journey. DATA SOURCES: Published review and research articles and textbook chapters. CONCLUSIONS: The experiences found at the end of the survivorship journey may be exacerbations of previously encountered symptoms and feelings. Achieving physical comfort replaces the goal of controlling the tumor. IMPLICATIONS FOR NURSING PRACTICE: Continued support is needed from the oncology health care team as expertise is sought from hospice or a palliative care team to provide a seamless transition in care.

Attitude to Death↗
PubMed2002

[Sociopsychiatric care as a municipal problem].

Because of their disease mentally ill persons are often unable to request and receive necessary help on their own. Hence, local authorities have the legal duty to offer support in subsidiary or complementary ways or to organize help together with other participants concerned with psychiatric care. If the transition from community care to the differently structured regular health care system is too fast there is a danger of worsening of the symptoms. In the city of Bochum health insurance bodies agreed to take over the costs of therapy for mentally ill people via the sociopsychiatric services within the scope of crisis intervention. Background information on the sociopsychiatric services of the city of Bochum is given.

Community Mental Health Services↗
PubMedDate not supplied

Maintaining normalcy: a grounded theory of engaging in HIV-oriented primary medical care.

Despite advances in the medical treatment of HIV disease, marginalized populations continue to shoulder a disproportionate burden of HIV/AIDS-related morbidity and mortality. This study explored the process by which clients at HIV-oriented primary care clinics transition from being sporadic users of care to engaging as regular users of care. A model illustrating how participants were striving to maintain normalcy, manage perceptions, and develop life mastery skills contributes to an understanding of living with HIV disease in a social context. Elements of the model are sensitive to nursing interventions aimed at improving health outcomes and reducing health disparities among persons at highest risk.

Adaptation, Psychological↗
PubMed2006

Health-related quality of life and patient reports about care outcomes in a multidisciplinary hospital intervention.

BACKGROUND: Patient perceptions of care and health-related quality of life (HRQOL) are important outcomes for hospitalized patients. PURPOSE: This study examined patient experiences with hospital care and HRQOL in individuals hospitalized at a west coast teaching hospital. METHODS: We assessed patient experiences with care and HRQOL using interviews with 1,207 hospitalized, general medicine patients participating in a multidisciplinary provider team intervention at a large academic medical center. Patient outcome variables included the Picker dimensions of hospital care (Continuity and Transition, Coordination of Care, Emotional Support, Information and Education, Involvement of Family and Friends, Physical Comfort, Respect for Patient Preferences, Overall Impression), the Health Utilities Index Mark 3 (HUI-3), and the SF-12 physical (PCS-12) and mental health (MCS-12) summary scores. RESULTS: Patients randomized to a multidisciplinary intervention reported higher emotional support (b = 3.32), t(903) = 2.01, p =.044, and physical comfort (b = 3.49), t(863) = 2.25, p = .025, from health care providers than did the control group, but these effects became nonsignificant after adjusting for multiple comparisons. The HUI-3, PCS-12, and MCS-12 summary scores improved significantly from baseline to the 30-day, ts(943, 919, 860) = 4.94, 2.20, and 5.31, ps < .0001, = .03, and < .0001, respectively, and the 4-month follow-ups, ts(871, 919, 943) = 7.25, 8.68, and 8.08, ps < .001, < .001, and < .0001, respectively, but change on these measures did not differ between intervention and control patients. Baseline health was significantly associated with patient evaluations of hospital care, but patient evaluations did not predict future health. CONCLUSIONS: There were no differences in reports and ratings of hospital care or HRQOL between the control and the intervention groups. Hence, the behavioral changes in hospital staff in the intervention group had no effect on patient-reported outcomes. Mental health at baseline was predictive of patient evaluations of the hospitalization, but evaluations of care were not associated with subsequent HRQOL. Thus, it may be important to adjust patient evaluations of hospital care for case-mix differences in health.

Adolescent↗
PubMed1988

Trends in health care education.

The world of health care education has been changing. This article has documented some of that change reflected in a recent survey. It has also provided some suggestions for the health care educator in making decisions regarding the structure of education, programs of education, and the marketing of education. Change frequently brings frustration, confusion, and stress. For health care educators, it brings all of that. However, this is a very exciting time to be part of health care education. Transitions enable us to develop health care education in new ways that are rewarding for the organization and for those involved.

Decision Making↗
PubMedDate not supplied

Foster child health and development: implications for primary care.

Children in foster care are the most vulnerable to experiencing poor health compared with any other group of children in the United States. Children enter foster care due to experiences that have been detrimental to their health and well-being, including child abuse and neglect. They have significantly higher rates of all health problems than the general population of children, including acute and chronic illnesses, growth and developmental problems, serious mental health problems, and difficulties accessing health services. Additionally, they often experience multiple foster care placement transitions, involvement in multiple systems of care (e.g., mental health, juvenile justice, special education), and aging-out of foster care at age 18 before they are developmentally ready for independent living. While management of the complex health and developmental needs of these children is challenging, nurses in primary care have the expertise and obligation to serve these vulnerable children. Priorities for clinical practice include care coordination and interdisciplinary collaboration; maintenance of adequate, up-to-date health records; vigorous follow-up; and health-targeted advocacy.

Adolescent↗
PubMed1991

[The epidemiologic transition in Latin America].

The concept of health transition is considered to include two interrelated processes: transition of health care and epidemiological transition. The latter encompasses three basic processes: (a) replacement of the common infectious diseases by noncommunicable diseases and injuries as the leading causes of death; (b) a shift in peak morbidity and mortality from the young to the elderly; and (c) change from a situation in which mortality predominates in the epidemiological panorama to one in which morbidity is dominant. Latin America is characterized by a heterogeneous health profile in which different countries are in various stages of epidemiological transition. However, in most of them, the transition experience is unlike that of the developed countries and is distinguished by: (a) a simultaneous high incidence of diseases from both the pre- and post-transitional stages; (b) a resurgence of some infectious diseases that had previously been under control; (c) a lack of resolution of the transition process, so that the countries appear to be caught in a state of mixed morbidity; (d) a peculiar epidemiological polarization, not only between countries but also in the different geographical areas and between the various social classes of a single country. This experience is called a "prolonged polarized model."

Adolescent↗
PubMed1993

Trauma fellowship training: the insiders' perspective.

Trauma care is in a period of transition from care given by surgeons at the closest community hospital to care given by trauma specialists at trauma centers and within emergency medical systems. It has thus become increasingly important for the educational goals of trauma fellowship training to reflect the needs of the future system as well as the views of future practitioners. These views differ from those of surgical colleagues practicing trauma surgery, and the views of future trauma specialists should be considered during the formulation of training guidelines. This survey appears to be the first attempt to interpret the views of trauma fellows: 48 of the 83 fellows (57.8%) in the 1991-1992 national cohort responded. They made suggestions about their own training, including ways to increase surgical experiences and opportunities for academic pursuits, but gave no insight as to an appropriate mix of critical care training. Although critical care certification is a major attraction for fellowship training, the cohort does not want to be thought of as nonoperating surgical intensivists. A second year of fellowship training is seen as necessary for research and trauma systems-related studies.

Adult↗