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A family nurse-led intervention for reducing health services’utilization in individuals with chronic diseases:The ADVICE pilot study

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International Journal of Nursing Sciences 2021年第3期8卷 264-270,I0002页

作者： Serenella Savini Paolo Iovino Dario Monaco Roberta Marchini Tiziana Di Giovanni giuseppe Donato Ausilia Pulimeno Carmela Matera giuseppe quintavalle Carlo Turci ASL Rome 4 RomeItaly Department of Biomedicine and Prevention University of Rome Tor VergataRomeItaly School of Nursing Midwifery and paramedicine Faculty of health sciencesAustralian Catholic UniversityMelbourneAustralia Presidente Ordine Professioni Infermieristiche RomeItaly

Objectives:Intensive health services'utilization is common in older individuals affected by chronic *** study assessed whether a structured family nurse-led educational intervention would be effective in reducing health services'use(readmissions and/or emergency service access)among older people affected by chronic ***:This is a non-randomized before-after pilot study.A sample of 78 patients was recruited from two general practices in Italy and 70 among them were followed for 8 *** home care was provided during the first four months'period(months 1-4),followed by the educational intervention until the end of the study(months 5-8).The intervention,based on the teach-back method,consisted of by-weekly 60-min home sessions targeting aspects of the disease and its treatment,potential complications,medication adherence,and health *** of health services'use were collected immediately before(T0),and after the interventions(T1).Differences in utilization rates were examined by the McNemar's *** factors associated with the risk of health services'use were explored with a Cox proportional hazard regression ***:The sample(n=78)was predominantly female(n=50,64.1%),and had a mean age of 76.2(SD=4.8)*** mellitus was the most frequent disease(n=27,34.6%).McNemar's test indicated a significant reduction in health services'use at T1(McNemar χ^(2)==28.03,P<0.001).Cox regressions indicated that time and patient education,as well as their interaction,were the only variables positively associated with the probability of health services'***:A teach-back intervention led by a family nurse practitioner has the potential to reduce health services'use in older patients with chronic diseases.

关键词： Aged Chronic disease Facilities and services utilization Family nurse practitioners Patient readmission Home care services Health services

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