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Care challenges in older general hospital patients: Impact of cognitive impairment and other patient-related factors
BACKGROUND: Older general hospital patients, particularly those with cognitive impairment, frequently experience adverse events and other care complications during their stay. As these findings have so far been based on small and selected patient samples, the aim of the present study was to provide...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Medizin
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6821661/ https://www.ncbi.nlm.nih.gov/pubmed/31628613 http://dx.doi.org/10.1007/s00391-019-01628-x |
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author | Hendlmeier, Ingrid Bickel, Horst Heßler-Kaufmann, Johannes Baltasar Schäufele, Martina |
author_facet | Hendlmeier, Ingrid Bickel, Horst Heßler-Kaufmann, Johannes Baltasar Schäufele, Martina |
author_sort | Hendlmeier, Ingrid |
collection | PubMed |
description | BACKGROUND: Older general hospital patients, particularly those with cognitive impairment, frequently experience adverse events and other care complications during their stay. As these findings have so far been based on small and selected patient samples, the aim of the present study was to provide reliable data on a) the prevalence of adverse care issues (summarized under the term care challenges) in older general hospital patients and on b) associated patient-related risk factors (e.g. cognitive impairment). METHODS: A cross-sectional representative study comprising 1469 patients aged ≥65 years from 33 randomly selected general hospitals in southern Germany (GHoSt). Data collection included the use of different data sources, e.g. structured interviews with responsible nursing staff concerning care challenges and procedures for determining the patients’ cognitive status. RESULTS: Care challenges were statistically significantly (p < 0.001) more often reported for patients with dementia and/or delirium (87.5%) and mild cognitive impairment (47.9%) compared to cognitively unimpaired patients (24.6%). Adjusted odds ratios suggested cognitive impairment, impaired activities of daily living, receiving long-term care and unplanned admission as significant patient-related risk factors for care challenges. Furthermore, the occurrence of such issues was associated with the application of physical restraints, support from relatives, prescription of psycholeptics and specialist consultations. CONCLUSION: The findings suggest a strong impact of different degrees of cognitive impairment on challenges in care. The results might help to design appropriate training programs for hospital staff and other interventions to prevent or reduce critical situations. |
format | Online Article Text |
id | pubmed-6821661 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Springer Medizin |
record_format | MEDLINE/PubMed |
spelling | pubmed-68216612019-11-06 Care challenges in older general hospital patients: Impact of cognitive impairment and other patient-related factors Hendlmeier, Ingrid Bickel, Horst Heßler-Kaufmann, Johannes Baltasar Schäufele, Martina Z Gerontol Geriatr Themenschwerpunkt BACKGROUND: Older general hospital patients, particularly those with cognitive impairment, frequently experience adverse events and other care complications during their stay. As these findings have so far been based on small and selected patient samples, the aim of the present study was to provide reliable data on a) the prevalence of adverse care issues (summarized under the term care challenges) in older general hospital patients and on b) associated patient-related risk factors (e.g. cognitive impairment). METHODS: A cross-sectional representative study comprising 1469 patients aged ≥65 years from 33 randomly selected general hospitals in southern Germany (GHoSt). Data collection included the use of different data sources, e.g. structured interviews with responsible nursing staff concerning care challenges and procedures for determining the patients’ cognitive status. RESULTS: Care challenges were statistically significantly (p < 0.001) more often reported for patients with dementia and/or delirium (87.5%) and mild cognitive impairment (47.9%) compared to cognitively unimpaired patients (24.6%). Adjusted odds ratios suggested cognitive impairment, impaired activities of daily living, receiving long-term care and unplanned admission as significant patient-related risk factors for care challenges. Furthermore, the occurrence of such issues was associated with the application of physical restraints, support from relatives, prescription of psycholeptics and specialist consultations. CONCLUSION: The findings suggest a strong impact of different degrees of cognitive impairment on challenges in care. The results might help to design appropriate training programs for hospital staff and other interventions to prevent or reduce critical situations. Springer Medizin 2019-10-18 2019 /pmc/articles/PMC6821661/ /pubmed/31628613 http://dx.doi.org/10.1007/s00391-019-01628-x Text en © The Author(s) 2019 Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Themenschwerpunkt Hendlmeier, Ingrid Bickel, Horst Heßler-Kaufmann, Johannes Baltasar Schäufele, Martina Care challenges in older general hospital patients: Impact of cognitive impairment and other patient-related factors |
title | Care challenges in older general hospital patients: Impact of cognitive impairment and other patient-related factors |
title_full | Care challenges in older general hospital patients: Impact of cognitive impairment and other patient-related factors |
title_fullStr | Care challenges in older general hospital patients: Impact of cognitive impairment and other patient-related factors |
title_full_unstemmed | Care challenges in older general hospital patients: Impact of cognitive impairment and other patient-related factors |
title_short | Care challenges in older general hospital patients: Impact of cognitive impairment and other patient-related factors |
title_sort | care challenges in older general hospital patients: impact of cognitive impairment and other patient-related factors |
topic | Themenschwerpunkt |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6821661/ https://www.ncbi.nlm.nih.gov/pubmed/31628613 http://dx.doi.org/10.1007/s00391-019-01628-x |
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