A continuum of care for frail elderly people
SND-ID: ext0134-1.
Access to data via
Contact
Katarina Wilhelmson
Associated documentation
Creator/Principal investigator(s)
Katarina Wilhelmson - University of Gothenburg, Institute of Neuroscience and Physiology
Synneve Dahlin-Ivanoff - University of Gothenburg, Institute of Neuroscience and Physiology
Research principal
University of Gothenburg
- Institute of Neuroscience and Physiology
Description
The intervention “A continuum of care for frail elderly people” takes place in the municipality of Mölndal, Sweden, including municipal health and social care, the hospital of Mölndal, and primary care. The study has a descriptive analytical and experimental design. The intervention is performed as a randomised controlled trial. The participants were randomised to two study arms, one intervention group and one control group.
Intervention group: The intervention includes an early geriatric assessment, early family support, a case manager in the community with a multi-professional team and the involvement of the elderly people and their relatives in the planning process.
Control group: The control group received conventional care and follow up.
The study group included 161 elderly people who sought care at the emergency department at Mölndal Hospital during the period October 2008 to June 2010 and who were discharged to their own homes in the municipality of Mölndal. Inclusion criteria were age 80 and older or 65 to 79 with at least one chronic disease and dependent in at least one activity
Intervention group: The intervention includes an early geriatric assessment, early family support, a case manager in the community with a multi-professional team and the involvement of the elderly people and their relatives in the planning process.
Control group: The control group received conventional care and follow up.
The study group included 161 elderly people who sought care at the emergency department at Mölndal Hospital during the period October 2008 to June 2010 and who were discharged to their own homes in the municipality of Mölndal. Inclusion criteria were age 80 and older or 65 to 79 with at least one chronic disease and dependent in at least one activity of daily living.
A baseline interview and assessment were done within a week of discharge. In some cases it was not possible to do the baseline interview so soon, mostly because the frail elderly person not having enough strength. Follow up data were collected at 3, 6 and 12 months, and after 2 years following the baseline measurement.
Purpose:
The overall aim of the study was to implement the intervention and thereby create a continuum of care for frail elderly people, from the emergency ward to their own homes, resulting in a better quality of care and higher cost-effectiveness. Another aim was to study the implementation process of the intervention programme.
The dataset includes the participants in the intervention group and the control group, a total of 161 participants. The baseline intervention was carried out between October 2008 and June 2010, and follow ups at 3, 6 and 12 months. Show less..
Data contains personal data
No
Population
The population is based on elderly people who sought care at the emergency department at Mölndal Hospital during the period October 2008 to June 2010 and who were discharged to their own homes in the municipality of Mölndal.
Study design
Experimental study
Sampling procedure
The participants were recruited at the emergency wards at Mölndal Hospital. Inclusion criteria were age 80 and older or 65 to 79 with at least one chronic disease and dependent in at least one activity of daily living. Exclusion criteria were acute severe illness with immediate need of assessment and treatment by a physician (within ten minutes), dementia (or severe cognitive impairment), and palliative care.
The nurse with geriatric competence screened most of the patients during her work shift to see if they fulfilled the inclusion criteria. If so, the nurse informed about the study both verbally and in writing. The information included a description of the study, how it would be conducted and what was expected of people who agreed to participate. There were opportunities to ask questions if anything was unclear. It was stressed, both in the verbal and the written information that participation was voluntarily. Of all those invited to participate, 17 were invited by letter, as they had been discharged before the nurse was able to ask them. People who accepted to participate in the study wer
The nurse with geriatric competence screened most of the patients during her work shift to see if they fulfilled the inclusion criteria. If so, the nurse informed about the study both verbally and in writing. The information included a description of the study, how it would be conducted and what was expected of people who agreed to participate. There were opportunities to ask questions if anything was unclear. It was stressed, both in the verbal and the written information that participation was voluntarily. Of all those invited to participate, 17 were invited by letter, as they had been discharged before the nurse was able to ask them. People who accepted to participate in the study were randomised to intervention or control by using a system of sealed opaque envelopes. All participants signed a written consent form. The study started with a pilot study to test intervention, inclusion/exclusion criteria and logistics. The pilot study comprised the first ten included participants. Show less..
Time period(s) investigated
2008-10 – 2011-07
Number of individuals/objects
161
Data format / data structure
Geographic spread
Geographic description: Mölndal municipality
Responsible department/unit
Institute of Neuroscience and Physiology
Ethics Review
Gothenburg - Ref. 413-08
Research area
Medical and health sciences (Standard för svensk indelning av forskningsämnen 2011)
Clinical medicine (Standard för svensk indelning av forskningsämnen 2011)
Geriatrics (Standard för svensk indelning av forskningsämnen 2011)
Nursing (Standard för svensk indelning av forskningsämnen 2011)
Other social sciences not elsewhere specified (Standard för svensk indelning av forskningsämnen 2011)
Health (CESSDA Topic Classification)
Keywords
Aged, Rehabilitation, Activities of daily living, Aged, 80 and over, Frail elderly, Geriatrics, Nursing care, Geriatric nursing, Signs and symptoms, Exercise, Surveys and questionnaires, Case-control studies, Cognition, Registries, Disease, Hospitalization, Social support, Fatigue, Weight loss, Health services
Wilhelmson K, Duner A, Eklund K, Gosman-Hedström G, Blomberg S, Hasson H, Gustafsson H, Landahl S, Dahlin-Ivanoff S. Design of a randomized controlled study of a multi-professional and multidimensional intervention targeting frail elderly people. BMC Geriatr. 2011 May 14;11:24. doi: 10.1186/1471-2318-11-24.
Read full text
Wilhelmson K, Fritzell E, Eklund K, Dahlin-Ivanoff S. Life satisfaction and frailty among older adults. Health Psychology Research 2013 1 (3): 167-172. doi: 10.4081/hpr.2013.e32
Read full text
Berglund H, Dunér A, Blomberg S, Kjellgren K. Care planning at home: a way to increase the influence of older people? Int J Integr Care. 2012 Aug 10;12:e134.
Read full text
Ebrahimi Z, Dahlin-Ivanoff S, Ekund K, Jakobsson A, Wilhelmson K. Self-rated health and health strengthens factors in community living frail elders. Accepted for publication in Journal of Advanced Nursing.
Ottenvall-Hammar I, Ekelund C, Wilhelmson K, Eklund K. Impact on Participation and Autonomy for older persons and its Validity and Reliability. In press Health Psychology Research. Doi 10.4081/hpr.2014.1825
Bångsbo A, Dunér A, Lidén E. Patient participation in the discharge planning conference. Int J Integr Care. 2014 Nov 6;14:e030.
Read full text
Berglund H, Hasson H, Kjellgren K, Wilhelmson K. Effects of a continuum of care intervention on frail older persons' life satisfaction: a randomized controlled study. J Clin Nurs. 2014 Oct 8. doi: 10.1111/jocn.12699.
Dunér A. Care planning and decision making in teams in Swedish elderly care - a study of interprofessional collaboration and professional boundaries. J Interprof Care. 2013 May;27(3):246-53. doi: 10.3109/13561820.2012.757730.
Berglund H, Blomberg S, Dunér A, Kjellgren K (accepted) Organizing integrated care for older persons: strategies in Sweden during the past decade. Journal of Health Organization and Management.
Eklund K, Wilhelmson K, Gustafsson H, Landahl S, Dahlin-Ivanoff S. One-year outcome of frailty indicators and activities of daily living following the randomised controlled trial: "Continuum of care for frail older people". BMC Geriatr. 2013 Jul 22;13:76. doi: 10.1186/1471-2318-13-76.
Read full text
Ebrahimi Z, Wilhelmson K, Eklund K, Moore CD, Jakobsson A Health despite frailty: exploring influences on frail older adults' experiences of health. Geriatr Nurs. 2013 Jul-Aug;34(4):289-94. doi: 10.1016/j.gerinurse.2013.04.008.
Ekelund, C, Dahlin-Ivanoff, S, Eklund, K. Self-determination and older people--a concept analysis. Scand J Occup Ther. 2014 Mar;21(2):116-24. doi: 10.3109/11038128.2013.853832.
Berglund H, Wilhelmson K, Blomberg S, Dunér A, Kjellgren K, Hasson H. Older people's views of quality of care: a randomised controlled study of continuum of care. J Clin Nurs. 2013 Oct;22(19-20):2934-44. doi: 10.1111/jocn.12276.
Ebrahimi Z, Wilhelmson K, Moore CD, Jakobsson A. Frail elders' experiences with and perceptions of health. Qual Health Res. 2012 Nov;22(11):1513-23. doi: 10.1177/1049732312457246.
Dunér A, Blomberg S, Hasson H. Implementing a continuum of care model for older people-results from a Swedish case study. Int J Integr Care. 2011 Oct;11:e136. Epub 2011 Nov 18.
Wilhelmson K, Eklund K, Gustafsson H, Larsson A-C, Landahl S, Dahlin-Ivanoff S. Skörhet bra begrepp för att hitta äldre stort behov av vård och omsorg. Läkartidningen 2012; 109 (16): 826-827.
Wilhelmson K, Dunér A, Eklund K, Gosman-Hedström, G, Gustafsson H, Dahlin-Ivanoff S. Bättre vård och omsorg för multisjuka äldre kräver samverkan och ansvariga vårdgivare. Läkartidningen 2009; 48: 3273-4.
Fornazar R, Spak F, Dahlin-Ivanoff S, Wilhelmson K. Alcohol consumption among the oldest old and how it changes during two years. ISRN Geriatrics 2013. Article ID 671218, 10 pages. doi:10.1155/2013/671218.
Ottenvall Hammar I, Dahlin-Ivanoff S, Wilhelmson K, Eklund K. Shifting between self-governing and being governed: a qualitative study of older persons' self-determination. BMC Geriatrics 2014,14:126 doi:10.1186/1471-2318-14-126.
If you have published anything based on these data, please notify us with a reference to your publication(s). If you are responsible for the catalogue entry, you can update the metadata/data description in DORIS.