Nursing Model and Health Outcomes of Elderly People with Multimorbidity: a Quasi-experimental Study

NCT06702150 | Completed

• 1 other identifier: CES/01/2022/ME
• Study Type: interventional
• Target: 206
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this quasi-experimental study is to analyze the effect of organizing nursing care according to the primary nursing model on therapeutic self-care and satisfaction with nursing care for elderly people with multimorbidity in hospital. Participants were patients of both sexes aged over 65 years with at least two chronic diseases admitted to an acute hospital ward. The main questions it aims to answer are:

• Does the use of the primary nursing model increase participants' perceived ability for therapeutic self-care?
• Does the use of the primary care model increase participants' satisfaction with nursing care? The researchers are comparing whether implementing the primary nursing model with the usual care model increases patients' capacity for therapeutic self-care. Participants:
• Complete a self-care skills questionnaire on admission to the inpatient unit;
• Complete the same self-care questionnaire on discharge from hospital;
• Complete the same self-care questionnaire by telephone one month after discharge from hospital
• Complete a nursing care satisfaction questionnaire on discharge from hospital;

Conditions

Multimorbidity; Aged; Patient Outcome Assessment

Outcome Measures

Primary Outcomes (2)

• Average global self-care score at discharge from inpatient unit

  Evaluated by the difference in response to the Therapeutic Self-Care Scale on admission and discharge from the unit. It is a 12-question Likert scale with a minimum score of zero (0) and a maximum score of five (5), with higher scores corresponding to better results. Average response scores are used.

  On the day of discharge from the inpatient unit, assessment up to 24 hours later.

• Average global self-care score at follow-up

  Evaluated by the difference between the response to the Therapeutic Self-Care Scale at discharge and at follow-up. Also assessed by the difference between the response to the Therapeutic Self-Care Scale at admission and at follow-up. Therapeutic Self-Care Scale is a 12-question Likert scale with a minimum score of zero (0) and a maximum score of five (5), with higher scores corresponding to better results. Average response scores are used.

  At the follow-up 30 days after hospital discharge

Secondary Outcomes (1)

• Average score for satisfaction with nursing care at discharge from inpatient unit

  On the day of discharge from the inpatient unit, assessment up to 24 hours later.

Study Arms (2)

Changing the nursing care model to the primary nursing model

EXPERIMENTAL

Inpatient unit where the primary nursing model has been implemented.

Behavioral: Changing the nursing care model to the primary nursing model

Standard of care

NO INTERVENTION

In this unit there was no change in the model of nursing care; the model used was the individualized care model. In this model, each nurse is responsible for the whole care of a group of patients on one working day and may or may not be given responsibility for the same patients on subsequent days. The patients who agreed to participate in the study completed the same questionnaires and at the same frequency as the patients in the intervention unit.

Interventions

Changing the nursing care model to the primary nursing model BEHAVIORAL

The nurses received training in primary nursing care before the start of the intervention. The model was tested and implemented in early April 2022. Since then, all patients admitted to the unit have been assigned to a primary nurse within the first 48 hours. This nurse is responsible for developing and monitoring the patient's care plan, assessing care needs, implementing the care plan and evaluating the outcomes. This nurse is also responsible for coordinating care needs and discharge planning with other healthcare professionals. When the primary nurse is not working, another nurse from his or her team continues the care plan that he or she has defined. All patients admitted to the unit who met the selection criteria were informed about the study and, if they agreed to take part, completed a self-care competence questionnaire at admission (baseline), at discharge and one month after discharge. They also completed a questionnaire on satisfaction with nursing care at discharge.

Changing the nursing care model to the primary nursing model

Eligibility Criteria

• Age: 65 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)

You may qualify if:

• Have at least two chronic diseases
• Have at least one disease classified in the International Classification of Diseases, Ninth Revision (ICD9) and belonging to one of the following groups: cardiovascular disease, cancer, chronic obstructive pulmonary disease and diabetes;
• Expect to be hospitalised for more than 48 hours;
• Have the cognitive ability to read, write and understand the information provided;
• Speak, read and write Portuguese.

You may not qualify if:

• Transfer to other levels of care within the organisation
• Discharged to other care units outside the organisation
• Episodes of readmission within 30 days of leaving hospital, as this made the last moment of data collection impossible.

Sponsors & Collaborators

• Hospital da Luz, Portugal: lead
• Universidade Católica Portuguesa: collaborator

Study Sites (1)

Hospital da LUz

Lisbon, 2745-849, Portugal

Location

Related Publications (1)

• Goncalves I, Almeida S, Jesus E, Nunes E. Effect of the Primary Nursing Model on Self-Care Skills of Hospitalized Older Patients with Multimorbidity: A Quasi-Experimental Study. Healthcare (Basel). 2025 Sep 27;13(19):2457. doi: 10.3390/healthcare13192457.

  PMID: 41095543 DERIVED

Study Officials

• Elvio Jesus, Professor

  Universidade Católica Portuguesa

  STUDY DIRECTOR

• Elisabete Nunes, Professor

  Nursing School of Lisbon

  STUDY CHAIR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Head of nursing

Model Details: In the hospital where the study was carried out, each nurse is responsible for the whole care of a group of people on one working day and may or may not be given responsibility for the same people on subsequent days (individualized care model). An intervention was proposed in an inpatient unit consisting of implementing the model of organizing care by primary nursing in which a nurse is responsible for the care plan for a group of people from admission to discharge from the unit.

Study Record Dates

• First Submitted: November 12, 2024
• First Posted: November 22, 2024
• Study Start: April 18, 2022
• Primary Completion: August 31, 2023
• Study Completion: August 31, 2023
• Last Updated: November 22, 2024

Record last verified: 2024-11

Data Sharing

• IPD Sharing: Will share
• Shared Documents: SAP

Locations

PT (1)