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Article: Effect of Nurse-Implemented Transitional Care for Chinese Individuals with Chronic Heart Failure in Hong Kong: A Randomized Controlled Trial

TitleEffect of Nurse-Implemented Transitional Care for Chinese Individuals with Chronic Heart Failure in Hong Kong: A Randomized Controlled Trial
Authors
Keywordshospital readmission
mortality
chronic heart failure
older adult
transitional care
self-care
Issue Date2015
Citation
Journal of the American Geriatrics Society, 2015, v. 63, n. 8, p. 1583-1593 How to Cite?
Abstract© 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society. Objectives To determine the effect of nurse-implemented transitional care (TC) on readmission and mortality rates in Chinese individuals with chronic heart failure (CHF) in Hong Kong. Design Single-center randomized controlled trial of TC versus usual care (UC). Setting University-affiliated hospital in Hong Kong. Participants Hospitalized Chinese individuals with CHF (N = 178; aged 78.6 ± 6.9, 45% male). Measurements: The TC group received a predischarge visit, two home visits, and then regular telephone calls over 9 months to provide self-care education and support, optimized health surveillance, and facilitation in use of community services. Primary endpoints were event-free survival, all-cause hospital readmission, and mortality during the 9-month follow-up. Secondary endpoints were length of hospital stay, self-care, and health-related quality of life (HRQL). Data were analyzed using survival analysis and generalized estimating equations, following an intention-to-treat principle. Results Survival analysis indicated no significant differences in event-free survival, hospital readmission, or mortality between the TC and UC groups, although the TC group had a lower hospital readmission rate at 6 weeks (8.1% vs 16.3%, P =.048) and lower mortality at 9 months (4.1% vs 13.8%, P =.03). The TC group also had a shorter hospital stay (P =.006) and significantly better self-care and HRQL. Because of attrition, sensitivity analyses were conducted to examine whether the intention-to-treat assumption affected the results. Per-protocol population analyses (hazard ratio (HR) = 0.40, 95% confidence interval (CI) = 0.17-0.93) and worst-case-scenario analysis (HR = 0.44, 95% CI = 0.25-0.77) suggested a lower mortality risk in the TC group. Conclusion The translation of individual-centered nurse-implemented TC to the Chinese culture and healthcare context of Hong Kong appears beneficial.
Persistent Identifierhttp://hdl.handle.net/10722/280564
ISSN
2023 Impact Factor: 4.3
2023 SCImago Journal Rankings: 1.872
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorYu, Doris S.F.-
dc.contributor.authorLee, Diana T.F.-
dc.contributor.authorStewart, Simon-
dc.contributor.authorThompson, David R.-
dc.contributor.authorChoi, Kai Chow-
dc.contributor.authorYu, Cheuk Man-
dc.date.accessioned2020-02-17T14:34:22Z-
dc.date.available2020-02-17T14:34:22Z-
dc.date.issued2015-
dc.identifier.citationJournal of the American Geriatrics Society, 2015, v. 63, n. 8, p. 1583-1593-
dc.identifier.issn0002-8614-
dc.identifier.urihttp://hdl.handle.net/10722/280564-
dc.description.abstract© 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society. Objectives To determine the effect of nurse-implemented transitional care (TC) on readmission and mortality rates in Chinese individuals with chronic heart failure (CHF) in Hong Kong. Design Single-center randomized controlled trial of TC versus usual care (UC). Setting University-affiliated hospital in Hong Kong. Participants Hospitalized Chinese individuals with CHF (N = 178; aged 78.6 ± 6.9, 45% male). Measurements: The TC group received a predischarge visit, two home visits, and then regular telephone calls over 9 months to provide self-care education and support, optimized health surveillance, and facilitation in use of community services. Primary endpoints were event-free survival, all-cause hospital readmission, and mortality during the 9-month follow-up. Secondary endpoints were length of hospital stay, self-care, and health-related quality of life (HRQL). Data were analyzed using survival analysis and generalized estimating equations, following an intention-to-treat principle. Results Survival analysis indicated no significant differences in event-free survival, hospital readmission, or mortality between the TC and UC groups, although the TC group had a lower hospital readmission rate at 6 weeks (8.1% vs 16.3%, P =.048) and lower mortality at 9 months (4.1% vs 13.8%, P =.03). The TC group also had a shorter hospital stay (P =.006) and significantly better self-care and HRQL. Because of attrition, sensitivity analyses were conducted to examine whether the intention-to-treat assumption affected the results. Per-protocol population analyses (hazard ratio (HR) = 0.40, 95% confidence interval (CI) = 0.17-0.93) and worst-case-scenario analysis (HR = 0.44, 95% CI = 0.25-0.77) suggested a lower mortality risk in the TC group. Conclusion The translation of individual-centered nurse-implemented TC to the Chinese culture and healthcare context of Hong Kong appears beneficial.-
dc.languageeng-
dc.relation.ispartofJournal of the American Geriatrics Society-
dc.subjecthospital readmission-
dc.subjectmortality-
dc.subjectchronic heart failure-
dc.subjectolder adult-
dc.subjecttransitional care-
dc.subjectself-care-
dc.titleEffect of Nurse-Implemented Transitional Care for Chinese Individuals with Chronic Heart Failure in Hong Kong: A Randomized Controlled Trial-
dc.typeArticle-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1111/jgs.13533-
dc.identifier.pmid26289684-
dc.identifier.scopuseid_2-s2.0-84939500838-
dc.identifier.volume63-
dc.identifier.issue8-
dc.identifier.spage1583-
dc.identifier.epage1593-
dc.identifier.eissn1532-5415-
dc.identifier.isiWOS:000360207000012-
dc.identifier.issnl0002-8614-

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