Multiple Chronic Diseases
Conditions
Keywords
home rehabilitation, Primary Health Care, Physiotherapy, chronic disease
Brief summary
In this research, investigators pretent to evaluate the effectiveness of clinical, functional, psychological and social impact of an intervention model based on shared care between the Mobile Rehabilitation and Physical therapy team (MRPTT) and nurse case managers of Primary Care in a sample of patients with multiple chronic diseases (comorbidities) and their caregivers. A non-randomised controlled trial.
Detailed description
The Experimental group consisted of patients with multiple chronic diseases referred to services in the province of Almería that comply the inclusion criteria and their caregivers. Outcome measures: sex, age, location, primary caregiver, disabling process, number and type of categories including by multiple pathologies, personal history, assessment (physical and functional), Barthel Index, Lawton and Brody index, risk of falls, Scale Pfeiffer, social support, caregiver burden, hospital readmissions and length, technical aids. Quality of Life (SF-12) and degree of user satisfaction. Regarding the intervention: date of application, date of assessment, objectives, treatment / intervention techniques, number of sessions, staff time spent. Control Group: Patients with multiple diseases and their caregivers, belonging to health centers or areas where there is no figure nurse case manager or MRPTT. Registration information will consist of the same assessments, questionnaires and scales that are comparable to the experimental and control groups for analysis.
Interventions
PROCEDUREHome-based rehabilitation
Procedure/Surgery: Home-based rehabilitation In the patient's home, the primarily applied treatment has been physical therapy, seeking to achieve the highest possible functionality and gait training. In more than 25% of cases, health education is conducted for families and caregivers. Thus, consistent with the patient's condition and their tolerance to activity and to exercise their self-care independently, rehabilitation interventions are activated that prevent sequelae derived from functional limitations.
Sponsors
Torrecárdenas Hospital
Almería Health District
Universidad de Almeria
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
DOUBLE (Subject, Investigator)
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* Patients with multiple chronic diseases that are referred to the nurse case managers and home rehabilitation. * Detected in Hospital or Primary Care. * To provide informed consent to participate in research.
Exclusion criteria
* clinical situation of agony; * No acceptance of treatment by the patient or family * Refuse to participate in the study * Lack of cooperation of the patient or caregiver.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Activities of daily living (ADLs) | The Barthel Index is assessing a change between initial assessment, at 2, 6 and 12 months | The Barthel Index to measure functional, activities of daily living (ADLs) (Mahoney and Barthel, 1965). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Risk of falls | Changes between initial assessment, at 2, 6 and 12 months | The risk of falls (Jonson Down questionnaire) |
Other
| Measure | Time frame | Description |
|---|---|---|
| Cognitive state | Changes between initial assessment, at 2, 6 and 12 months | The cognitive state with Pfeiffer Scale (Pfeiffer, 1975) |
| The Social Support State | Changes between initial assessment, at 2, 6 and 12 months | The Social Support State ( assessed with the Gijon abbreviated questionnaire) |
| Hospital readmissions | Hospital readmissions assessment at 12 months | number of hospital readmissions |
Countries
Spain
Outcome results
None listed