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Jerez-Barranco D, Gutiérrez-Rodríguez L, Morilla-Herrera JC, Cuevas Fernandez-Gallego M, Rojano-Perez R, Camuñez-Gomez MD, Sanchez-Del Campo JL, García-Mayor S. Components of case management in caring for patients with dementia: a mixed-methods study. BMC Nurs 2022; 21:163. [PMID: 35739550 PMCID: PMC9219194 DOI: 10.1186/s12912-022-00935-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 06/10/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Case management has shown improvements in some health outcomes for dementia patients and their families. However, despite its benefits the components of case management in order to provide effective patient and family care remain unknown at present. Thus, the aim of this study is to identify the specific components of case management in caring for patients with dementia and to determine the necessary intensity of its deployment to enhance outcomes for these patients and their caregivers. METHODS Mixed-methods study with a qualitative phase to characterise forms of service provision, according to the case management components involved, followed by a quantitative phase to analyse the correlations between different patterns of service provision, adverse events in patients and caregiver overload. This study will be based on the variables described in the RANGE.COM register. DISCUSSION This research is expected to achieve a reproducible, evaluable set of interventions that can be modelled to optimise case management effectiveness for patients with dementia. Interactions between patients with dementia, their family caregivers and case management healthcare services, the components of these interactions and their association with the conditions of the individuals concerned are issues of great interest in the field of case management, which is constantly evolving.
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Affiliation(s)
- Desirée Jerez-Barranco
- Faculty of Health Sciences, Department of Nursing (Spain), University of Málaga, C/Arquitecto Francisco Peñalosa, 3, Campus Universitario de Teatinos, 29071, Málaga, Spain
- Andalusian Health Service, District Costa del Sol, Málaga, Spain
| | - Laura Gutiérrez-Rodríguez
- Faculty of Health Sciences, Department of Nursing (Spain), University of Málaga, C/Arquitecto Francisco Peñalosa, 3, Campus Universitario de Teatinos, 29071, Málaga, Spain.
- Institute of Biomedical Research in Malaga (IBIMA), Málaga, Spain.
| | - Juan Carlos Morilla-Herrera
- Faculty of Health Sciences, Department of Nursing (Spain), University of Málaga, C/Arquitecto Francisco Peñalosa, 3, Campus Universitario de Teatinos, 29071, Málaga, Spain
- Institute of Biomedical Research in Malaga (IBIMA), Málaga, Spain
- Andalusian Health Service, District Málaga-Guadalhorce, Málaga, Spain
| | - Magdalena Cuevas Fernandez-Gallego
- Faculty of Health Sciences, Department of Nursing (Spain), University of Málaga, C/Arquitecto Francisco Peñalosa, 3, Campus Universitario de Teatinos, 29071, Málaga, Spain
- Institute of Biomedical Research in Malaga (IBIMA), Málaga, Spain
- Andalusian Health Service, District Málaga-Guadalhorce, Málaga, Spain
| | | | | | | | - Silvia García-Mayor
- Faculty of Health Sciences, Department of Nursing (Spain), University of Málaga, C/Arquitecto Francisco Peñalosa, 3, Campus Universitario de Teatinos, 29071, Málaga, Spain
- Institute of Biomedical Research in Malaga (IBIMA), Málaga, Spain
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Oliveros Rodríguez H, Buitrago G, Castellanos Saavedra P. Use of matching methods in observational studies with critical patients and renal outcomes. Scoping review. COLOMBIAN JOURNAL OF ANESTHESIOLOGY 2020. [DOI: 10.5554/22562087.e944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction: The use of matching techniques in observational studies has been increasing and is not always used appropriately. Clinical experiments are not always feasible in critical patients with renal outcomes, and observational studies are an important alternative.
Objective: Through a scoping review, determine the available evidence on the use of matching methods in studies involving critically ill patients and assessing renal outcomes.
Methods: Medline, Embase, and Cochrane databases were used to identify articles published between 1992 and 2020 up to week 10, which studied different exposures in the critically ill patient with renal outcomes and used propensity matching methods.
Results: Most publications are cohort studies 94 (94. 9 %), five studies (5. 1 %) were cross-sectional. The main pharmacological intervention was the use of antibiotics in seven studies (7. 1%) and the main risk factor studied was renal injury prior to ICU admission in 10 studies (10. 1%). The balance between the baseline characteristics assessed by standardized means, in only 28 studies (28. 2%). Most studies 95 (96 %) used logistic regression to calculate the propensity index.
Conclusion: Major inconsistencies were observed in the use of methods and in the reporting of findings. A summary is made of the aspects to be considered in the use of the methods and reporting of the findings with the matching by propensity index.
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Llaó I, Gómez-Hospital JA, Aboal J, Garcia C, Montero S, Sambola A, Ortiz J, Tomás C, Bonet G, Viñas D, Oliveras T, Sans-Roselló J, Cantalapiedra J, Andrea R, Hernández I, Pérez-Rodriguez M, Gual M, Cequier A, Ariza-Solé A. Risk-adjusted early invasive strategy in patients with non-ST-segment elevation acute coronary syndrome in Intensive Cardiac Care Units. Med Intensiva 2019; 44:475-484. [PMID: 31362838 DOI: 10.1016/j.medin.2019.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 05/27/2019] [Accepted: 06/01/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Current guidelines recommend a risk-adjusted early invasive strategy (EIS) in patients with non-ST-segment elevation acute coronary syndrome (NSTEACS). The present study assesses the application if this strategy, the conditioning factors and prognostic impact upon patients with NSTEACS admitted to Intensive Cardiac Care Units (ICCU). DESIGN A prospective cohort study was carried out. SETTING The ICCUs of 8 hospitals in Catalonia (Spain). PATIENTS Consecutive patients with NSTEACS between October 2017 and March 2018. The risk profile was defined by the European Society of Cardiology criteria. INTERVENTIONS EIS was defined as the performance of coronary angiography within the first 6hours in patients at very high-risk or within 24hours in high-risk patients. OUTCOME VARIABLES Mortality or readmission at 6 months. RESULTS A total of 629 patients were included (mean age 66.6 years), of whom 225 (35.9%) were at very high risk, and 392 (62.6%) at high risk. Most patients (96.2%) underwent an invasive strategy. EIS was performed in 284 patients (45.6%), especially younger patients with fewer comorbidities. These patients had a shorter ICCU and hospital stay, as well as a lesser incidence of ACS, revascularization and death or readmission at 6 months. After adjusting for confounders, the association between EIS and death or readmission at 6 months remained significant (hazard ratio: .66, 95% confidence interval .45-.97; P=.035). CONCLUSIONS The EIS was performed in a minority of NSTEACS admitted to ICCU, being associated with better outcomes.
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Affiliation(s)
- I Llaó
- Unidad de Cuidados Intensivos Cardiológicos, Servicio de Cardiología, Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, España
| | - J A Gómez-Hospital
- Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, España
| | - J Aboal
- Unidad de Cuidados Intensivos Cardiolígicos, Servicio de Cardiología, Hospital Universitari Josep Trueta, Girona, España
| | - C Garcia
- Unidad de Cuidados Intensivos Cardiolígicos, Servicio de Cardiología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España
| | - S Montero
- Unidad de Cuidados Intensivos Cardiológicos, Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Instituto de Investigación Biomédica IIB Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, España
| | - A Sambola
- Unidad de Cuidados Intensivos cardiológicos. Hospital Universitari de la Vall d'Hebron, Barcelona, España
| | - J Ortiz
- Unidad de Cuidados Intensivos cardiológicos. Hospital Clínic i Provincial, Barcelona, España
| | - C Tomás
- Unidad de Cuidados Intensivos cardiológicos. Hospital Arnau de Vilanova, Lleida, España
| | - G Bonet
- Unidad de Cuidados Intensivos cardiológicos. Hospital Joan XXIII, Tarragona, España
| | - D Viñas
- Unidad de Cuidados Intensivos Cardiolígicos, Servicio de Cardiología, Hospital Universitari Josep Trueta, Girona, España
| | - T Oliveras
- Unidad de Cuidados Intensivos Cardiolígicos, Servicio de Cardiología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España
| | - J Sans-Roselló
- Unidad de Cuidados Intensivos Cardiológicos, Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Instituto de Investigación Biomédica IIB Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, España
| | - J Cantalapiedra
- Unidad de Cuidados Intensivos Cardiolígicos, Servicio de Cardiología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España
| | - R Andrea
- Unidad de Cuidados Intensivos cardiológicos. Hospital Arnau de Vilanova, Lleida, España
| | - I Hernández
- Unidad de Cuidados Intensivos cardiológicos. Hospital Arnau de Vilanova, Lleida, España
| | - M Pérez-Rodriguez
- Unidad de Cuidados Intensivos cardiológicos. Hospital Joan XXIII, Tarragona, España
| | - M Gual
- Unidad de Cuidados Intensivos Cardiológicos, Servicio de Cardiología, Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, España
| | - A Cequier
- Servicio de Cardiología. Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, España
| | - A Ariza-Solé
- Unidad de Cuidados Intensivos Cardiológicos, Servicio de Cardiología, Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, España.
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Determinants of invasive strategy in elderly patients with non-ST elevation myocardial infarction. JOURNAL OF GERIATRIC CARDIOLOGY : JGC 2017; 14:465-472. [PMID: 28868075 PMCID: PMC5545189 DOI: 10.11909/j.issn.1671-5411.2017.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Background Knowledge gaps across literature prevent current guidelines from providing the profile of elderly patients most likely to derive benefit from invasive strategy (IS) in non ST-elevation myocardial infarction (NSTEMI). Furthermore, the benefit of IS in a real-world elderly population with NSTEMI remains unclear. The aims of this study were to determine factors that lead the cardiologist to opt for an IS in elderly patients with NSTEMI, and to assess the impact of IS on the 6-month all-cause mortality. Methods This multicenter prospective study enrolled all consecutive patients aged ≥ 75 years old who presented a NSTEMI and were hospitalized in cardiology intensive care unit between February 2014 and February 2015. Patients were compared on the basis of reperfusion strategy (invasive or conservative) and living status at six months, in order to determine multivariate predictors of the realization of an IS and multivariate predictors of 6-month mortality. Results A total of 141 patients were included; 87 (62%) underwent an IS. The strongest independent determinants of IS were younger age [odds ratio (OR): 0.85, 95%-confidence interval (CI): 0.78–0.92; P < 0.001) and lower “Cumulative Illness Rating Scale-Geriatric” number of categories score (OR: 0.83, 95%CI: 0.73–0.95; P = 0.002). IS was not significantly associated with 6-month survival (OR: 0.80, 95%CI: 0.27–2.38; P = 0.69). Conclusions In real-world elderly patients with NSTEMI, younger patients with fewer comorbidities profited more often from an IS. However, IS did not modify 6-month all-cause mortality.
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de-Miguel-Balsa E, Latour-Pérez J, Baeza-Román A, Amorós-Verdú C, Fernández-Lozano JA, the ARIAM-SEMICYUC group. GRACE Score Validation in Predicting Hospital Mortality: Analysis of the Role of Sex. J Womens Health (Larchmt) 2017; 26:420-425. [DOI: 10.1089/jwh.2016.5940] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Affiliation(s)
- Eva de-Miguel-Balsa
- Intensive Care and Coronary Unit, Hospital General Universitario de Elche, Elche, Spain
| | - Jaime Latour-Pérez
- Intensive Care and Coronary Unit, Hospital General Universitario de Elche, Elche, Spain
| | - Anna Baeza-Román
- Intensive Care and Coronary Unit, Hospital General Universitario de Elche, Elche, Spain
| | - Cristina Amorós-Verdú
- Intensive Care and Coronary Unit, Hospital General Universitario de Elche, Elche, Spain
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