Effect of nurse-implemented transitional care for chinese individuals with chronic heart failure in Hong Kong : A randomized controlled trial
Journal article
Yu, Doris, Lee, Diana, Stewart, Simon, Thompson, David, Choi, Kai-Chow and Yu, Cheuk-Man. (2015). Effect of nurse-implemented transitional care for chinese individuals with chronic heart failure in Hong Kong : A randomized controlled trial. Journal of the American Geriatrics Society. 63(8), pp. 1583 - 1593. https://doi.org/10.1111/jgs.13533
Authors | Yu, Doris, Lee, Diana, Stewart, Simon, Thompson, David, Choi, Kai-Chow and Yu, Cheuk-Man |
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Abstract | 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. |
Year | 2015 |
Journal | Journal of the American Geriatrics Society |
Journal citation | 63 (8), pp. 1583 - 1593 |
ISSN | 0002-8614 |
Digital Object Identifier (DOI) | https://doi.org/10.1111/jgs.13533 |
Page range | 1583 - 1593 |
Research Group | Mary MacKillop Institute for Health Research |
Publisher's version | File Access Level Controlled |
https://acuresearchbank.acu.edu.au/item/88zz0/effect-of-nurse-implemented-transitional-care-for-chinese-individuals-with-chronic-heart-failure-in-hong-kong-a-randomized-controlled-trial
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