Concerns of older patients and their caregivers in the emergency department
Older emergency department (ED) patients often have complex problems and severe illnesses with a high risk of adverse outcomes. It is likely that these older patients are troubled with concerns, which might reflect their preferences and needs concerning medical care. However, data regarding this top...
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| Veröffentlicht in: | PloS one 2020-07, Vol.15 (7), p.e0235708-e0235708 |
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| creator | Zelis, Noortje Huisman, Sarah E Mauritz, Arisja N Buijs, Jacqueline de Leeuw, Peter W Stassen, Patricia M |
| description | Older emergency department (ED) patients often have complex problems and severe illnesses with a high risk of adverse outcomes. It is likely that these older patients are troubled with concerns, which might reflect their preferences and needs concerning medical care. However, data regarding this topic are lacking. This study is a sub study of a prospective, multicenter, observational cohort study among older medical ED patients ([greater than or equal to]65 years). Patients or their caregivers were asked about their illness-related concerns during the first stage of the ED visit using a questionnaire. All concerns were categorized into 10 categories, and differences between patients and caregivers, and between age groups were analyzed. Odds Ratios were calculated to determine the association of the concerns for different adverse outcomes. Most of the 594 included patients (or their caregivers) were concerned (88%) about some aspects of their illness or their need for medical care. The most often reported concerns were about the severity of disease (43.6%), functional decline (9.4%) and dying (5.6%). Caregivers were more frequently concerned than patients (p |
| doi_str_mv | 10.1371/journal.pone.0235708 |
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It is likely that these older patients are troubled with concerns, which might reflect their preferences and needs concerning medical care. However, data regarding this topic are lacking. This study is a sub study of a prospective, multicenter, observational cohort study among older medical ED patients ([greater than or equal to]65 years). Patients or their caregivers were asked about their illness-related concerns during the first stage of the ED visit using a questionnaire. All concerns were categorized into 10 categories, and differences between patients and caregivers, and between age groups were analyzed. Odds Ratios were calculated to determine the association of the concerns for different adverse outcomes. Most of the 594 included patients (or their caregivers) were concerned (88%) about some aspects of their illness or their need for medical care. The most often reported concerns were about the severity of disease (43.6%), functional decline (9.4%) and dying (5.6%). Caregivers were more frequently concerned than patients (p<0.001) especially regarding the severity of disease (50.5 vs 39.6%, p = 0.016) and cognitive decline (10.8 vs. 0.3%, p 7 days, loss of independent living and unplanned readmission within 30 days) (OR 2.32; 95%CI: 1.12-4.82). In addition, unspecified concerns were associated with mortality (OR 1.88; 95%CI: 1.09-3.22). The majority of older patients and especially their caregivers are concerned about their medical condition or need for medical care when they visit the ED. These concerns are associated with adverse outcomes and most likely reflect their needs regarding medical care. More attention should be paid to these concerns because they may offer opportunities to reduce anxiety and provide care that is adjusted to their needs.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0235708</identifier><identifier>PMID: 32645113</identifier><language>eng</language><publisher>San Francisco: Public Library of Science</publisher><subject>Activities of daily living ; Age groups ; Biology and Life Sciences ; Care and treatment ; Caregivers ; Cognitive ability ; Cohort analysis ; Disease ; Elderly patients ; Emergency medical care ; Emergency medical services ; Gastroenterology ; Health care ; Health services ; Hospital emergency services ; Illnesses ; Internal medicine ; Medical research ; Medicine ; Medicine and Health Sciences ; Mortality ; Officials and employees ; Older people ; Patients ; People and Places ; Population ; Questionnaires ; Research and Analysis Methods ; Researchers ; Social aspects ; Studies</subject><ispartof>PloS one, 2020-07, Vol.15 (7), p.e0235708-e0235708</ispartof><rights>COPYRIGHT 2020 Public Library of Science</rights><rights>2020 Zelis et al. 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It is likely that these older patients are troubled with concerns, which might reflect their preferences and needs concerning medical care. However, data regarding this topic are lacking. This study is a sub study of a prospective, multicenter, observational cohort study among older medical ED patients ([greater than or equal to]65 years). Patients or their caregivers were asked about their illness-related concerns during the first stage of the ED visit using a questionnaire. All concerns were categorized into 10 categories, and differences between patients and caregivers, and between age groups were analyzed. Odds Ratios were calculated to determine the association of the concerns for different adverse outcomes. Most of the 594 included patients (or their caregivers) were concerned (88%) about some aspects of their illness or their need for medical care. The most often reported concerns were about the severity of disease (43.6%), functional decline (9.4%) and dying (5.6%). Caregivers were more frequently concerned than patients (p<0.001) especially regarding the severity of disease (50.5 vs 39.6%, p = 0.016) and cognitive decline (10.8 vs. 0.3%, p 7 days, loss of independent living and unplanned readmission within 30 days) (OR 2.32; 95%CI: 1.12-4.82). In addition, unspecified concerns were associated with mortality (OR 1.88; 95%CI: 1.09-3.22). The majority of older patients and especially their caregivers are concerned about their medical condition or need for medical care when they visit the ED. These concerns are associated with adverse outcomes and most likely reflect their needs regarding medical care. 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one</jtitle><date>2020-07-09</date><risdate>2020</risdate><volume>15</volume><issue>7</issue><spage>e0235708</spage><epage>e0235708</epage><pages>e0235708-e0235708</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Older emergency department (ED) patients often have complex problems and severe illnesses with a high risk of adverse outcomes. It is likely that these older patients are troubled with concerns, which might reflect their preferences and needs concerning medical care. However, data regarding this topic are lacking. This study is a sub study of a prospective, multicenter, observational cohort study among older medical ED patients ([greater than or equal to]65 years). Patients or their caregivers were asked about their illness-related concerns during the first stage of the ED visit using a questionnaire. All concerns were categorized into 10 categories, and differences between patients and caregivers, and between age groups were analyzed. Odds Ratios were calculated to determine the association of the concerns for different adverse outcomes. Most of the 594 included patients (or their caregivers) were concerned (88%) about some aspects of their illness or their need for medical care. The most often reported concerns were about the severity of disease (43.6%), functional decline (9.4%) and dying (5.6%). Caregivers were more frequently concerned than patients (p<0.001) especially regarding the severity of disease (50.5 vs 39.6%, p = 0.016) and cognitive decline (10.8 vs. 0.3%, p 7 days, loss of independent living and unplanned readmission within 30 days) (OR 2.32; 95%CI: 1.12-4.82). In addition, unspecified concerns were associated with mortality (OR 1.88; 95%CI: 1.09-3.22). The majority of older patients and especially their caregivers are concerned about their medical condition or need for medical care when they visit the ED. These concerns are associated with adverse outcomes and most likely reflect their needs regarding medical care. More attention should be paid to these concerns because they may offer opportunities to reduce anxiety and provide care that is adjusted to their needs.</abstract><cop>San Francisco</cop><pub>Public Library of Science</pub><pmid>32645113</pmid><doi>10.1371/journal.pone.0235708</doi><tpages>e0235708</tpages><orcidid>https://orcid.org/0000-0003-0015-5240</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Activities of daily living Age groups Biology and Life Sciences Care and treatment Caregivers Cognitive ability Cohort analysis Disease Elderly patients Emergency medical care Emergency medical services Gastroenterology Health care Health services Hospital emergency services Illnesses Internal medicine Medical research Medicine Medicine and Health Sciences Mortality Officials and employees Older people Patients People and Places Population Questionnaires Research and Analysis Methods Researchers Social aspects Studies |
| title | Concerns of older patients and their caregivers in the emergency department |
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