Background
Methods
Study design
Participants
Randomization, allocation, and blinding
Intervention
Transitional care
Category | Time | Implementation method |
---|---|---|
Structural assessments and corresponding interventions designed on the basis of the Omaha System | 1, 4, 8, and 12 weeks after discharge | Face-to-face contact with the participants. A client-centered approach was used to address patients’ existing or potential health problems. First, identify patients’ existing or potential health problems: 23 systemic lupus erythematosus–related health problems were scored on knowledge, behavior, and status of disease management by using the three Likert 5-point scales. Second, provide corresponding interventions: If any one of the scores of a patient’s knowledge, behavior, or status is less than 4 points, the intervention categories and specific interventions corresponding to the problem would be provided. |
Telephone follow-up | 2, 3, 6, and 10 weeks after discharge | Phone counseling was conducted to identify and discuss any barriers and concerns which the patient may have regarding their disease. |
Usual care
Outcome measures
Disease activity
Self-care
Quality of life
Statistical analysis
Results
Demographic and clinical characteristics
Variable | Total | Control group (n = 61) | Intervention group (n = 64) |
t
| P value |
---|---|---|---|---|---|
Mean (SD) | Mean (SD) | Mean (SD) | |||
Age, years | 37.1 (14.1) | 38.4 (15.8) | 35.9 (12.3) | 1.015 | 0.312 |
SLEDAI-2K | 10.3 (4.4) | 9.7 (3.8) | 10.9 (4.9) | −1.584 | 0.116 |
Variable | n (%) | n (%) | n (%) |
χ
2
| P value |
Gender | |||||
Male | 14 (11.2) | 7 (11.5) | 7 (10.9) | 0.009 | 0.924 |
Female | 111 (88.8) | 54 (88.5) | 57 (89.1) | ||
Education level | |||||
High school or less | 60 (48.0) | 30 (49.2) | 30 (46.9) | 0.066 | 0.797 |
Above high school | 65 (52.0) | 31 (50.8) | 34 (53.1) | ||
Marital status | |||||
Married | 92 (73.6) | 47 (77.0) | 45 (70.3) | 0.729 | 0.393 |
Single | 33 (26.4) | 14 (23.0) | 19 (29.7) | ||
Work status | |||||
Employed | 27 (21.6) | 12 (19.7) | 15 (23.4) | 0.261 | 0.609 |
Unemployed | 98 (78.4) | 49 (80.3) | 49 (76.6) | ||
Medical insurance | |||||
Yes | 82 (65.6) | 39 (63.9) | 43 (67.2) | 0.146 | 0.702 |
No | 43 (34.4) | 22 (36.1) | 21 (32.8) | ||
Diagnosis duration | |||||
≤3 years | 63 (50.4) | 30 (49.2) | 33 (51.6) | 0.071 | 0.790 |
>3 years | 62 (49.6) | 31 (50.8) | 31 (48.4) | ||
Hospitalizations (past 1 year) | |||||
Yes | 81 (64.8) | 40 (65.6) | 41 (64.1) | 0.031 | 0.860 |
No | 44 (35.2) | 21 (34.4) | 23 (35.9) | ||
Comorbidity | |||||
Yes | 109 (87.2) | 51 (83.6) | 58 (90.6) | 1.378 | 0.240 |
No | 16 (12.8) | 10 (16.4) | 6 (9.4) | ||
Type of SLE medicine | |||||
GC | 21 (16.8) | 11 (18.0) | 10 (15.6) | 0.844 | 0.839 |
GC plus HCQ | 65 (52.0) | 32 (52.5) | 33 (51.6) | ||
GC plus ISD | 20 (16.0) | 8 (13.1) | 12 (18.8) | ||
GC plus HCQ plus ISD | 19 (15.2) | 10 (16.4) | 9 (14.1) |
Effects of transitional care on outcomes
Variables | Control group (n = 61) | Intervention group (n = 64) |
F
| P value | ||
---|---|---|---|---|---|---|
Pre-test Mean (SD) | Post-test Mean (SD) | Pre-test Mean (SD) | Post-test Mean (SD) | |||
Self-care agency | ||||||
Total score | 95.7 (9.6) | 100.9 (8.5) | 92.9 (10.8) | 112.9 (6.8) | 162.978 | < 0.001 |
Self-concept | 15.8 (3.5) | 15.7 (2.3) | 15.4 (3.4) | 18.9 (1.9) | 173.321 | < 0.001 |
Motivation | 17.3 (4.0) | 18.9 (1.2) | 16.5 (1.3) | 21.6 (0.7) | 251.959 | < 0.001 |
Knowledge | 33.9 (4.5) | 37.9 (3.9) | 33.2 (5.5) | 41.4 (3.6) | 55.925 | < 0.001 |
Passivity | 28.7 (2.5) | 28.5 (2.7) | 27.8 (2.9) | 31.0 (1.9) | 67.825 | < 0.001 |
Quality of life | ||||||
SF-36 PCS | 50.0 (11.9) | 60.5 (12.3) | 48.8 (12.4) | 63.7 (10.9) | 4.061 | 0.046 |
SF-36 MCS | 49.8 (13.1) | 57.4 (9.3) | 45.4 (14.3) | 61.1 (9.1) | 11.438 | 0.001 |
Variables | Control group (n = 61) | Intervention group (n = 64) |
χ
2
| P value |
---|---|---|---|---|
30-day readmissions | 13 (21.3) | 3 (4.7) | 7.733 | 0.005 |
60-day readmissions | 16 (26.2) | 7 (10.9) | 4.864 | 0.027 |
90-day readmissions | 17 (27.9) | 9 (14.1) | 4.611 | 0.032 |