Health status and intensity of need for nursing care outcomes in a socially vulnerable population
Tuesday, November 5, 2013
: 9:30 a.m. - 9:50 a.m.
Background: Populations with Type 2 diabetes experience many challenges which are especially burdensome for those without health insurance or adequate access to care. The overall purpose of this study was to examine outcomes in a vulnerable population with Type 2 diabetes who received a public health nurse care coordination intervention (case management) Home visitation was the primary modality. Methods: A longitudinal, descriptive correlational design was used to examine outcomes of the care coordination intervention. Major outcomes studied were self-reported health status (SRHS), intensity of need for nursing care, diabetes empowerment and depression. The sample was purposive (n=27). The intervention goal was improved self-management of diabetes and health promoting lifestyle behaviors. Results: 43% of the sample was Spanish-speaking.; 67% female and the mean age 53 years. Mean intensity of need scores at admission were moderate (30) and decreased over time with higher dose effects. The Respiratory/Circulatory intensity parameter had the highest mean score at admission. Mean admission SRHS total scores = 486 (177 SD); mean Diabetes Empowerment scores = 4.3 (SD .61); mean PHQ-9 scores = 8.4 (6.8 SD). Lessons Learned: Care coordination for vulnerable populations is challenging but positive change in self- management can be made with intensive self-management support using tailored action plans, higher doses of PHN care coordination and adequate resources. Conclusions: As implementation of the Affordable Care Act continues, care coordination is an effective intervention strategy for health improvement and enhancing client self- efficacy for very vulnerable populations but may take higher doses of care.
Chronic disease management and prevention
Public health or related nursing
Assess a variety of outcome measures useful in providing a care coordination intervention for vulnerable Type2 diabetes populations
Keyword(s): Case Management
Presenting author's disclosure statement:
Qualified on the content I am responsible for because: I have been a PHN educator, researcher and practice consultant for many years related to care coordination interventions (case management)
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.