Key result
Continuity of care is linked to better quality of life and fewer readmissions through self-care.
Why the study?
It was unknown whether a conceptual model linking continuity of care, perceived control, and self-care explains variations in health-related quality of life and readmissions in patients with chronic cardiac conditions after discharge.
Does continuity of care, perceived control, and self-care improve health-related quality of life and reduce hospital readmissions in patients with chronic cardiac conditions after discharge?
Cross-Sectional (n=542)
Yes
Does continuity of care, perceived control, and self-care improve health-related quality of life and reduce hospital readmissions in patients with chronic cardiac conditions after discharge?
Enhancing continuity of care, perceived control, and self-care in patients recently discharged for cardiac conditions positively impacts health-related quality of life and reduces readmissions.
Post-discharge care continuity may improve outcomes via enhanced self-care.
AIM: The aim of this study is to examine whether a conceptual model including the associations between continuity of care, perceived control and self-care could explain variations in health-related quality of life and hospital readmissions in people with chronic cardiac conditions after hospital discharge. DESIGN: Correlational design based on cross-sectional data from a multicentre survey study. METHODS: People hospitalized due to angina, atrial fibrillation, heart failure or myocardial infarction were included at four hospitals using consecutive sampling procedures during 2017-2019. Eligible people received questionnaires by regular mail 4-6 weeks after discharge. A tentative conceptual model describing the relationship between continuity of care, self-care, perceived control, health-related quality of life and readmission was developed and evaluated using structural equation modelling. RESULTS: In total, 542 people (mean age 75 years, 37% females) were included in the analyses. According to the structural equation model, continuity of care predicted self-care, which in turn predicted health-related quality of life and hospital readmission. The association between continuity of care and self-care was partly mediated by perceived control. The model had an excellent model fit: RMSEA = 0.06, 90% CI, 0.05-0.06; CFI = 0.90; TLI = 0.90. CONCLUSION: Interventions aiming to improve health-related quality of life and reduce hospital readmission rates should focus on enhancing continuity of care, perceived control and self-care. IMPACT: This study reduces the knowledge gap on how central factors after hospitalization, such as continuity of care, self-care and perceived control, are associated with improved health-related quality of life and hospital readmission in people with cardiac conditions. The results suggest that these factors together predicted the quality of life and readmissions in this sample. This knowledge is relevant to researchers when designing interventions or predicting health-related quality of life and hospital readmission. For clinicians, it emphasizes that enhancing continuity of care, perceived control and self-care positively impacts clinical outcomes. PATIENT OR PUBLIC CONTRIBUTION: People and healthcare personnel evaluated content validity and were included in selecting items for the short version.
No takes yet. Share an insight, caveat, or question.
Säfström et al. (2023) conducted a cross-sectional in chronic cardiac conditions (n=542). Continuity of care, perceived control, and self-care was evaluated on Structural equation model fit (RMSEA 0.06, 95% CI 0.05-0.06). A structural equation model demonstrated that continuity of care predicted self-care, which in turn predicted improved health-related quality of life and lower hospital readmissions.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: