Multi-dimensional Problem Scoring in the Continuing Management of Elderly Patients
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Date
2023-02
Journal Title
Journal ISSN
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Publisher
International Journal of Contemporary Medical Research
Abstract
Introduction: Usual diagnosis in hospitalised elderly addresses mainly their physical ailment. However, there is a need to also take into account various other issues like the psychological status, financial status, ability of activities of daily living, family support which will help plan continuing care at the home after discharge. This study aims to look at various aspects in the care of an elderly person and to make a multi-dimensional problem identification structure for them before discharge. Method and materials: This descriptive study done over 3 months at the NRI Medical College General Hospital involved 120 inpatients (equal males & females) aged above 65 years. After taking an informed consent, a predetermined instrument covering 10 different dimensions i.e. physical, mental, emotional, spiritual, nutritional, family support, social, occupational, financial, and home environment was administered. A total of 40 responses were assigned appropriate scores, the minimum being 40 for those doing well and maximum being 105 indicating severity in all dimensions. The collected data was entered in Microsoft Excel and presented in tables and graphs. Important findings were subjected to tests of significance like Chi square and Z tests at 5% LOS. Results: The prepared scoring instrument showed a Cronbach's Alpha value of 0.78 which indicates internal consistency and an acceptable level of reliability. The mean score was 71 (range 50 – 95, Standard deviation 10.7). High scores show an inverse relationship to the financial situation of the patient (Chi square 32.4, p value < 0.0001). When the purpose in life for the elderly was weak, the score was higher (Chi square 53.7, p value < 0.00001). Discussion: The study indicates the need for a problem scoring system which looks at all aspects of an elderly person’s life i.e. psychological, emotional, social etc. in addition to the physical diagnosis. Elderly patients living alone, widowed or financially weak are prone to neglect and depression. Patients who feel lonely or have a poor will to live are also at risk. Conclusion: A multi-dimensional problem identification system for elderly hospitalised patients can yield a comprehensive understanding of the patient’s real life circumstances and help make better post discharge care plans.
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Keywords
Multi-dimensional Problem, Continuing Management, Elderly Patients
Citation
Chandrasekhar G. Mohan, Rao Nallapu Samson Sanjeeva. Multi-dimensional Problem Scoring in the Continuing Management of Elderly Patients. International Journal of Contemporary Medical Research. 2023 Feb; 10(2): 1-7