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Associations between continuity of care, perceived control and self-care and their impact on health-related quality of life and hospital readmission - A structural equation model
Sörmland County Council, Sweden;Linköping University, Sweden;Uppsala University, Sweden.
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linnaeus University, Linnaeus Knowledge Environments, Sustainable Health. Region Kalmar County, Sweden.ORCID iD: 0000-0002-0961-5250
Linköping University, Sweden;Uppsala University, Sweden.
Uppsala University, Sweden.
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2023 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 79, no 6, p. 2305-2315Article in journal (Refereed) Published
Abstract [en]

AimThe 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. DesignCorrelational design based on cross-sectional data from a multicentre survey study. MethodsPeople 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. ResultsIn 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. ConclusionInterventions 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. ImpactThis 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 ContributionPeople and healthcare personnel evaluated content validity and were included in selecting items for the short version.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023. Vol. 79, no 6, p. 2305-2315
Keywords [en]
adult nursing chronic illness, conceptual models of nursing, discharge planning, older people, quality of life, self-care
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
URN: urn:nbn:se:lnu:diva-119966DOI: 10.1111/jan.15581ISI: 000928387700001PubMedID: 36744677Scopus ID: 2-s2.0-85147508370OAI: oai:DiVA.org:lnu-119966DiVA, id: diva2:1746037
Available from: 2023-03-27 Created: 2023-03-27 Last updated: 2023-09-07Bibliographically approved

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Årestedt, Kristofer

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