Transitional Care Based e-Health Program for Older Muslim Thai Adults with Chronic Obstructive Pulmonary Disease After Hospital Discharge: A Feasibility Study

Authors

  • Latifah Jehloh Faculty of Nursing, Prince of Songkla University, Thailand.
  • Praneed Songwathana Faculty of Nursing, Prince of Songkla University, Thailand.
  • Luppana Kitrungrote Faculty of Nursing, Prince of Songkla University, Thailand.

DOI:

https://doi.org/10.60099/prijnr.2024.264962

Keywords:

Chronic obstructive pulmonary disease, e-Health program, Feasibility study, Hospital discharge, Muslim, Nursing, Older adults, Transitional care

Abstract

Older adults with chronic obstructive pulmonary disease frequently visit the emergency department due to an acute exacerbation of the disease or symptoms after discharge from hospital. Therefore, providing programs that enable caregivers to recognize and manage alert signs and symptoms in caring for older adults with chronic obstructive pulmonary disease at home is essential. This feasibility study is a part of emergency health management in transitional care program to reduce emergency department visits in older adults with dyspnea, and aimed to develop and test the Transitional Care Based e-Health Program. The program was tested using one group pre-test and post-test design with 50 family caregivers of older adults living with chronic obstructive pulmonary disease. Data was collected from November 2021 to May 2022. The ability to manage dyspnea symptoms among family caregivers and patient emergency department visits was assessed 30 days after hospital discharge. Data were analyzed using the Wilcoxon Signed Rank Test to compare the pre- and post-score differences.

After implementation, it was found that the program was feasible and could improve the ability to manage dyspnea. Only three of 50 cases had emergency department visits within 30 days after discharge, accounting for 6% compared to the earlier report of 27.18%. The findings provide potential transitional care based on an e-health program to enhance the ability of dyspnea symptom management among family caregivers. Nurses can use this program in practice. However, further study is needed with randomized controlled trials before it can be widely used nationally.

References

Economic Research Institute for ASEAN and East Asia. Population ageing in Thailand [Internet]. 2021 June 25 [cited 2023 March 5]. Available from: https://www.eria.org/publications/population-ageing-in-thailand/

World Health Organization. Thailand’s leadership and innovations towards healthy ageing [Internet]. 2023 Feb 9 [cited 2023 Sept 19]. Available from: https://www.who.int/southeastasia/news/feature-stories/detail/thailands-leadership-and-innovation-towards-healthy-ageing

Mwakilasa MT, Foley C, O’Carroll T, Flynn R, Rohde D. Care experiences of older people in the emergency department: a concurrent mixed-methods study. J Patient Exp. 2021;8: 23743735211065267. doi:10.1177/23743735211065267. DOI: https://doi.org/10.1177/23743735211065267

Ukkonen M, Jämsen E, Zeitlin R, Pauniaho SL. Emergency department visits in older patients: a population-based survey. BMC Emerg Med. 2019;19(1):20. doi:10.1186/s12873-019-0236-3. DOI: https://doi.org/10.1186/s12873-019-0236-3

Paksopis T, Suteparuk C, Sinsuwan N, Rojsaengroeng R, Sri-on J, Vanichkulbodee A. Emergency department visited for elderly patients in Bangkok, Thailand before and after severe flooding in 2011. Thai J Emerg Med. 2019;1(1):5-15.

https://he02.tcithaijo.org/index.php/TJEM/article/view/247074

Wang Y, He R, Dong F, Liu D, Ren X, Yang T, Wang C. Re-exacerbation within 30 days of discharge is associated with poor prognosis in the following year among patients hospitalised with exacerbation of chronic obstructive pulmonary disease: a clinical cohort study. BMJ Open Respir Res. 2023;10(1):e001759. doi:10.1136/bmjresp-2023-001759. DOI: https://doi.org/10.1136/bmjresp-2023-001759

Santos FS, Dias BM, Reis AM. Emergency department visits of older adults within 30 days of discharge: analysis from the pharmacotherapy perspective. Einstein (Sao Paulo). 2020;18:eAO4871. doi:10.31744/einstein_journal/2020AO4871. DOI: https://doi.org/10.31744/einstein_journal/2020AO4871

Dresden SM, Hwang U, Garrido MM, Sze J, Kang R, Vargas-Torres C, et al. Geriatric emergency department innovations: the impact of transitional care nurses on 30- day readmissions for older adults. Acad Emerg Med. 2020; 27(1):43-53. doi:10.1111/acem.13880. DOI: https://doi.org/10.1111/acem.13880

Baxter R, Shannon R, Murray J, O’Hara JK, Sheard L, Cracknell A, et al. Delivering exceptionally safe transitions of care to older people: a qualitative study of multidisciplinary staff perspectives. BMC Health Serv Res. 2020;20:780. https://doi.org/10.1186/s12913-020-05641-4 DOI: https://doi.org/10.1186/s12913-020-05641-4

Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease [Internet]. 2023 [cited 2023 Sept 19]. Available from: https://goldcopd.org/2023-gold-report-2/

Moriyama M, Kazawa K, Jahan Y, Ikeda M, Mizukawa M, Fukuoka Y, et al. The effectiveness of telenursing for self-management education on cardiometabolic conditions: a pilot project on a remote island of Ōsakikamijima, Japan. J Prim Care Community Health. 2021;12:21501327 211030817. doi:10.1177/21501327211030817. DOI: https://doi.org/10.1177/21501327211030817

Lindeman DA, Kim KK, Gladstone C, Apesoa-Varano EC. Technology and caregiving: emerging interventions and directions for research. Gerontologist. 2020;60(Suppl 1): S41-9. doi:10.1093/geront/gnz178. DOI: https://doi.org/10.1093/geront/gnz178

Naylor MD. Advancing high value transitional care: the central role of nursing and its leadership. Nurs Adm Q. 2012;36:115-26. doi:10.1097/NAQ.0b013e31824a040b. DOI: https://doi.org/10.1097/NAQ.0b013e31824a040b

Dodd M, Janson S, Facione N, Faucett J, Froelicher ES, Humphreys J, et al. Advancing the science of symptom management. J Adv Nurs. 2001;33(5):668-76. doi:10.1046/j.1365-2648.2001.01697.x. DOI: https://doi.org/10.1046/j.1365-2648.2001.01697.x

Songwathana P, Fongsuwan C, Jehloh L, Binsa F. Health emergency management program in transitional period to minimize readmission in emergency department of older adults with dyspnea in the community. Chiang Mai: Siampimnana Publishing; 2022.

Hirschman K, Shaid E, McCauley K, Pauly M, Naylor MD. Continuity of care: the transitional care model. Online J Issues Nurs. 2015;20(3):1. PMID: 26882510. DOI: https://doi.org/10.3912/OJIN.Vol20No03Man01

Peruzza S, Sergi G, Vianello A, Pisent C, Tiozzo F, Manzan A, et al. Chronic obstructive pulmonary disease (COPD) in elderly subjects: impact on functional status and quality of life. Respir Med. 2003;97(6): 612-7. doi:10.1053/rmed.2003.1488. DOI: https://doi.org/10.1053/rmed.2003.1488

van den Broek S, Westert GP, Hesselink G, Schoon Y. Effect of ED-based transitional care interventions by healthcare professionals providing transitional care in the emergency department on clinical, process and service use outcomes: a systematic review. BMJ Open. 2023;13(3):e066030. doi:10.1136/bmjopen-2022-066030. DOI: https://doi.org/10.1136/bmjopen-2022-066030

Pinkaew O, Kangchai W, Rattanajarana S. The effects of a symptom management program combined with SKT meditation on dyspnea, oxygen saturation, and anxiety among older people with chronic obstructive pulmonary disease. JFONUBUU. 2021; 29(2): 59-70. https://he02.tci-thaijo.org/index.php/Nubuu/article/view/251851/171106 (in Thai)

Polit DF, Beck CT. Nursing research: generating and assessing evidence for nursing practice. Philadelphia: Lippincott Williams & Wilkins; 2012.

Cohen J. Statistical power analysis for the behavioral sciences. Hillsdale, NJ: Lawrence Erlbaum Associates, Publishers; 1998.

Chantaro N. Effect of self-management support program on ability to manage symptoms and dyspnea among patients with chronic obstructive pulmonary disease. [Master’s thesis]. [Songkla]: Prince of Songkla University; 2017.

Park Y, Kim J, Kim S, Moon D, Jo H. Effects of transitional care after hospital discharge in patients with chronic obstructive pulmonary disease: an updated systematic review and meta-analysis. Int J Environ Res Public Health. 2023;20(11):6053. doi:10.3390/ijerph20116053. DOI: https://doi.org/10.3390/ijerph20116053

Morkisch N, Upegui-Arango LD, Cardona MI, van den Heuvel D, Rimmele M, Sieber CC, et al. Components of the transitional care model (TCM) to reduce readmission in geriatric patients: a systematic review. BMC Geriatr. 2020;20(1):345. doi:10.1186/s12877-020-01747-w. DOI: https://doi.org/10.1186/s12877-020-01747-w

Fønss Rasmussen L, Grode LB, Lange J, Barat I, Gregersen, M. Impact of transitional care interventions on hospital readmissions in older medical patients: a systematic review. BMJ Open. 2021;11:e040057. doi:10.1136/bmjopen-2020-040057. DOI: https://doi.org/10.1136/bmjopen-2020-040057

McGilton KS, Vellani S, Krassikova A, Roertson S, Irwin, C, Cumal A, et al. Understanding transitional care programs for older adults who experience delayed discharge: a scoping review. BMC Geriatr. 2021;21(1):210. https://doi.org/10.1186/s12877-021-02099-9 DOI: https://doi.org/10.1186/s12877-021-02099-9

Markle-Reid M, McAiney C, Ganann R, Fisher K, Gafni A, Gauthier AP, et al. Study protocol for a hospital-to-home transitional care intervention for older adults with multiple chronic conditions and depressive symptoms: a pragmatic effectiveness-implementation trial. BMC Geriatr. 2020; 20(1):240. doi: 10.1186/s12877-020-01638-0. DOI: https://doi.org/10.1186/s12877-020-01638-0

Yoshimura M, Sumi N. Components of hospital-to-home care interventions for patients with heart failure in Japan: an integrative review. Int J Nurs Res. 2022;1(1): e2021- 0001. https://doi.org/10.53044/jinr.2021-0001. DOI: https://doi.org/10.53044/jinr.2021-0001

Liu M, Zhao Y, Hao H. Intervention of high-quality nursing care in combination with transitional care in the treatment of COPD patients. Int J Clin Exp Med. 2019; 12(3):2583-90.

Downloads

Published

2023-12-01

How to Cite

1.
Jehloh L, Songwathana P, Kitrungrote L. Transitional Care Based e-Health Program for Older Muslim Thai Adults with Chronic Obstructive Pulmonary Disease After Hospital Discharge: A Feasibility Study. PRIJNR [Internet]. 2023 Dec. 1 [cited 2024 May 14];28(1):103-15. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/264962