Signs and symptoms in Integrated Continuous Care Units: a study in two medium-term and rehabilitation units

Authors

DOI:

https://doi.org/10.32385/rpmgf.v38i2.13235

Keywords:

Signs, Symptoms, RNCCI, Medium-term and rehabilitation unit

Abstract

Objectives: To characterize the socio-demographic profile, signs, and symptoms of patients admitted to Medium-Term and Rehabilitation Units (UMDR) of the National Integrated Continuing Care Network, and to reflect on the appropriateness of the referral to these units.

Methods: A quantitative, descriptive, cross-sectional, observational, and retrospective study was carried out in two UMDRs in the district of Leiria (Central Portugal) by analyzing clinical records, from July to December 2019. Socio-demographic data, main diagnoses, and signs and symptoms presented during hospitalization, using the International Classification of Primary Care (ICPC-2) were collected. Descriptive statistical analysis was performed using the computer program Statistical Package for the Social Sciences (SPSS) v. 27.0.

Results: Patients (n=141), predominantly female, average age 78 years, were admitted for 3.1 months on average (minimum 10 days, maximum 8 months). The most prevalent diagnoses were acute vascular brain disease (28.4%), femur neck fracture (16.3%), community-acquired pneumonia (5.7%), and trochanter fracture (4.3%). The most prevalent signs and symptoms concerned musculoskeletal, nervous/psychological, skin, urinary, gastrointestinal, respiratory, circulatory, and endocrine systems.

Conclusions: The signs and symptoms collected meet the most frequent pathologies and have been targeted for pharmacological or non-pharmacological interventions. According to the most prevalent diagnoses, patients were referred to rehabilitation programs, which is the basis of the UMDRs. The fact that most patients were hospitalized for an average period of three months means that the objectives proposed for the hospitalization were achieved and that the complications were, generally, resolved, this allowed the patients to be discharged home. In this context, it is concluded that, in general, referencing is carried out in an appropriate manner.

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References

Organização Mundial da Saúde. Relatório mundial de saúde 2008: cuidados de saúde primários agora mais que nunca [Internet]. Lisboa: Alto Comissariado da Saúde; 2008. Available from: https://www.who.int/eportuguese/publications/whr08_pr.pdf

Gaspar VC. Perfil epidemiológico dos utentes consumidores da Rede de Cuidados Continuados Integrados do distrito de Bragança [dissertation]. Bragança: Instituto Politécnico de Bragança; 2015. Available from: https://bibliotecadigital.ipb.pt/handle/10198/12047

Decreto-Lei nº 101/2006, de 6 de junho. Diário da República. I Série A;(109).

Broeiro-Gonçalves P, Aguiar P, Loureiro I. Magnitude, padrão e gravidade da multimorbilidade em idosos assistidos pelas equipas de cuidados continuados integrados: estudo transversal [Magnitude, pattern and severity of multimorbidity in elderly people followed by integrated continuing care teams: a cross-sectional study]. Rev Port Med Geral Fam. 2019;35(2):83-97. Portuguese

Martins R, Henriques T, Carvalho N. Impacto do internamento na rede nacional de cuidados continuados integrados na melhoria dos níveis da capacidade funcional dos utentes [Impact of internation on the national network of continuous integrated care in improving user functional capacity levels]. Gestão Desenvol. 2018;(26):177-91. Portuguese

Pinto D, Corte-Real S. Codificação com a classificação internacional de cuidados primários (ICPC) por internos de medicina geral e familiar [International classification for primary care (ICPC) coding by family medicine trainees]. Rev Port Med Geral Fam. 2010;26(4):370-82. Portuguese

Campos AC. Reformas da saúde: o fio condutor. Coimbra: Almedina; 2008. ISBN 9789724036045

Boquinhas JM. Políticas e sistemas de saúde. Coimbra: Almedina; 2012. ISBN 9789724049298

Santana R, Marques AP, Lopes S, Boto P, Telles JL, Félix S, et al. A influência das características dos prestadores e dos utentes no consumo de recursos em unidades de cuidados continuados [The influence of providers’ and patients’ characteristics on resource use in long-term care inpatient units]. Port J Public Health. 2017;35(2):114-25. Portuguese

Seitz D, Purandare N, Conn D. Prevalence of psychiatric disorders among older adults in long-term care homes: a systematic review. Int Psychogeriatr. 2010;22(7):1025-39.

Woodhouse R, Burton JK, Rana N, Pang YL, Lister JE, Siddiqi N. Interventions for preventing delirium in older people in institutional long-term care. Cochrane Database Syst Rev. 2019;(4):CD009537.

Haupt M, Jänner M, Richert F. Die bedeutung psychischer störungen für den stationär akutgeriatrischen behandlungsverlauf: ein eexplorative untersuchung [Impact of psychiatric disorders on the outcome of acute geriatric inpatient treatment: an exploratory investigation]. Z Gerontol Geriatr. 2020;53(8):749-55. German

Killington M, Davies O, Crotty M, Crane R, Pratt N, Mills K, et al. People living in nursing care facilities who are ambulant and fracture their hips: description of usual care and an alternative rehabilitation pathway. BMC Geriatr. 2020;20:128.

Anthony D, Alosoumi D, Safari R. Prevalence of pressure ulcers in long-term care: a global review. J Wound Care. 2019;28(11):702-9.

Matthews SJ, Lancaster JW. Urinary tract infections in the elderly population. Am J Geriatr Pharmacother. 2011;9(5):286-309.

Rowe TA, Juthani-Mehta M. Diagnosis and management of urinary tract infection in older adults. Infect Dis Clin North Am. 2014;28(1):75-89.

Ortega O, Martín A, Clavé P. Diagnosis and management of oropharyngeal dysphagia among older persons, state of the art. J Am Med Dir Assoc. 2017;18(7):576-82.

Treatments for constipation: a review of systematic reviews (Internet). Canadian Agency for Drugs and Technologies in Health; 2014. Available from: https://www.ncbi.nlm.nih.gov/books/NBK263445/

Huffman GB. Evaluating and treating unintentional weight loss in the elderly. Am Fam Physician. 2002;65(4):640-50.

Jump RL, Crnich CJ, Mody L, Bradley SF, Nicolle LE, Yoshikawa TT. Infectious diseases in older adults of long-term care facilities: update on approach to diagnosis and management. J Am Geriatr Soc. 2018;66(4):789-803.

Mitoku K, Masaki N, Ogata Y, Okamoto K. Vision and hearing impairments, cognitive impairment and mortality among long-term care recipients: a population-based cohort study. BMC Geriatr. 2016;16:112.

Ellis-Smith C, Evans CJ, Bone AE, Henson LA, Dzingina M, Kane PM, et al. Measures to assess commonly experienced symptoms for people with dementia in long-term care settings: a systematic review. BMC Med. 2016;14:38.

Gibson SJ. Pain and aging: the pain experience over the adult lifespan. In: Dostrovsky JO, Carr DB, Koltzenburg M, editors. Proceedings of the 10th World Congress on Pain. Seattle: International Association for the Study of Pain; 2004. p. 767-90. ISBN 9780931092466

Unidade de Missão para os Cuidados Continuados Integrados. Manual do prestador: recomendações para a melhoria contínua [Internet]. Lisboa: UMCCI; 2011. Available from: http://www4.seg-social.pt/documents/10152/3735071/Man_Prestador_UMCCI-RNCCI

Published

2022-04-29

How to Cite

Signs and symptoms in Integrated Continuous Care Units: a study in two medium-term and rehabilitation units. (2022). Portuguese Journal of Family Medicine and General Practice, 38(2), 158-70. https://doi.org/10.32385/rpmgf.v38i2.13235