FACTORS ASSOCIATED WITH HEALTH OUTCOMES OF PATIENTS HOSPITALIZED WITH SELECTED CARDIAC CONDITIONS.
Contributors: University of Maryland at Baltimore.
Published: 1987
Number of pages: 292
Subjects: Health Sciences, Nursing.
Description: A study was conducted to identify patient, nursing care and environmental factors associated with health outcomes of patients hospitalized with selected cardiac conditions. The process and outcome components of Donabedian's (1966) framework to evaluate health care effectiveness served as the conceptual basis for the study. Process was defined as nursing care activities in terms of teaching and discharge planning and the patients' perception of the nurses' involvement in these activities. Outcomes included the discharge status of the patient, self-care behaviors following discharge and health status outcomes six to eight weeks after discharge.

An initial sample of 202 hospitalized patients was obtained from three study sites. Of these, 182 patients participated in the follow-up stage of the study. Forced entry multiple regression analysis was used to analyze the data and identify sets of predictors which explained a significant (p =.05) amount of the variance in the outcomes.

Process-outcome relationships between nursing activities and two discharge outcomes were demonstrated: knowledge of the desease and its treatment and the patients' perceived readiness for self-care. Nursing activities were significant predictors of two post-discharge self-care outcomes, life style and utilization of health services while discharge outcomes were significant predictors of both adherence and life style. The latter finding suggests that nursing activities might be indirectly related to self-care behaviors through discharge outcomes. Initial status variables were the best predictors of health status outcomes, accounting for as much as 30% of the variance in the criterion. Demographic characteristics explained up to 15% of the variance in health status outcomes while the environmental variable, social support, predicted life style and psychophysiologic health status. It was concluded that, together with the care process, the unique characteristics of the patient and his environment influence the extent to which health outcomes may be achieved. Thus, to demonstrate process-outcome relationships, health care evaluation studies should include selected characteristics of the patient, initial health status and environmental factors as well as process and outcome variables.
Notes: Source: Dissertation Abstracts International, Volume: 48-06, Section: B, page: 1639.

Thesis (PH.D.)--UNIVERSITY OF MARYLAND AT BALTIMORE, 1987.

School code: 0373.