THE EFFECTS OF NURSING CASE MANAGEMENT INTERVENTION ON PERCEIVED SEVERITY OF ILLNESS, ENABLING SKILL, SELF-HELP, AND LIFE QUALITY IN CHRONICALLY ILL OLDER ADULTS.
Contributors: University of Texas at Austin.
Published: 1995
Number of pages: 290
Subjects: Health Sciences, Nursing.; Gerontology.; Social Work.
Description: Recent cost-containment measures have impacted health care delivery to chronically ill older adults. New practice models, such as the Professional Nurse Case Management (PNCM) Model, have been implemented to provide lower cost, high quality care. Although positive fiscal outcomes of this model have been demonstrated, research identifying and measuring quality care outcomes has been limited.

The purpose of this study was to determine if nurse case manager (NCMr) interventions using the PNCM Model increase the self-care responses of chronically ill clients. Using Braden's (1986) Self-Help Model as a conceptual framework, the hypotheses of this study predicted there would be significant differences in six dependent client outcome variables after three months of NCMr intervention. These variables were perceived severity of illness, enabling skill, life quality, and self-help. The three indicators of self-help were perceived physical disability, engagement in socially satisfying activities, and management of symptom distress. A secondary purpose of this study was to determine subject-identified outcomes from NCMr interventions.

This study was conducted with a nonprobability convenience sample of 76 chronically ill adults from two hospitals in a southwestern state. A pre-experimental single group pretest-posttest design was employed to test the research hypotheses. A purposive sub-sample of 12 subjects was interviewed to identify outcome exemplars.

Data analyses included a multivariate analysis of variance (MANOVA) and post-hoc paired t-tests to examine the differences in the pre- and post-intervention subject scores and content analysis of the interview data. The MANOVA was significant at the $p$ $<$.001 level. The post-hoc t-test findings revealed that subjects perceived a significant difference $p$ $<$.001) in their severity of illness and their ability to control and manage symptom distress. Additionally, subjects perceived an increased ability to perform basic and instrumental activities of daily living significant at the $p$ $<$.05 level. Hypotheses that predicted subjects would perceive an increase in enabling skill, life quality, and engagement in socially satisfying activities were not supported. Exemplars of the six dependent variables and six additional outcome categories were identified by content analysis.
Notes: Source: Dissertation Abstracts International, Volume: 56-06, Section: B, page: 3129.

Thesis (PH.D.)--THE UNIVERSITY OF TEXAS AT AUSTIN, 1995.

School code: 0227.