View clinical trials related to Dependency.
Filter by:Understanding the risk of dependence and its severity before hospital discharge for stroke is important for health and social care planning as instrument to prioritize people where the assistance is more appropriate in a context o limited resources and avoid the gap across the health care continuum. The goal is to conduct an assessment, which will identify the patient's needs. In doing so, the team, along with family may effectively coordinate, plan and implement any steps necessary to ensure a safe and healthy environment for the patient. The main study's objective is to asses which factors are associated with outcome of dependence after stroke and propose a suitable instrument for identifying patients in higher risk for needing formal care from health and/or social care providers.
The present study "Comprehensive Geriatric Assessment for frail older people in Swedish acute care settings - a randomized controlled study" comprises two study arms: one intervention and one control group. It is a multicentre trial with 5 centres with diverse local conditions in different parts of Sweden, with an implementation study alongside. The intervention "Comprehensive Geriatric Assessment (CGA) for frail older people" addresses people 75 years and older who are seeking acute hospital care at the hospital emergency department, and who are identified as frail. The CGA intervention, including a multidisciplinary team that assesses the patients socio-demographic background, social network, health and medical history, medications, functional status, cognitive status, nutritional status, somatic status and psychosocial status including depression, as well as treatment and planning for discharge and follow-up, contributes to a person-centred, and a comprehensive assessment tailored for each person. The results of this study are expected to optimize the implementation of future complex interventions and lead to the improvement of the care, support and rehabilitation for frail older people with complex needs. This study will contribute to an evidence base for full scale implementation of CGA in Swedish hospital care. The process evaluation, aiming to provide insight into function and consequences of the intervention, why it works or fails, is an important part of the design that will contribute with insights into real life conditions that may be challenging in implementing CGA. The investigators will evaluate fidelity and quality of the implementation, clarify causal mechanisms and identify contextual factors associated with variation in outcomes. The development of screening for frailty and CGA are potential and important tools to identify needs of this older population, and to direct the right health care actions towards those in most need. The study will address the following research questions: 1. Can Comprehensive Geriatric Assessment for frail older patients in Swedish acute hospital settings: - increase/maintain independence, functional status, health related quality of life and life satisfaction? - increase satisfaction with health care? - reduce health care consumption? 2. How feasible and acceptable are the study processes and procedures of CGA from the perspective of care givers and older persons in Swedish settings?