ABSTRACT
Hospital care of medically complex children (MCC) is increasing, although its real prevalence in Spain is unknown. OBJECTIVE: to analyze hospital admissions and outpatient follow-up of MCC in order to identify strategies to improve the quality of care of MCC. PATIENTS AND METHOD: An analytical, observational, and retrospective study was carried out. We included MCC who were admitted to Pediatric Hospitalization in the last 5 years, in a tertiary hospital without a specific unit for MCC. Clinical data related to their underlying pathology, outpatient visits, and hospital admissions were collected. A multivariate study was carried out to describe risk factors of the need for technological support and to predict prolonged admissions and the hospital consultation rate. RESULTS: 99 MCC (55.6% males) aged 3.9 (2-8) years were included. 41.4% of MCC required technological support at home and presented the highest number of comorbidities, hospital admissions, and care by different specialists (p < 0.01). Older MCC (p < 0.01) with underlying digestive disease (p < 0.04) and respiratory comorbidity (p < 0.04) presented a longer mean hospital stays. Younger patients with more admissions, longer average stay, and a lack of follow-up by the link nurse were associated with a greater number of annual consultations (p < 0.05). CONCLUSIONS: MCC require a high number of annual consultations and have long hospital stays. The creation of specialized consultations for MCC, multidisciplinary care, and the participation of the link nurse are strategies to improve the quality of care for MCC in hospitals without specific MCC units.
Subject(s)
Hospitalization , Referral and Consultation , Child , Female , Humans , Male , Length of Stay , Retrospective Studies , Tertiary Care Centers , Child, PreschoolABSTRACT
Introducción: La humanización de la asistencia sanitaria conlleva considerar al paciente como un ser integral, y proporcionar asistencia más allá de los cuidados médicos, abarcando áreas como la social, emocional, espiritual y relacional. Objetivo: Conocer las necesidades de los adolescentes hospitalizados y los déficits percibidos por estos en la asistencia sanitaria. Sujetos y método: Estudio transversal descriptivo realizado a través de una encuesta anónima, dirigido a pacientes ingresados de entre 12-16 años. La encuesta estaba formada por 2 partes: preguntas abiertas para exponer sus necesidades, indicar aspectos positivos o negativos de la hospitalización, y sugerencias de mejora, y preguntas cerradas con posibles respuestas afirmativas o negativas, y escalas numéricas del 1 al 10 para cuantificar los resultados. Se llevó a cabo un pilotaje previo en 6 pacientes adolescentes como prueba de factibilidad y de comprensión de todos los apartados. Resultados: Se obtuvieron un total de 39 encuestas de pacientes, con una mediana de edad de 14 años. La experiencia más desagradable percibida durante el ingreso fue la realización de pruebas invasivas. El 95% de ellos padeció dolor y el 17% sintió en algún momento que se iba a realizar algún procedimiento sin su pleno conocimiento. Más del 75% demandaba más entretenimiento, siendo la no disponibilidad de Wi-Fi el elemento más reclamado. Conclusiones: La población estudiada mostró necesidades que deben ser consideradas en el momento de la hospitalización, destacando: cognitivas (necesidad de obtener información clara y extensa), sociales (mantener el contacto y las relaciones con el exterior, familiares y amigos), emocionales (la enfermedad y sus procesos diagnóstico-terapéuticos crearán alteraciones en el estado anímico) y prácticas (los aspectos ambientales y arquitectónicos pueden mejorar o empeorar la percepción del ingreso hospitalario). Todos estos factores han demostrado que pueden contribuir al restablecimiento de la salud de una forma más temprana.
Introduction: The humanisation of health care involves considering the patient as an integral human being, providing assistance beyond medical care, and covering other fields such as social, emotional, spiritual, or relational areas. Objective: To evaluate the requirements and concerns of the hospitalised children. Subjects and method: A cross-sectional, descriptive study was conducted using an anonymous questionnaire on children aged 12-16. Results: The study included 39 patients, with a median age of 14 years. The most unpleasant experience during the hospitalisation was the invasive procedures. Almost all (95%) of patients suffered from pain, and 17% of them felt at some point that a procedure was performed without them being fully aware. More than 75% of children asked for more entertainment, with the lack of Wi-Fi being the more demanded item. Conclusions: The needs of the population included in this survey, showed the importance to consider cognitive (necessity of obtaining clear and extensive information), social (maintaining everyday relationships), emotional (illness and its diagnostic and therapeutic procedures often generate mood disorders), and practical (environmental and architectural aspects can lead to either an improvement or a worsening of the hospitalisation perception) factors. All of these factors have shown a beneficial contribution, leading to an earlier recovery of health.
Subject(s)
Humans , Male , Female , Child , Adolescent , Adolescent, Hospitalized/psychology , Health Services Needs and Demand , Hospitals/standards , Humanism , Perception , Cross-Sectional Studies , Surveys and Questionnaires , Psychology, Adolescent , HospitalizationABSTRACT
INTRODUCTION: The humanisation of health care involves considering the patient as an integral human being, providing assistance beyond medical care, and covering other fields such as social, emotional, spiritual, or relational areas. OBJECTIVE: To evaluate the requirements and concerns of the hospitalised children. SUBJECTS AND METHOD: A cross-sectional, descriptive study was conducted using an anonymous questionnaire on children aged 12-16. RESULTS: The study included 39 patients, with a median age of 14 years. The most unpleasant experience during the hospitalisation was the invasive procedures. Almost all (95%) of patients suffered from pain, and 17% of them felt at some point that a procedure was performed without them being fully aware. More than 75% of children asked for more entertainment, with the lack of Wi-Fi being the more demanded item. CONCLUSIONS: The needs of the population included in this survey, showed the importance to consider cognitive (necessity of obtaining clear and extensive information), social (maintaining everyday relationships), emotional (illness and its diagnostic and therapeutic procedures often generate mood disorders), and practical (environmental and architectural aspects can lead to either an improvement or a worsening of the hospitalisation perception) factors. All of these factors have shown a beneficial contribution, leading to an earlier recovery of health.