Investigation And Analysis On The Demands Of Transitional Care For The Elderly Patients With Rheumatoid Arthritis

Objective:Prepare a questionnaire of the demands of transitional care for the elderly patients with Rheumatoid Arthritis,investigate the transitional care demands of elderly rheumatoid arthritis,analyze the current status and main influencing factors of transitional care demands,and provide a reference basis for the development and implementation of transitional care plans for such patients.Methods:Part?:Based on literature review,semi-structured interviews,and group discussions,a questionnaire for transitional care demands for the elderly patients with Rheumatoid Arthritis was initially developed.The convenient sampling method selects 150 patients for pre-experiment,and then forms the final formal questionnaire after analyzing the questionnaire by eye analysis,validity test and reliability test.Part ?:The convenience sampling method was used to select 200 patients,and then the general information questionnaire and the self-made questionnaire for transitional care demands of elderly rheumatoid arthritis were investigated on the day of discharge.Data were sorted and statistically analyzed using Excel and SPSS21.0.Count data are described by frequency and percentage[n(%)],and measurement data that conforms to the normal distribution are described by mean±standard deviation(x?s).Two independent samples t test and analysis of variance were used for single factor analysis of variance,LSD test was used for pairwise comparison.Nonparametric test for data that do not conform to normal distribution or homogeneity of variance,and multivariate analysis was used for multiple linear stepwise regression analysis.Results:Part?:On the basis of literature analysis,semi-structured interview and group discussion,the initial questionnaire of elderly rheumatoid arthritis transitional care demands was developed.In the pre survey,the first part of the questionnaire,namely the content demand questionnaire,was tested for reliability and validity.In the exploratory factor analysis,one item with factor load less than 0.40 was deleted,and four common factors were finally extracted.The cumulative variance contribution rate was 81.042%,and the content validity test result was 0.95.The Cronbach's?coefficient of the questionnaire is 0.956,and the split half reliability is 0.820.The final transitional care content questionnaire is formed,which includes professional guidance needs(9 items),health guidance needs(7 items),life guidance needs(3 items)and psychological guidance needs(4 items).Part ?:(1)The results of the current survey showed that patients'transitional care demands were higher(3.76±0.36 points),and the order of the demands of each dimension was professional guidance,health guidance,life guidance and psychological guidance.The top five items of the demand score were RA medication guidance(4.19±0.75),complication education and prevention guidance(4.07±0.77),guidance on how to deal with joint pain(4.06±0.74),disease self-evaluation guidance(4.06±0.73),and routine follow-up guidance(4.05±0.60).The most acceptable way of transitional care for patients is outpatient follow-up and telephone follow-up,accounting for 84.0%and 65.0%respectively;the expected transitional care providers are mostly multi-disciplinary transitional care teams,accounting for 49.0%;in terms of the starting time of transitional care,the patients who choose to start out of hospital transitional care two weeks after discharge are the most,accounting for 45.0%;in terms of the frequency of follow-up,the patients who choose once a month are the most In the follow-up period,the frequency of8:00~12:00 was the most,accounting for 44.5%,accounting for 71%.(2)The results of multiple linear stepwise regression analysis showed that age,monthly income per capita,living environment,activities of daily living,disease activity score,and education level were the main influencing factors for the elderly patients with rheumatoid arthritis to transitional care demands(R~2=0.391,R~2=0.372,F=20.654,P<0.001).Conclusion:Part?:The questionnaire of transitional care demands for elderly rheumatoid arthritis is scientific and reasonable,and can be used to evaluate and understand the transitional care demands of elderly rheumatoid arthritis.Part?:The demands of transitional care for elderly rheumatoid arthritis is high.Medical staff should take patient demands as the guide,choose the transitional care method and frequency suitable for the patient,and develop a personalized transitional care plan.At the same time,the patient's age,monthly income,living environment,activities of daily living,disease activity score and degree of education are the main factors affecting the transitional care demands of elderly rheumatoid arthritis.Medical staff should focus on and meet the demands of these patients.