Wakabayashi Hidetaka
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Professor and Division head
Article types Original article
Language English
Peer review Peer reviewed
Title Correlation of patient complexity with the burden for health-related professions, and differences in the burden between the professions at a Japanese regional hospital: a prospective cohort study.
Journal Formal name:BMJ open
Abbreviation:BMJ Open
ISSN code:20446055/20446055
Domestic / ForeginForegin
Volume, Issue, Page 9(2),pp.1-8
Author and coauthor Yoshida Shuhei, Matsushima Masato, Wakabayashi Hidetaka, Mutai Rieko, Sugiyama Yoshifumi, Yodoshi Toshifumi, Horiguchi Ryoko, Watanabe Takamasa, Fujinuma Yasuki
Publication date 2019/02
Summary OBJECTIVES:An ageing society includes high patient complexity. Various biopsychosocial problems result in a high burden for health-related professionals. The direct relationship between the burden and patient complexity, however, has not been reported. We aimed to examine correlations between the burden for the attending physicians and nurses, and Patient Centred Assessment Method (PCAM) scores of patient complexity.DESIGN:Prospective cohort study.SETTING:A regional secondary care hospital in Japan.PARTICIPANTS:We included all inpatients admitted to our acute care unit between 1 July 2014 and 30 September 2014. Exclusion criteria were age <20 years, refusal to participate in the study and length of stay fixed at the time of admission.MAIN PREDICTOR:PCAM total score in the initial phase of hospital admission.MAIN OUTCOME:The burden for each profession (measured on a Visual Analogue Scale).RESULTS:In total, 201 inpatients participated [female/male=98/103, mean (SD) age of 77.4±11.9 years]. Spearman's rank correlation coefficients between the burden and the PCAM score ranged from 0.23 to 0.32. All p values were <0.05. Multivariate analysis was conducted using multilevel mixed-effects linear regression to determine the association between the burden and the PCAM score in two models. Model 1 used the total PCAM score as the predictive variable. Model 2 used the PCAM factors, patient-oriented complexity and medicine-oriented complexity, as predictive variables. In Model 2, with the burden of physicians, medicine-oriented complexity was statistically significant, whereas with the burden of nurses, both age and patient-oriented complexity were statistically significant.CONCLUSIONS:PCAM scores correlated with the burden for physicians and nurses. Individual PCAM factors affected the burden for each profession differently.
DOI 10.1136/bmjopen-2018-025176
PMID 30796125