Online Program

Health status and intensity of need for nursing care outcomes in a socially vulnerable population

Tuesday, November 5, 2013 : 9:30 a.m. - 9:50 a.m.

Katherine Kaiser, PhD, PHCNS, BC, College of Nursing, UNMC College of Nursing, Omaha, NE
Teresa Hultquist, PhD, PHCNS, BC, College of Nursing, UNMC, Omaha, NE
Jenene Geske, PhD, Department of Family Medicine, UNMC, Omaha, NE
Background: Populations with Type 2 diabetes experience many challenges which are especially burdensome for those without health insurance or adequate access to care. The overall purpose of this study was to examine outcomes in a vulnerable population with Type 2 diabetes who received a public health nurse care coordination intervention (case management) Home visitation was the primary modality. Methods: A longitudinal, descriptive correlational design was used to examine outcomes of the care coordination intervention. Major outcomes studied were self-reported health status (SRHS), intensity of need for nursing care, diabetes empowerment and depression. The sample was purposive (n=27). The intervention goal was improved self-management of diabetes and health promoting lifestyle behaviors. Results: 43% of the sample was Spanish-speaking.; 67% female and the mean age 53 years. Mean intensity of need scores at admission were moderate (30) and decreased over time with higher dose effects. The Respiratory/Circulatory intensity parameter had the highest mean score at admission. Mean admission SRHS total scores = 486 (177 SD); mean Diabetes Empowerment scores = 4.3 (SD .61); mean PHQ-9 scores = 8.4 (6.8 SD). Lessons Learned: Care coordination for vulnerable populations is challenging but positive change in self- management can be made with intensive self-management support using tailored action plans, higher doses of PHN care coordination and adequate resources. Conclusions: As implementation of the Affordable Care Act continues, care coordination is an effective intervention strategy for health improvement and enhancing client self- efficacy for very vulnerable populations but may take higher doses of care.

Learning Areas:

Chronic disease management and prevention
Public health or related nursing

Learning Objectives:
Assess a variety of outcome measures useful in providing a care coordination intervention for vulnerable Type2 diabetes populations

Keyword(s): Case Management

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been a PHN educator, researcher and practice consultant for many years related to care coordination interventions (case management)
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.