Background Sociodemographic variables that are predictors of rehospitalization for heart failure may better inform hospital discharge strategies. Objectives (1) To determine whether sociodemographic variables are predictors of hospital readmission, (2) to determine whether sociodemographic or laboratory variables differ by age group as predictors of readmission, and (3) to compare whether patients' discharge disposition differs by age group in predicting readmission. Methods Retrospective chart review of hospitalized patients with heart failure admitted in 2007. Results Mean age was 68 (SD, 17) years for the 809 patients, with slightly more than one-third (n = 311, 38%) reporting a legal partner. Fewer than half (n = 359, 44%) were white. Almost one-third (n = 261, 32%) were rehospitalized within 90 days. Multivariable analysis revealed that patients younger than 65 years old and not partnered were at 1.8 times greater risk for being readmitted 90 days after discharge (P = .02; 95% CI, 0.33-0.92). Patients who were 65 years and older and not partnered were at 2.2 times greater risk for readmission (P = .01; 95% CI, 0.25-0.85) after creatinine level and discharge disposition were controlled for. For older patients discharged to home or to home with home services, the risk of readmission was 2.6 times greater than that for patients discharged to a skilled nursing facility (P = .02; 95% CI, 1.20-5.56). Conclusions The absence of a partner was predictive of readmission in all patients. Older patients with heart failure who were discharged to a skilled nursing facility had lower readmission rates. The effect of partner and disposition status may suggest a proxy for social support. Strategies to provide social support during discharge planning may have an effect on hospital readmission rates.
A grounded theory of Salvaging Quality of Life provided the conceptual framework for the development of the Living with HIV scale which was validated in this study. The HIV + convenience sample (n = 187) was 66% male, with a mean age of 40.6 years, 69% African-American, and with an average CD4 count of 229 mm3. A principal components factor analysis with varimax rotation was conducted on the final 32-item scale and nine factors with Eigenvalues > 1 explained 60% of the variance. A second order factor analysis of these nine factors resulted in a two factor solution (HIV Struggles and HIV Reverence) which explained 49.4% of the variance. Cronbach alpha reliability coefficient for the total scale was 0.84. Differences between gender, ethnicity, education and presence of an AIDS diagnosis, and quality of life, were explored. Females had higher total scores which suggested they had a more positive quality of life than males. The Living with HIV scale can be used as a method of obtaining input from patients for care planning and for evaluating the effectiveness of nursing care intervention using quality of life as an outcome of care.
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