ED Utilization and Self-Reported Symptoms in Community-Dwelling Older Adults

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• 作者：Gordana Dermody ; PhD ; RN ; CNL ; ^{gordana.dermody@wsu.edu}Author Vitae ; Patricia Sawyer ; PhDAuthor Vitae ; Richard Kennedy ; MD ; PhDAuthor Vitae ; Courtney Williams ; MPHAuthor Vitae ; Cynthia J. Brown ; MD ; MSPH ; AGSFAuthor Vitae
• 关键词：Activities of daily living ; Aged ; Locomotion ; Rural populations ; Emergency service
• 刊名：Journal of Emergency Nursing
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：43
• 期：1
• 页码：57-69
• 全文大小：230 K
• 卷排序：43

文摘

The rise in ED utilization among older adults is a nursing concern, because emergency nurses are uniquely positioned to have a positive impact on the care of older adults. Symptoms have been associated with ED utilization; however, it remains unclear whether symptoms are the primary reason for ED utilization. The purpose of this study was to describe the self-reported symptoms of community-dwelling older adults prior to accessing the emergency department and to examine the differences in self-reported symptoms among those who did and did not utilize the emergency department.MethodsA prospective longitudinal design was used. The sample included 403 community-dwelling older adults aged 75 years and older. Baseline in-home interviews were conducted followed by monthly telephone interviews over 15 months.ResultsCommonly reported symptoms at baseline included pain, feeling tired, and having shortness of breath. In univariate analysis, pain, shortness of breath, fair/poor well-being, and feeling tired were significantly correlated with ED utilization. In multivariable models, problems with balance and fair/poor well-being were significantly associated with ED utilization.DiscussionSeveral symptoms were common among this cohort of older adults. However, no significant differences were found in the types of symptoms reported by older adults who utilized the emergency department compared with those who did not utilize the emergency department. Based on these findings, it appears that symptoms among community-dwelling older adults may not be the primary reason for ED utilization.