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Healthcare 2014, 2(3), 401-416; doi:10.3390/healthcare2030401

The Role of Preference on Outcomes of People Receiving Evidence-Informed Community Wound Care in Their Home or in a Nurse-Clinic Setting: A Cohort Study (n = 230)

1
School of Nursing, Queen's University, 92 Barrie Street, Kingston, ON K7L 3N6, Canada
2
Department of Anesthesiology, Queen's University, Kingston, ON K7L 2V7, Canada
3
Clinical Research Centre, Kingston General Hospital, Kingston, ON K7L 2V7, Canada
4
Department of Public Health Sciences, Queen's University, Kingston, ON K7L 3N6, Canada
*
Author to whom correspondence should be addressed.
Received: 13 May 2014 / Revised: 1 August 2014 / Accepted: 4 September 2014 / Published: 19 September 2014
(This article belongs to the Special Issue Wound Care)
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Abstract

This study followed a cohort of community-dwelling individuals receiving wound-care in a large urban-rural region. During a randomized control trial (RCT) evaluating outcomes of receiving care in a nurse-clinic or at home, many approached were willing to participate if they could choose their location of care. This provided a unique opportunity to enroll them as a “choice” cohort, following them in the same manner as the trial participants but allowing them to select their setting of care. The objective was to investigate the role of preference and location of care on care outcomes, including satisfaction with care, healing, health-related quality of life (HRQL), pain, and resource use. This is a secondary analysis of a prospective cohort of 126 individuals enrolled in an RCT to receive care at home or in a nurse-clinic (Allocated group), and an additional 104 who received care at home or in a nurse-clinic based on their preference (Choice group). Mobile individuals with a leg ulcer of venous or mixed venous etiology, referred for community leg ulcer care, were eligible. Specially-trained nurses provided care to both groups using an evidence-informed protocol. Baseline data included socio-demographic, circumstance-of-living and a detailed wound assessment. Mean age of the cohort was 68 years. Satisfaction, healing, recurrence, pain, HRQL, and resource utilization did not differ between groups. If available, individuals should have an option of care venue given almost half of those approached indicated a clear preference for clinic or home. With outcomes being similar, health care planners and decision-makers, as well as individuals and their families, can feel confident that the setting of care will not impact the outcomes. However, larger studies in other contexts are needed to explore the interaction between choice and setting. View Full-Text
Keywords: patient preference; community wound-care; leg ulcers; community clinics; homecare patient preference; community wound-care; leg ulcers; community clinics; homecare
This is an open access article distributed under the Creative Commons Attribution License (CC BY 3.0).

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MDPI and ACS Style

Harrison, M.B.; VanDenKerkhof, E.G.; Hopman, W.M.; Carley, M.E. The Role of Preference on Outcomes of People Receiving Evidence-Informed Community Wound Care in Their Home or in a Nurse-Clinic Setting: A Cohort Study (n = 230). Healthcare 2014, 2, 401-416.

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