The effects of intervention on frequent attenders' adherence to health regimens, depression, somatization and hypochondriasis
Bibliographic record
Abstract
Background and objective: Frequent attender is the largest group to whom health care resources are allocated. Therefore potential interventions should be targeted at this group. Nurse-based case management considers frequent attenders’ (FAs’) needs for care as a whole and thus may reduce the use of other health services operators’ resources. The objective of this study is to evaluate the effects of nurse-led case management on adherence to health regimens, depression, somatization and hypochondriasis in FAs.Methods: The study is a quasi-experimental intervention trial, carried out as a prospective 2-year follow-up design with an intervention group (n = 285) and a control group (n = 435). The hypothesis was that nurse-led case management based intervention would have a positive impact on FAs’ adherence to health regimens, somatization, hypochondriasis, and depression. The intervention patients received nurse-led case management which included an evaluation of patient needs and resources, an individualized care plan, the coordination of multidisciplinary services, and support for self-management. The control patients received the usual care, which means patient support and education during visits to the health center. The data were collected from at least 18 years of age frequent attenders by self-reported instruments: the Adherence of Chronic Disease Inventory, the Whiteley Index, the Symptom Checklist-90-R and Beck Depression Inventory, and one- and two-year follow-ups between October 2008 and May 2011.Results: The intervention had an uplifting effect on the FAs’ mood, and there was a statistically significant difference between the intervention patients and the control patients (p = .03). Intervention reduced somatization with FAs, and it improved FAs’ adherence to health regimens, but there was not a statistically significant difference between groups. Hypochondriasis increased in the intervention group compared to the control group after intervention (p = .01).Conclusions: Nurse-led case management has a positive effect on FAs’ depression symptoms, somatization, and adherence to health regimens. The results will be useful in developing effective nurse-led interventions and support methods for FAs with complex long-term health conditions. Hypochondriasis increased in the intervention group although the purpose was for the community matron to discuss with FAs and reduce their concerns.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".