Designing Outcome-Based Nursing Interventions for Multimorbid Populations: A Framework Grounded in Core Health Domains
DOI:
https://doi.org/10.61978/curatio.v2i4.1406Keywords:
Multimorbidity, Outcome-Based Nursing, Care Coordination, Patient Activation, SMART Goals, Nursing FrameworkAbstract
Multimorbidity poses a growing challenge to health systems worldwide, necessitating patient-centered, outcome-based approaches in nursing. This article introduces an innovative nursing framework designed to align care interventions with measurable outcomes reflecting both clinical priorities and patient needs. The framework draws from COSmm (Core Outcome Set for Multimorbidity), incorporating nine core domains relevant to chronic care, including HRQoL, treatment burden, and patient activation, operationalized using validated instruments such as EQ-5D, PHQ-9, and PAM. Nursing challenges commonly observed in multimorbid patients were mapped to SMART goals and matched with evidence-based strategies to form a structured intervention matrix, presented through two tables: one summarizing the nine COSmm outcome domains with definitions and instruments, and another linking six common nursing challenges (e.g., polypharmacy, frailty, poor coordination) to specific goals and interventions—for example, reducing treatment burden through deprescribing strategies monitored via the MTBQ. The framework enhances care clarity, evaluation, and personalization by integrating nursing roles into broader outcome monitoring systems, offering benefits such as improved accountability and collaboration, alongside challenges related to data integration and workforce readiness. This structured, adaptable model supports outcome-based nursing care in complex chronic conditions, with future research needed to empirically test it across diverse clinical environments.
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