Nursing Reports· 2026Q1
Longitudinal Patterns of Nursing Care Needs Among Highly Complex Chronic Patients in the Canary Islands: A Population-Based Retrospective Cohort Study
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- Q1SCImago
- 2026year
Short summary
Highly complex chronic patients in the Canary Islands (n=92,855) exhibit heterogeneous longitudinal nursing care needs, with diagnoses like "readiness for enhanced health self-management" and "impaired skin integrity" being most frequent. Gender, age, complexity, and province influenced diagnostic patterns, while frailty and self-care deficits evolved over time.
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Key points
- 92,855 highly complex chronic patients in the Canary Islands were followed from 2016-2024.
- Predominant diagnoses included readiness for enhanced health self-management, impaired skin integrity, and frailty syndrome.
- Gender, age, complexity, and province were associated with distinct nursing diagnosis patterns.
- Time was linked to changes in frailty, risk for falls, discomfort, and self-care deficit.
- Approximately 44% of the cohort died during the follow-up period.
AI-generated from the title and abstract; the full text is not read.
Abstract
Background/Objectives: The care provided to people with high-complexity chronic diseases requires knowing their longitudinal evolution and care needs. This study describes population-level longitudinal patterns of nursing care needs among highly complex chronic patients in the Canary Islands (Spain) and analyses the associations between nursing diagnoses and sociodemographic, clinical and contextual variables. Methods: A retrospective and population-based cohort study with yearly follow-up (2016–2024) was conducted. The subjects included were 92,855 patients classified as presenting high/very high complexity in Primary Health Care. Sociodemographic and clinical variables were analysed, as well as use of health resources and 40 NANDA-I nursing diagnoses duly recorded in electronic health records. Descriptive, bivariate and multivariate analyses were performed by means of generalized estimating equations. Results: The cohort was predominantly female, with a mean age of 70.5 years old. Approximately 44% of participants died during follow-up. Arterial hypertension, diabetes, osteoarthritis, polypharmacy and frailty prevailed. The most frequent diagnoses were as follows: readiness for enhanced health self-management; impaired skin integrity; high-complexity chronic patient frailty syndrome; impaired urinary elimination; and risk for falls. In the multivariate model, gender, age, complexity and province showed independent associations with different diagnostic patterns, whereas time was especially related to frailty, risk for falls, discomfort and self-care deficit. Conclusions: These patients show heterogeneous population-level temporal patterns in documented nursing care needs, highlighting the value of standardised nursing terminology and longitudinal follow-up to inform individualised care planning in Primary Health Care. Geographical variations in recorded nursing diagnoses may partly reflect differences in clinical documentation practices rather than solely differences in underlying care needs.
The authors' abstract, as published at the source. Nursing Reports, 2026 · DOI ↗
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