Complexité des prises en soins à domicile : développement d'un outil d'évaluation infirmier et résultat d'une étude d'acceptabilité

Population aging as well as increasing rates of non-communicable diseases and multimorbidities heavily contribute to enhance complexity in home care delivery. The early identification and evaluation of so-called “complex” situation need to be integrated in routine practice. In response to these needs, the Genova Institution for home care and assistance (imad) developed a multidimensional complexity scale (COMID) for everyday use by nurses. In the COMID, complexity was operationalized along six dimensions, which cover medical, socioeconomic, mental and behavioral issues, as well as instability and density of the care network. The present paper describes the rational underlying the development of the COMID and provides a detailed description of the instrument. This description is complemented by the results of acceptability study conducted with 44 home care nurses. The results demonstrated that nurses perceived the COMID as easy-to-use, useful and relevant for the practice. These encouraging results support further development of the COMID to pursue the identification on complexity in home care practice.