Nursing Department, Medical Sciences Faculty, Tarbiat Modares University, Bridge Nasr (Gisha), Tehran, Iran.
Eur J Cardiovasc Nurs. 2009 Dec;8(5):355-63. doi: 10.1016/j.ejcnurse.2009.08.003. Epub 2009 Sep 12.
Readmission due to congestive heart failure is a global problem during the recent decades; however, little is known about the process of readmission in these patients.
To clarify the readmission process of patients suffering from congestive heart failure in two large referral hospitals in Tehran, Iran.
A grounded theory approach was utilized. 42 experienced patients, families, nurses and cardiologists participated in the study. Data analysis was carried out over a period of 12months (November 2007 to November 2008).
The main concern of participants was "managing the acute problems" of disease. The process of readmission begins with "concentrating on the concern". So, all the participants neglected the patient readmission. Having managed the acute problems, the patients were discharged without a "comprehensive context oriented discharge planning" leading to their return to community without preparation or supporting system. This results in "traditional self-treatment" owing to unhealthy behaviors which brings about the readmission of patients. Neglecting or "lack of sensitivity to readmission" was presented as the core variable.
In order to control readmission, we recommend those in charge of policy-making for public health to pay particular attention to this variable and taking step such as sensitizing people concerned.
充血性心力衰竭导致的再入院是近几十年来的一个全球性问题；然而，人们对这些患者的再入院过程知之甚少。
阐明伊朗德黑兰两家大型转诊医院充血性心力衰竭患者的再入院过程。
采用扎根理论方法。42 名有经验的患者、家属、护士和心脏病专家参与了这项研究。数据分析持续了 12 个月（2007 年 11 月至 2008 年 11 月）。
参与者最关心的是“处理疾病的急性问题”。再入院过程始于“关注问题”。因此，所有参与者都忽视了患者的再入院。急性问题得到处理后，患者未经“全面面向背景的出院计划”出院，导致他们在没有准备或支持系统的情况下返回社区。这导致由于不健康的行为而导致患者再次入院的“传统自我治疗”。忽视或“对再入院缺乏敏感性”被认为是核心变量。
为了控制再入院，我们建议负责公共卫生政策制定的人特别关注这一变量，并采取措施提高相关人员的敏感性。
