City University London, School of Community and Health Sciences, Philpot Street, Whitechapel London E1 2EA, UK.
Int J Nurs Stud. 2010 Jan;47(1):89-107. doi: 10.1016/j.ijnurstu.2009.09.009. Epub 2009 Oct 24.
To explore older people's and their relatives' views on and experiences of acute health care.
Systematic procedures were used for study selection and data extraction and analysis. A comparative thematic approach to synthesis was taken with a number of features adopted from the literature on meta-ethnography.
Worldwide grey and published literature written in English between January 1999 and June 2008 identified from databases: CINAHL, Medline, British Nursing Index, EMBASE Psychiatry, International Bibliography of the Social Sciences, PsychINFO, and AgeInfo.
We conducted a systematic review and synthesis of qualitative studies describing older patients' and/or their relatives' experiences of care in acute hospital settings. 42 primary studies and 1 systematic review met the inclusion criteria.
A number of themes emerged. The quality of technical care is often taken for granted by older patients, and good or bad experiences are described more in terms of relational aspects of care. Older patients in hospital may feel worthless, fearful or not in control of what happens, especially if they have impaired cognition, or communication difficulties. Three key features of care consistently mediated these negative feelings and were linked to more positive experiences: "creating communities: connect with me", "maintaining identity: see who I am" and "sharing decision-making: include me".
These findings highlight the perspectives of older people and their relatives on the delivery of personalized and dignified care in acute settings. They lend support to previous calls for relationship-centred approaches to care and provide a useful experience-based framework for practice for those involved in care for older people.
探讨老年人及其亲属对急性医疗保健的看法和体验。
系统程序用于研究选择和数据提取与分析。采用了一些来自元人种学文献的特征，对综合采用了比较主题方法。
1999 年 1 月至 2008 年 6 月期间，从 CINAHL、Medline、British Nursing Index、EMBASE Psychiatry、International Bibliography of the Social Sciences、PsychINFO 和 AgeInfo 数据库中检索到全球灰色文献和英文出版文献。
我们对描述急性医院环境中老年人患者和/或其亲属护理体验的定性研究进行了系统评价和综合。有 42 项主要研究和 1 项系统评价符合纳入标准。
出现了一些主题。技术护理的质量往往被老年人视为理所当然，而好坏体验更多地是从护理的关系方面来描述的。住院的老年人可能会感到自己毫无价值、恐惧或无法控制发生的事情，尤其是如果他们认知受损或沟通困难。有三个关键的护理特征始终调解了这些负面情绪，并与更积极的体验相关联：“建立社区：与我联系”、“维护身份：了解我是谁”和“共享决策：包括我”。
这些发现强调了老年人及其亲属对在急性环境中提供个性化和有尊严的护理的观点。它们支持了以前对以关系为中心的护理方法的呼吁，并为参与老年人护理的人员提供了一个有用的基于经验的实践框架。
