Plank Angelika, Mazzoni Valentina, Cavada Luisa
Physical Rehabilitation Unit, F.Tappeiner Hospital, Merano, Italy.
J Clin Nurs. 2012 Jul;21(13-14):2072-82. doi: 10.1111/j.1365-2702.2011.04025.x.
To explore and understand the experience of new informal caregivers in Italy during the transition from hospital to home.
Frequent patient discharge into the home environment has lead to a significant increase in postdischarge care being provided by family caregivers. The transition period in particular is seen as a period of great significance, as caregivers may be unprepared and concerned as to the amount of care required by the recipient.
A qualitative phenomenological approach was used to gain a deeper understanding of caregivers' lived experiences.
Data were collected at two points in time using different methodologies: in-depth interviews were conducted to explore the caregivers' perspective of the predischarge period; focus groups obtained data after the patients' re-entry into the home environment and aimed to validate interview findings.
Family caregivers reflected on three main themes during the transition period: (1) their newly acquired role; (2) the recipient's condition; and (3) the support they required. The core concept of 'being responsible for everything' seemed to be a recurring theme running through these three subject matters. Fulfilling numerous commitments and different social roles besides the caring activity itself seemed to weigh heavily on caregivers. Carers were referring particularly to their need for hope, confidence and safety during the transition from hospital to home.
It cannot be assumed a priori that families can cope with the demands of care-giving. Therefore, healthcare professionals should come to recognise caregivers as persons in need of emotional and practical support.
The findings of this study can stimulate healthcare professionals to acquire effective communication skills and display an empathic attitude when assessing caregivers' needs in the particularly challenging phase of transition from hospital to home.
探讨并了解意大利新的非正式照料者在从医院过渡到家庭期间的经历。
患者频繁出院回家导致家庭照料者提供的出院后护理显著增加。特别是过渡时期被视为一个非常重要的阶段，因为照料者可能对接受者所需的护理量没有准备且感到担忧。
采用定性现象学方法以更深入地理解照料者的生活经历。
在两个时间点使用不同方法收集数据：进行深入访谈以探讨照料者对出院前阶段的看法；焦点小组在患者重新回到家庭环境后获取数据，旨在验证访谈结果。
家庭照料者在过渡时期反思了三个主要主题：（1）他们新获得的角色；（2）接受者的状况；（3）他们所需的支持。“对一切负责”这一核心概念似乎是贯穿这三个主题的反复出现的主题。除了照料活动本身之外，履行众多承诺和扮演不同社会角色似乎给照料者带来了沉重负担。照料者特别提到他们在从医院过渡到家庭期间对希望、信心和安全感的需求。
不能先验地假定家庭能够应对照料需求。因此，医疗保健专业人员应开始将照料者视为需要情感和实际支持的人。
本研究结果可促使医疗保健专业人员在评估照料者在从医院过渡到家庭这一特别具有挑战性阶段的需求时，获得有效的沟通技巧并展现出共情态度。
