Rodrigue Nathalie, Laizner Andréa Maria, Tze Nancy, Sewitch Maida
McGill University Health Centre, Montreal, Canada (Mss Rodrigue and Tze and Drs Laizner and Sewitch); and Ingram School of Nursing (Dr Laizner) and Department of Medicine (Dr Sewitch), McGill University, Montreal, Canada.
J Trauma Nurs. 2017 May/Jun;24(3):182-192. doi: 10.1097/JTN.0000000000000288.
The number of patients 65 years and older has been rising steadily every year at our Level I trauma center. Our clinical experience demonstrated that once discharged, some of these patients were not managing well. Postdischarge portrait is difficult to ascertain because this information is not captured in the trauma registry database. The purpose of this study was to describe the experiences of hospitalized trauma patients 65 years and older who are discharged home. A descriptive cross-sectional study of hospitalized trauma patients was conducted 1 month postdischarge using PREPARED Patient and 36-item Short Form Health Survey questionnaires. Data were analyzed with SPSS and NVivo. A convenience sample of 33 participants was recruited from four surgical inpatient trauma units of an urban, downtown hospital in Eastern Canada. Participants scored below 50% on most categories related to discharge preparedness and reported not having received enough information about their medication, available community resources, and permitted activities. They had worries about managing at home and 40% experienced unexpected problems. Participants reported feeling confident (80%) to be discharged home mostly because of support or previous experience with illness and 53% felt very prepared to return home. Health status scores were lowest for the domain "role limitation due to physical health" at 16% and highest around 70% for "emotional well-being" and "general health." Patients did not receive enough information; some experienced unexpected problems once home but having support and previous experience with illness seems to help participants be confident with discharge home. There is room for improvement on specific aspects of discharge planning and preparedness.
在我们的一级创伤中心，65岁及以上患者的数量每年都在稳步上升。我们的临床经验表明，这些患者一旦出院，部分患者的情况并不理想。出院后的情况很难确定，因为创伤登记数据库中没有记录这些信息。本研究的目的是描述65岁及以上出院回家的住院创伤患者的经历。出院1个月后，使用“准备就绪患者”问卷和36项简明健康调查问卷对住院创伤患者进行了描述性横断面研究。数据用SPSS和NVivo进行分析。从加拿大东部一个城市市中心医院的四个外科住院创伤科室招募了33名便利样本参与者。参与者在与出院准备相关的大多数类别上得分低于50%，并报告未获得足够关于其药物、可用社区资源和允许活动的信息。他们担心在家中自理，40%的人遇到了意外问题。参与者报告称，大多因家人支持或既往患病经历而有信心（80%）出院回家，53%的人感觉对回家做好了充分准备。在“因身体健康导致的角色限制”领域，健康状况得分最低，为16%；在“情绪健康”和“总体健康”方面得分最高，约为70%。患者没有获得足够信息；一些人回家后遇到了意外问题，但家人支持和既往患病经历似乎有助于参与者对出院回家充满信心。出院计划和准备工作的具体方面仍有改进空间。
