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老年人从医院到家庭过渡的用户体验和护理:患者和照顾者的观点。

User experience and care for older people transitioning from hospital to home: Patients' and carers' perspectives.

机构信息

School of Nursing and Midwifery, Deakin University, Geelong, Burwood, Vic., Australia.

Centre for Quality and Patient Safety, Monash Health Partnership, Monash Health, Burwood, Vic., Australia.

出版信息

Health Expect. 2018 Apr;21(2):518-527. doi: 10.1111/hex.12646. Epub 2017 Nov 9.

Abstract

BACKGROUND

Transitioning from hospital to home is challenging for many older people living with chronic health conditions. Transitional care facilitates safe and timely transfer of patients between levels of care and across care settings and includes communication between practitioners, assessment and planning, preparation, medication reconciliation, follow-up care and self-management education. To date, there is limited understanding of how to actively involve care recipient service users in transitional care.

OBJECTIVE

This study was part of a larger research project. The objective of this article was to report the first study phase, in which we aimed to describe user experience pertaining to patients and carers.

DESIGN, SETTING AND PARTICIPANTS: The study design was qualitative descriptive using interviews. Patients (n = 19) and carers (n = 7) participated in semi-structured interviews about their experience of transition from hospital to home in an urban Australian health-care setting. Interview data were analysed using thematic analysis.

FINDINGS

All participants reported that they needed to become independent in transition. Participants perceived a range of social processes supported their independence at home: supportive relationships with carers, caring relationships with health-care practitioners, seeking information, discussing and negotiating the transitional care plan and learning to self-care.

DISCUSSION

Findings contribute to our understanding that quality transitional care should focus on patients' need to regain independence. Social processes supporting the capacities of patients and carers should be emphasized in future initiatives.

CONCLUSION

Future transitional care interventions should emphasize strategies to enable negotiation for suitable supports and assist care recipients to overcome barriers identified in this study.

摘要

背景

对于许多患有慢性疾病的老年人来说,从医院过渡到家庭是具有挑战性的。过渡性护理促进了患者在不同护理水平和不同护理环境之间的安全和及时转移,包括从业者之间的沟通、评估和规划、准备、药物调整、随访护理和自我管理教育。迄今为止,对于如何积极让护理服务使用者参与过渡性护理,我们的了解有限。

目的

本研究是一个更大的研究项目的一部分。本文的目的是报告第一研究阶段,旨在描述与患者和照顾者相关的用户体验。

设计、设置和参与者:研究设计是使用访谈的定性描述。在澳大利亚城市医疗保健环境中,19 名患者(n=19)和 7 名照顾者(n=7)参加了关于从医院过渡到家庭的半结构化访谈,以了解他们的体验。使用主题分析对访谈数据进行分析。

发现

所有参与者都表示他们在过渡期间需要独立。参与者认为一系列社会过程支持他们在家中的独立性:与照顾者的支持性关系、与医疗保健从业者的关怀关系、寻求信息、讨论和协商过渡护理计划以及学习自我护理。

讨论

研究结果有助于我们理解,高质量的过渡性护理应关注患者重新获得独立的需求。在未来的举措中,应强调支持患者和照顾者能力的社会进程。

结论

未来的过渡性护理干预措施应强调协商合适支持的策略,并帮助护理接受者克服本研究中确定的障碍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2974/5867324/b8e1a5b049dd/HEX-21-518-g001.jpg

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