Flink Maria, Ekstedt Mirjam
Department of Learning, Informatics, Management, and Ethics, Karolinska Institutet, Stockholm, SE.
Functional Area of Social Work, Karolinska University Hospital, Stockholm, SE.
Int J Integr Care. 2017 Nov 13;17(6):1. doi: 10.5334/ijic.3003.
Despite recent interest in care transitions, little is known about how patients are prepared for the self-management tasks following the hospitalization. The objective of the study was to explore how discharge information is prepared and provided to patients in the transition from hospital to home.
The discharge process at three hospitals in Sweden was observed over 12 days spread over ten weeks. In total, 30 discharge encounters were observed followed by interviews with patients and professionals. Data were analysed using qualitative content analysis.
Much time, effort and resources were used to prepare the discharge; home-going teams and registered nurses planned the practical and social aspects of the discharge and the physicians compiled a plain-language discharge letter. Less focus was given on the actual discharge information to the patients. The discharge encounters lasted for a median of 4:46 minutes and the information had a retrospective focus with information on the hospitalization period, though omitting self-management tasks and life-style advice.
The discharge letter constitutes the basis for all patient information at discharge. The focus of the discharge encounter needs to be extended beyond mere information to include patient understanding, motivation and skills for self-management at home.
尽管近期人们对护理转接颇为关注，但对于患者在住院后如何为自我管理任务做好准备却知之甚少。本研究的目的是探讨在从医院到家庭的过渡过程中，出院信息是如何准备并提供给患者的。
在瑞典的三家医院，对为期十周、历时12天的出院过程进行了观察。总共观察了30次出院交接情况，随后对患者和专业人员进行了访谈。采用定性内容分析法对数据进行分析。
准备出院花费了大量的时间、精力和资源；回家团队和注册护士规划了出院的实际和社会方面的事宜，医生编写了通俗易懂的出院信。对向患者提供的实际出院信息关注较少。出院交接的时间中位数为4分46秒，所提供的信息侧重于回顾住院期间的情况，不过遗漏了自我管理任务和生活方式建议。
出院信是出院时所有患者信息的基础。出院交接的重点需要从单纯的信息扩展到包括患者的理解、自我管理的动力和在家中的技能。
