Roux Pauline, Pereira Filipa, Santiago-Delefosse Marie, Verloo Henk
University of Lausanne, Institute of Psychology, Research Center for Psychology of Health, Aging and Sport Examination, Lausanne, Switzerland.
University of Applied Sciences and Arts Western Switzerland, Department of Nursing Sciences, Sion, Switzerland.
Patient Prefer Adherence. 2018 Jun 19;12:1055-1063. doi: 10.2147/PPA.S160990. eCollection 2018.
Switzerland's aging population raises pressing questions about maintaining older adults in their home environments and the problems associated with managing complex treatments requiring medication in such contexts. Few studies have examined older adults' experiences of changes in their medication on discharge home following hospitalization for illness or an accident. Similarly, few studies have evaluated the involvement of informal and professional caregivers in the medication practices used with older adults living at home. However, medication practices are complex and understanding them requires an interest in their underlying logic and the interactions that constitute them. This study will explore the feasibility of recruiting older adults and then collecting and analyzing data on their medication practices and their experiences of discharge home after hospitalization for an illness or following an accident. Furthermore, it will describe the involvement of informal caregivers and homecare professionals in these processes.
The study will use a qualitative methodology. The first phase will be developed in the general medicine and surgery wards of Sion hospital and in the town's community healthcare center. This phase will aim to build a close collaboration between the research team and the health care professionals of Valais hospitals and the community healthcare center. It will enable data collection from professional caregivers to identify the tools, and potentially the interventions, which are used to prepare older adults for hospital discharge and return home, particularly with regard to the medication prescribed to them. In the second phase, semi-structured interviews will be conducted with eight patients aged 75 years old or more who have returned home after hospitalization. Interviews will also be conducted with their informal and professional caregivers.
This feasibility study will enable the identification of tools that leverage improved adhesion to a medical treatment that has been adjusted and stabilized following discharge home from hospital. It will incorporate the points of view of older adults and the different stakeholders involved in the management of their medication and the development of tangible solutions to encourage treatment adhesion on discharge home. This study's findings will enable us to design a much larger future study.
瑞士人口老龄化引发了一些紧迫问题，涉及如何让老年人维持居家生活环境，以及在此背景下管理复杂药物治疗所带来的问题。很少有研究探讨老年人在因病或事故住院后出院回家时药物变化的经历。同样，很少有研究评估非正式和专业护理人员在居家老年人用药实践中的参与情况。然而，用药实践很复杂，要理解它们需要关注其潜在逻辑以及构成这些实践的相互作用。本研究将探讨招募老年人，然后收集和分析他们用药实践以及因病或事故住院后出院回家经历的数据的可行性。此外，它将描述非正式护理人员和家庭护理专业人员在这些过程中的参与情况。
本研究将采用定性方法。第一阶段将在锡永医院的普通内科和外科病房以及该镇的社区医疗中心开展。该阶段旨在建立研究团队与瓦莱州医院及社区医疗中心的医护人员之间的密切合作。这将使我们能够从专业护理人员那里收集数据，以确定用于帮助老年人准备出院回家的工具以及可能的干预措施，特别是与他们所开药物相关的措施。在第二阶段，将对八名75岁及以上出院回家的患者进行半结构化访谈。还将对他们的非正式和专业护理人员进行访谈。
这项可行性研究将有助于确定一些工具，这些工具能够提高对出院后调整并稳定下来的药物治疗的依从性。它将纳入老年人以及参与其用药管理的不同利益相关者的观点，并制定切实可行的解决方案，以鼓励出院回家后的治疗依从性。本研究的结果将使我们能够设计一个规模更大的未来研究。
