Tufts University School of Medicine (A Martens and M DeLucia), Boston, Mass.
Department of Pediatrics, Dartmouth-Hitchcock Medical Center and Dartmouth Institute for Health Policy and Clinical Practice (JK Leyenaar), Lebanon, NH.
Acad Pediatr. 2018 Nov-Dec;18(8):928-934. doi: 10.1016/j.acap.2018.06.007. Epub 2018 Jul 7.
Children entering foster care after discharge from the hospital are at risk for adverse events associated with the hospital-to-home transition. Education of foster caregivers regarding transitional care needs is key. However, little is known about the unique needs of foster caregivers as they transition from hospital to home with a new foster child or how hospital-based health care teams can better support foster caregivers. We aimed to examine the experiences and preferences of foster caregivers' regarding hospital-to-home transitions of children newly discharged into their care and to identify opportunities for inpatient providers to improve outcomes for these children.
We conducted semistructured telephone interviews of foster caregivers who newly assumed care of a child at the time of hospital discharge between May 2016 and June 2017. Interviews were continued until thematic saturation was reached. Interviews were audio recorded, transcribed, and analyzed to identify themes using a general inductive approach.
Fifteen interviews were completed. All subjects were female, 87% were Caucasian, and 73% were first-time foster caregivers. Thirteen themes were identified and grouped into the following domains: 1) knowing the child, 2) medicolegal issues, 3) complexities of multistakeholder communication, and 4) postdischarge preparation and support.
Caregivers of children newly entering foster care following hospital discharge face unique challenges and may benefit from enhanced care processes to facilitate successful transitions. Hospitalization provides an opportunity for information gathering and sharing, clarification of custodial status, and facilitation of communication among multistakeholders, including child protective services and biological parents.
从医院出院后进入寄养的儿童面临与医院到家庭过渡相关的不良事件的风险。对寄养照顾者进行有关过渡护理需求的教育是关键。然而，对于寄养照顾者在与新寄养儿童从医院过渡到家庭时的独特需求，以及医院为基础的医疗保健团队如何更好地支持寄养照顾者，知之甚少。我们旨在检查寄养照顾者在儿童新出院进入其照顾期间对医院到家庭过渡的经历和偏好，并确定住院提供者改善这些儿童结局的机会。
我们对 2016 年 5 月至 2017 年 6 月期间在医院出院时新承担照顾儿童的寄养照顾者进行了半结构化电话访谈。访谈持续进行，直到主题达到饱和。对访谈进行录音、转录，并使用一般归纳方法分析以确定主题。
完成了 15 次访谈。所有参与者均为女性，87%为白种人，73%为首次寄养照顾者。确定了 13 个主题，并将其分为以下几个领域：1）了解孩子，2）医学法律问题，3）多利益相关者沟通的复杂性，以及 4）出院后准备和支持。
在从医院出院后新进入寄养的儿童的照顾者面临独特的挑战，可能受益于增强的护理流程，以促进成功过渡。住院为信息收集和共享、明确监护地位以及促进包括儿童保护服务和亲生父母在内的多利益相关者之间的沟通提供了机会。
