McGill University School of Social Work, Quebec, Canada.
Gerontologist. 2020 Jan 24;60(1):32-40. doi: 10.1093/geront/gny141.
This prospective longitudinal qualitative study sought to identify the conditions that help or hinder older adults' capacities to adjust to long-term care (LTC) when relocating from hospital.
Informed by the principles of constructivist grounded theory, this study employed semi-structured interviews with LTC home residents. Participants were interviewed 4 weeks after their initial relocation, and again every 6 months until they had either resided in their final LTC home for at least 3 months or been enrolled in the study for 2 years. Transcribed interviews were analyzed using the constant comparative method that employs the principle of comparison to guide the analytic process.
A total of nine residents participated in 24 interviews and most had undergone two or more moves. Analysis of the data revealed that multiple forced moves challenged residents' capacities to find home in LTC by contributing to anxiety and uncertainty, hindering resident-staff relations, and interfering with residents' desires to connect with one another. Analysis of the data further revealed that relocation frameworks may require adaptations to more accurately reflect older adults' experiences with relocation from hospital to LTC.
Hospital relocations pose many challenges to residents' capacities to find home in LTC, in part, because they initiate a process of multiple moves. Until the moving process from hospital truly acknowledges and explores residents' preferences, offers choices, and supports joint decision making, it will remain challenging for the LTC home sector to help residents find meaning, purpose, and home in LTC.
本前瞻性纵向定性研究旨在确定当老年人从医院转移到长期护理(LTC)时,有助于或阻碍其适应长期护理的条件。
本研究以建构主义扎根理论为指导原则,采用半结构式访谈方法对 LTC 家庭居民进行研究。参与者在最初搬迁后的 4 周接受访谈,并每隔 6 个月进行一次访谈,直到他们在 LTC 家中居住至少 3 个月或参加研究 2 年为止。使用不断比较的方法对转录的访谈进行分析,该方法采用比较的原则来指导分析过程。
共有 9 名居民参加了 24 次访谈,大多数居民经历了两次或多次搬迁。数据分析显示,多次强制搬迁通过增加焦虑和不确定性、阻碍居民与工作人员之间的关系以及干扰居民之间建立联系的愿望,对居民在 LTC 中寻找归属感的能力构成挑战。数据分析还进一步表明,重新安置框架可能需要进行调整,以更准确地反映老年人从医院到 LTC 的搬迁经历。
医院搬迁对居民在 LTC 中寻找归属感的能力提出了许多挑战,部分原因是它们引发了多次搬迁的过程。在搬迁过程真正承认和探讨居民的偏好、提供选择并支持共同决策之前,LTC 部门将难以帮助居民在 LTC 中找到意义、目的和归属感。