University of Bradford, Bradford, UK.
BMC Geriatr. 2019 Jul 31;19(1):202. doi: 10.1186/s12877-019-1220-1.
People living with dementia in care homes are regularly admitted to hospital. The transition between hospitals and care homes is an area of documented poor care leading to adverse outcomes including costly re-hospitalisation. This review aims to understand the experiences and outcomes of care for people living with dementia who undergo this transition from the perspectives of key stakeholders; people living with dementia, their families and health care professionals.
A systematic search was conducted on the CINAHL, ASSIA, EMBASE, MEDLINE, PsychINFO, and Scopus databases without any date restrictions. We hand searched reference lists of included papers. Papers were included if they focused on people living with dementia moving from hospital to a short or long term care setting in the community including sub-acute, rehabilitation, skilled nursing facilities or care homes. Titles, abstracts and full texts were screened. Two authors independently evaluated study quality using a checklist. Themes were identified and discussed to reach consensus.
In total, nine papers reporting eight studies met the inclusion criteria for the systematic review. A total of 257 stakeholders participated; 37 people living with dementia, 95 family members, and 125 health and social care professionals. Studies took place in Australia, Canada, United Kingdom (UK), and the United States of America (US). Four themes were identified as factors influencing the experience and outcomes of the transition from the perspectives of stakeholders; preparing for transition; quality of communication; the quality of care; family engagement and roles.
This systematic review presents a compelling case for the need for robust evidence to guide best practice in this important area of multi-disciplinary clinical practice. The evidence suggests this transition is challenging for all stakeholders and that people with dementia have specific needs which need attention during this period.
PROSPERO Registration Number: CRD42017082041 .
居住在养老院的痴呆症患者经常住院。医院和养老院之间的过渡是一个有记录的护理不善的领域，导致不良后果，包括昂贵的再住院。本综述旨在从痴呆症患者、他们的家属和医疗保健专业人员等主要利益相关者的角度，了解接受这一过渡的痴呆症患者的护理体验和结果。
我们在 CINAHL、ASSIA、EMBASE、MEDLINE、PsychINFO 和 Scopus 数据库中进行了系统检索，没有任何日期限制。我们还手动检索了纳入文献的参考文献列表。如果研究重点是痴呆症患者从医院转移到社区中的短期或长期护理机构，包括亚急性、康复、熟练护理设施或养老院，则纳入研究。筛选标题、摘要和全文。两位作者使用清单独立评估研究质量。确定主题并进行讨论以达成共识。
共有 9 篇报告 8 项研究的论文符合系统综述的纳入标准。共有 257 名利益相关者参与；37 名痴呆症患者、95 名家属和 125 名医疗和社会保健专业人员。研究地点在澳大利亚、加拿大、英国和美国。从利益相关者的角度确定了影响过渡体验和结果的四个主题；过渡准备；沟通质量；护理质量；家庭参与和角色。
本系统综述有力地证明了需要有强有力的证据来指导这一多学科临床实践重要领域的最佳实践。证据表明，这一过渡对所有利益相关者都是一个挑战，痴呆症患者在此期间有特定的需求需要关注。
PROSPERO 注册号：CRD42017082041。
