Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.
Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.
BMC Geriatr. 2020 Mar 12;20(1):97. doi: 10.1186/s12877-020-1488-1.
In the European Union (EU), informal caregivers provide 60% of all care. Informal caregiving ranges from assistance with daily activities and provision of direct care to helping care recipients to navigate within complex healthcare and social services systems. While recent caregiver surveys document the impact of informal caregivers, systematic reviews show that they have unmet needs. Because of the political desire to reduce the length of hospital stays, older patients are discharged from the hospital 'quicker and sicker' than before. The transition between different levels of the healthcare system and the period after hospital discharge is critical for elderly patients. Caregivers' perspectives on the quality of older patients' care journeys between levels of the healthcare system may provide valuable information for healthcare providers and policymakers. This study aims to explore older patient's informal caregivers' views on healthcare quality in the hospital and in the first 30 days after hospitalisation.
We conducted semi-structured individual interviews with 12 participants to explore and describe informal caregivers' subjective experiences of providing care to older relatives. The interviews were then transcribed and analysed thematically.
The analysis yielded the overarching theme 'Informal caregivers - a health service alliance - quality contributor', which was divided into four main themes: 'Fast in, fast out', 'Scant information', 'Disclaimer of responsibility' and 'A struggle to secure professional care'. The healthcare system seemed to pay little attention to ensuring mutual understandings between those involved in discharge, treatment and coordination. The participants experienced that the healthcare providers' main focus was on the patients' diseases, although the health services are supposed to view patients holistically.
Based on the information given by informal caregivers, health services must take into account each person's needs and preferences. To deliver quality healthcare, better coordination between inter-professional care teams and the persons they serve is necessary. Health professionals must strengthen the involvement of caregivers in transitions between care and healthcare. Future work should evaluate targeted strategies for formal caregivers to cooperate, support and empower family members as informal caregivers.
在欧盟(EU),非正式护理人员提供了所有护理的 60%。非正式护理从协助日常活动和提供直接护理,到帮助护理接受者在复杂的医疗保健和社会服务系统中导航不等。尽管最近的护理人员调查记录了非正式护理人员的影响,但系统评价表明他们有未满足的需求。由于政治上希望缩短住院时间,老年患者比以前出院时“更快、更病重”。在不同层次的医疗保健系统之间过渡以及出院后的时期对老年患者至关重要。护理人员对老年患者在医疗保健系统各级之间的护理旅程的质量看法,可能为医疗保健提供者和政策制定者提供有价值的信息。本研究旨在探讨老年患者的非正式护理人员对医院内和出院后 30 天内医疗质量的看法。
我们对 12 名参与者进行了半结构化的个人访谈,以探索和描述非正式护理人员为老年亲属提供护理的主观经验。然后对访谈进行转录并进行主题分析。
分析产生了一个总体主题“非正式护理人员-卫生服务联盟-质量贡献者”,该主题分为四个主要主题:“快速进出”、“信息匮乏”、“免责声明”和“争取获得专业护理”。医疗保健系统似乎很少关注确保参与出院、治疗和协调的各方之间的相互理解。参与者认为,医疗保健提供者的主要重点是患者的疾病,尽管卫生服务应该全面看待患者。
根据非正式护理人员提供的信息,卫生服务必须考虑到每个人的需求和偏好。为了提供高质量的医疗保健,需要改善跨专业护理团队与他们所服务的人员之间的协调。卫生专业人员必须加强护理人员在护理和医疗保健之间过渡的参与。未来的工作应该评估针对正式护理人员的目标策略,以合作、支持和增强家庭成员作为非正式护理人员的能力。