Faculty of Health Medicine and Life Sciences, Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Living Lab of Ageing and Long Term Care, Maastricht University, Maastricht, the Netherlands; KU Leuven Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Leuven, Belgium.
Faculty of Health Medicine and Life Sciences, Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Living Lab of Ageing and Long Term Care, Maastricht University, Maastricht, the Netherlands.
J Am Med Dir Assoc. 2021 Feb;22(2):351-356. doi: 10.1016/j.jamda.2020.09.041. Epub 2020 Nov 19.
The transition from home to a nursing home can be stressful and traumatic for both older persons and informal caregivers and is often associated with negative outcomes. Additionally, transitional care interventions often lack a comprehensive approach, possibly leading to fragmented care. To avoid this fragmentation and to optimize transitional care, a comprehensive and theory-based model is fundamental. It should include the needs of both older persons and informal caregivers. Therefore, this study, conducted within the European TRANS-SENIOR research consortium, proposes a model to optimize the transition from home to a nursing home, based on the experiences of older persons and informal caregivers. These experiences were captured by conducting a literature review with relevant literature retrieved from the databases CINAHL and PubMed. Studies were included if older persons and/or informal caregivers identified the experiences, needs, barriers, or facilitators during the transition from home to a nursing home. Subsequently, the data extracted from the included studies were mapped to the different stages of transition (pre-transition, mid-transition, and post-transition), creating the TRANSCIT-model. Finally, results were discussed with an expert panel, leading to a final proposed TRANSCIT model. The TRANSCIT model identified that older people and informal caregivers expressed an overall need for partnership during the transition from home to a nursing home. Moreover, it identified 4 key components throughout the transition trajectory (ie, pre-, mid-, and post-transition): (1) support, (2) communication, (3) information, and (4) time. The TRANSCIT model could advise policy makers, practitioners, and researchers on the development and evaluation of (future) transitional care interventions. It can be a guideline reckoning the needs of older people and their informal caregivers, emphasizing the need for a partnership, consequently reducing fragmentation in transitional care and optimizing the transition from home to a nursing home.
从家庭到养老院的过渡对老年人和非正式照顾者来说都是有压力和创伤的，通常会导致负面结果。此外，过渡性护理干预措施往往缺乏全面的方法，可能导致护理碎片化。为了避免这种碎片化并优化过渡性护理，全面的和基于理论的模型是基础。它应该包括老年人和非正式照顾者的需求。因此，这项在欧洲 TRANS-SENIOR 研究联盟内进行的研究，提出了一个基于老年人和非正式照顾者的经验优化从家庭到养老院过渡的模型。这些经验是通过对 CINAHL 和 PubMed 数据库中检索到的相关文献进行文献回顾来获取的。如果老年人和/或非正式照顾者在从家庭到养老院的过渡期间确定了经验、需求、障碍或促进因素，则纳入研究。随后，从纳入的研究中提取的数据被映射到过渡的不同阶段（过渡前、过渡中和过渡后），创建了 TRANSCIT 模型。最后，结果与专家小组进行了讨论，形成了最终提出的 TRANSCIT 模型。TRANSCIT 模型确定，老年人和非正式照顾者在从家庭到养老院的过渡期间表示总体上需要伙伴关系。此外，它在整个过渡轨迹（即过渡前、过渡中和过渡后）中确定了 4 个关键组成部分：（1）支持，（2）沟通，（3）信息，和（4）时间。TRANSCIT 模型可以为政策制定者、从业者和研究人员提供关于（未来）过渡性护理干预措施的制定和评估的建议。它可以作为一个指导方针，考虑到老年人及其非正式照顾者的需求，强调伙伴关系的必要性，从而减少过渡性护理的碎片化，优化从家庭到养老院的过渡。
