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干预措施以改善从家庭到养老院的过渡:范围综述。

Interventions to Improve the Transition From Home to a Nursing Home: A Scoping Review.

机构信息

Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Faculty of Health Medicine and Life Sciences, Maastricht University, The Netherlands.

Department of Public Health and Primary Care, Academic Center for Nursing and Midwifery, KU Leuven, Belgium.

出版信息

Gerontologist. 2022 Aug 12;62(7):e369-e383. doi: 10.1093/geront/gnab036.

Abstract

BACKGROUND AND OBJECTIVES

The transition from home to a nursing home is a stressful event for both older persons and informal caregivers. Currently, this transition process is often fragmented, which can create a vicious cycle of health care-related events. Knowledge of existing care interventions can prevent or break this cycle. This project aims to summarize existing interventions for improving transitional care, identifying their effectiveness and key components.

RESEARCH DESIGN AND METHODS

A scoping review was performed within the European TRANS-SENIOR consortium. The databases PubMed, EMBASE (Excerpta Medica Database), PsycINFO, Medline, and CINAHL (Cumulated Index to Nursing and Allied Health Literature) were searched. Studies were included if they described interventions designed to improve the transition from home to a nursing home.

RESULTS

17 studies were identified, describing 13 interventions. The majority of these interventions focused on nursing home adjustment with 1 study including the entire transition pathway. The study identified 8 multicomponent and 5 single-component interventions. From the multicomponent interventions, 7 main components were identified: education, relationships/communication, improving emotional well-being, personalized care, continuity of care, support provision, and ad hoc counseling. The study outcomes were heterogeneous, making them difficult to compare. The study outcomes varied, with studies often reporting nonsignificant changes for the main outcome measures.

DISCUSSION AND IMPLICATIONS

There is a mismatch between the theory on optimal transitional care and current transitional care interventions, as they often lack a comprehensive approach. This research is the first step toward a uniform definition of optimal transitional care and a tool to improve/develop (future) transitional care initiatives on the pathway from home to a nursing home.

摘要

背景与目的

从家中过渡到养老院对老年人和非正式照顾者来说都是一件压力很大的事情。目前,这个过渡过程通常是碎片化的,这可能会导致一连串与医疗保健相关的事件。了解现有的护理干预措施可以预防或打破这一循环。本项目旨在总结改善过渡护理的现有干预措施,确定其有效性和关键组成部分。

研究设计与方法

在欧洲 TRANS-SENIOR 联盟内进行了范围综述。检索了 PubMed、EMBASE(医学文摘数据库)、PsycINFO、Medline 和 CINAHL(护理和联合健康文献累积索引)数据库。如果研究描述了旨在改善从家中过渡到养老院的干预措施,则将其纳入研究。

结果

确定了 17 项研究,描述了 13 项干预措施。这些干预措施大多侧重于养老院的调整,有 1 项研究包括整个过渡过程。研究确定了 8 项多组分干预措施和 5 项单组分干预措施。从多组分干预措施中,确定了 7 个主要组成部分:教育、关系/沟通、改善情绪健康、个性化护理、连续性护理、支持提供和特别咨询。研究结果具有异质性,难以进行比较。研究结果差异很大,研究往往报告主要结果测量无显著变化。

讨论与意义

理想的过渡护理理论与当前的过渡护理干预措施之间存在不匹配,因为它们往往缺乏全面的方法。这项研究是朝着统一定义理想的过渡护理以及改善/开发(未来)从家中到养老院的过渡护理途径的过渡护理倡议的工具迈出的第一步。

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