Brooks Laura, Stolee Paul, Elliott Jacobi, Heckman George
University of Waterloo, CA.
Int J Integr Care. 2021 Apr 8;21(2):2. doi: 10.5334/ijic.4720.
Transitions of care often result in fragmented care, leading to unmet patient needs and poor satisfaction with care, especially in patients with multiple chronic conditions. This project aimed to understand how experiences of patients with hip fracture, caregivers, and healthcare providers differ across different points of transition.
A secondary analysis of 103 qualitative, semi-structured interviews was conducted using emergent coding techniques, to gain an understanding of how transitional care experiences may differ across varying settings of care. Following the secondary analysis, a focus group interview was conducted to review findings.
Seven key themes, each relating to distinct transition points, emerged from the secondary analysis: (1) Multiple providers contributed to patient and caregiver confusion; (2) Family caregivers were not considered important in the patient's care; (3) System-related issues impacted experiences; (4) Patients and caregivers felt uninformed; (5) Transitions increased stress in patients and caregivers; (6) Care was not tailored to patient needs; (7) Providers faced barriers in getting adequate information. The focus group results built upon these themes, adding some additional context to understand the current transitional care landscape.
In transitions to formal care settings, similarities were related to feeling confused, while in transitions to home, similarities existed in regards to feeling unprepared. These findings support the view that models of integrated care should consider the context to which they are applied.
护理过渡往往导致护理碎片化，致使患者需求未得到满足，护理满意度较低，尤其是在患有多种慢性病的患者中。本项目旨在了解髋部骨折患者、护理人员和医疗服务提供者在不同过渡点的经历有何不同。
采用新兴编码技术对103份定性、半结构化访谈进行二次分析，以了解不同护理环境下过渡护理经历可能存在的差异。二次分析之后，进行了一次焦点小组访谈以审查研究结果。
二次分析得出了七个关键主题，每个主题都与不同的过渡点相关：（1）多个提供者导致患者和护理人员感到困惑；（2）家庭护理人员在患者护理中未被视为重要因素；（3）与系统相关的问题影响了体验；（4）患者和护理人员感到信息不足；（5）过渡增加了患者和护理人员的压力；（6）护理未根据患者需求进行调整；（7）提供者在获取足够信息方面面临障碍。焦点小组的结果基于这些主题，增加了一些额外背景信息以了解当前的过渡护理情况。
在向正规护理机构过渡时，相似之处在于感到困惑，而在向家庭过渡时，相似之处在于感到准备不足。这些发现支持了这样一种观点，即综合护理模式应考虑其应用的背景。
