Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
J Adv Nurs. 2021 Nov;77(11):4291-4305. doi: 10.1111/jan.14893. Epub 2021 May 24.
The purpose of this concept analysis is to define and analyse the concept of unplanned readmission to hospital for older persons.
Review the literature and analyse the concept of unplanned readmission.
Guided by Walker and Avant's eight-stage method of concept analysis, four databases (Ovid MEDLINE, Scopus, CINAHL, and Embase) were searched between 1946 and 2020 for empirical studies focused on older persons with multiple chronic conditions, experiences or perspectives and unplanned readmission. A total of 34 articles (10 quantitative, 17 qualitative, three mixed methods), one concept analysis and three historical articles were included.
An unplanned readmission is an experience, process and event. The proposed definition of unplanned readmission is an older person's need for acute care treatment for an urgent or emergent health crisis that has occurred after a previous hospitalization(s). Unplanned readmission is characterized by the attributes of older persons' previous hospitalization(s), the urgent or emergent nature of the older persons' health and the older persons' need for acute care hospital services to resolve their health crisis.
Unplanned readmission is a complex concept that is different from planned and emergency visits/admissions and readiness for discharge. These findings provide a link for understanding unplanned readmission as a consequence of discharge readiness. Analysing this concept supports the need for older persons to seek unplanned readmission for acute care treatment of urgent and emergent health crisis, reduces the blame that older persons may feel from questions related to preventability, and stresses the need to include older persons' experiences in the development and expansion of nursing theory, interventions and current understandings of unplanned readmission.
本概念分析旨在定义和分析老年人非计划性住院再入院的概念。
回顾文献并分析非计划性再入院的概念。
在 Walker 和 Avant 的概念分析八步方法的指导下，于 1946 年至 2020 年期间，对四个数据库（Ovid MEDLINE、Scopus、CINAHL 和 Embase）进行了检索，以获取关注患有多种慢性病的老年人、经验或观点以及非计划性再入院的实证研究。共纳入 34 篇文章（10 篇定量研究、17 篇定性研究、3 篇混合方法研究）、1 篇概念分析和 3 篇历史文章。
非计划性再入院是一种经历、过程和事件。提出的非计划性再入院的定义是指老年人因先前住院治疗后发生的紧急或紧急健康危机而需要急性护理治疗。非计划性再入院的特征是老年人先前的住院治疗、老年人健康的紧急或紧急性质以及老年人需要急性护理医院服务来解决其健康危机。
非计划性再入院是一个复杂的概念，与计划性和急诊就诊/入院以及出院准备不同。这些发现为理解非计划性再入院作为出院准备的后果提供了一个联系。分析这一概念支持老年人因急性护理治疗紧急和紧急健康危机而寻求非计划性再入院的需要，减少了老年人因与可预防相关的问题而感到的指责，并强调了在护理理论、干预措施和当前对非计划性再入院的理解的发展和扩展中纳入老年人经验的必要性。
