Department of Geriatrics, Gelre Hospitals, Apeldoorn.
Department of Internal Medicine, University Medical Centre Groningen, University of Groningen, Groningen.
Intern Med J. 2022 May;52(5):770-775. doi: 10.1111/imj.15508. Epub 2022 Mar 10.
Due to the rising number of acutely hospitalised older people in the coming years, there is increased interest in tailoring care to the individual goals and preferences of patients in order to reach patient-centred care.
To investigate the goals of older hospitalised patients and the extent to which these goals were reached during hospitalisation.
A single-centre prospective cohort study was performed in The Netherlands between December 2017 and January 2018. Participants aged 70 years or older were included. In the first 3 days of hospitalisation, a semi-structured interview was conducted to assess the patient goals regarding the hospital admission. At 1-2 weeks after discharge, patients were asked to what extent the recent hospitalisation had contributed to reaching their goals.
One hundred and four patients were included and follow up was completed for 86 patients. The main goals reported at hospital admission were 'remaining alive' (72.1%), 'feeling better' (71.2%) and 'improving condition' (65.4%). Hospitalisation seemed to have a positive contribution to reaching the goals 'remaining alive', 'knowing what is wrong', 'feeling better', 'reducing pain' and 'controlling disease'. Hospitalisation seemed to contribute little to reaching the goals in the categories 'enjoying life', 'independency and freedom', 'improving daily functioning', 'hobbies and work' and 'social functioning'.
It is important for healthcare professionals to know the goals of their patients. The majority of these goals were not achieved at hospital discharge. It is important to be aware of this, so sufficient aftercare can be arranged and patients can be prepared.
由于未来几年内急性住院的老年人数量不断增加,人们越来越关注根据患者的个体目标和偏好来定制护理,以实现以患者为中心的护理。
调查老年住院患者的目标以及在住院期间实现这些目标的程度。
2017 年 12 月至 2018 年 1 月在荷兰进行了一项单中心前瞻性队列研究。纳入年龄 70 岁或以上的参与者。在住院的前 3 天内,进行半结构化访谈以评估患者入院的目标。在出院后 1-2 周,询问患者近期住院对实现其目标的贡献程度。
共纳入 104 例患者,86 例完成了随访。入院时报告的主要目标是“保持存活”(72.1%)、“感觉更好”(71.2%)和“改善病情”(65.4%)。住院似乎对实现“保持存活”、“了解病情”、“感觉更好”、“减轻疼痛”和“控制疾病”等目标有积极的贡献。住院对实现“享受生活”、“独立性和自由”、“改善日常生活功能”、“爱好和工作”以及“社会功能”等类别的目标贡献较小。
医疗保健专业人员了解患者的目标非常重要。大多数目标在出院时未实现。了解这一点很重要,以便可以安排足够的后续护理并为患者做好准备。