Pedrosa Rita, Ferreira Óscar, Baixinho Cristina Lavareda
Nursing School of Lisbon, Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), 1600-090 Lisbon, Portugal.
Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, 2410-541 Leiria, Portugal.
J Pers Med. 2022 Apr 5;12(4):582. doi: 10.3390/jpm12040582.
The increasing incidence of chronic and dependence leads to the need for hospitalization and adaptation in the process of returning home, as well as transition between care levels to ensure continuity of care. The World Health Organization has been warning about this problem since 2016, and consider reorganizing the care model as one of the solutions. The present study aimed to analyse the nurses' perspective on transitional care for dependent people with rehabilitation care needs after hospital discharge.
A focus was developed with the participation of Rehabilitation Nurses from the hospital and community context, and content analysis was defined a .
From the content analysis emerged four related categories: promotion of continuity of care, nurse of advanced practice as a care manager, capacitation of the person and caregiver, and promotion of the care coordination.
The present study allowed the strategies identification that minimize fragmentation risk of care and promote the person participation in transitional care. Ensuring transitional care is imperative to increase the quality of care, the satisfaction of professionals, clients, and the development of a system of sustainable health.
慢性病和依赖性的发病率不断上升，导致在回家过程中需要住院治疗和适应，以及在护理级别之间过渡，以确保护理的连续性。自2016年以来，世界卫生组织一直在警告这个问题，并将重新组织护理模式视为解决方案之一。本研究旨在分析护士对出院后有康复护理需求的依赖人群过渡性护理的看法。
在医院和社区环境中的康复护士参与下开展了一项焦点研究，并确定了内容分析方法。
通过内容分析得出了四个相关类别：促进护理连续性、高级实践护士作为护理管理者、增强患者和照顾者能力以及促进护理协调。
本研究确定了一些策略，这些策略可将护理碎片化风险降至最低，并促进患者参与过渡性护理。确保护理过渡对于提高护理质量、专业人员和患者的满意度以及可持续健康体系的发展至关重要。
