Department of Health Sciences, University of Leicester, University Road, Leicester LE1 7RH, UK.
Leicestershire and Rutland Older Persons Patient and Public Involvement Forum, Department of Health Sciences, University of Leicester, University Road, Leicester LE1 7RH, UK.
Int Emerg Nurs. 2022 Jul;63:101189. doi: 10.1016/j.ienj.2022.101189. Epub 2022 Jun 7.
Little is known of the goals of care of older people living with frailty when they access urgent care. Equally whether these goals are attained from a patient and carer perspective is often unclear. This qualitative study examined the views of older people living with frailty and their families in relation to specific episodes of urgent care, what they wanted to achieve and whether those goals were attained.
Semi-structured interviews with older people living with frailty and their families between Jan and July 2019. Patient and carer participants were recruited in three hospitals in England and interviewed following the urgent care episode. Interviews were audio-recorded, transcribed verbatim and analysed following the principles of the Framework approach. Results were validated by an older people's involvement group.
Forty participants were interviewed either alone or jointly (24 patients and 16 carers), describing episodes of urgent care which started in ED for 28 patients. The goals of care for participants accessing emergency care were that their medical problem be diagnosed and resolved; information about tests and treatment be given to them and their relatives; they receive an appropriate well-planned discharge to their own home with support where needed and without readmission or re-attendance at ED; and that they retain mobility, function and normal activities. Participants perceived that many of these goals of care were not attained.
Older people living with frailty have heterogeneous urgent care goals which require individual ascertainment. Identifying these goals of care early could result in improved attainment through person-centred care.
当体弱的老年人需要紧急护理时，他们的护理目标鲜为人知。同样，从患者和照顾者的角度来看，这些目标是否实现往往也不清楚。本定性研究调查了体弱的老年人及其家属在特定的紧急护理事件中与具体护理目标的相关看法，以及他们希望实现什么目标以及这些目标是否实现。
2019 年 1 月至 7 月期间，对体弱的老年人及其家属进行了半结构化访谈。在英格兰的三家医院招募了患者和照顾者参与者，并在紧急护理事件后对他们进行了采访。采访进行了录音，逐字转录，并按照框架方法的原则进行了分析。研究结果由一个老年人参与小组进行了验证。
40 名参与者接受了单独或联合访谈（24 名患者和 16 名照顾者），描述了在急诊室开始的 28 名患者的紧急护理事件。参与者在紧急护理中寻求的护理目标是诊断和解决他们的医疗问题；向他们和他们的亲属提供有关检查和治疗的信息；他们在自己的家中得到适当的、有计划的出院，在需要时得到支持，而不会再次入院或重新就诊于急诊室；并且他们保持行动能力、功能和正常活动。参与者认为，这些护理目标中的许多都没有实现。
体弱的老年人有不同的紧急护理目标，需要单独确定。早期确定这些护理目标可能会通过以患者为中心的护理来提高目标的实现率。
