Pereira Filipa, Bieri Marion, Martins Maria Manuela, Del Río Carral María, Verloo Henk
Institute of Biomedical Sciences Abel Salazar, University of Porto, 4050-313 Porto, Portugal.
School of Health Sciences, HES-SO Valais/Wallis, 1950 Sion, Switzerland.
Nurs Rep. 2022 May 31;12(2):403-423. doi: 10.3390/nursrep12020039.
Safe medication management is particularly challenging among polymedicated home-dwelling older adults after hospital discharge. This study aimed to identify and categorise the stressors experienced and reconstitution strategies adopted by older adults, their informal caregivers, and healthcare professionals as they manage older adults' medications after hospital discharge. A primary study collected the perspectives of 28 older adults, 17 informal caregivers, and 13 healthcare professionals using a qualitative descriptive design. The Neuman Systems Model was used as the basis for a secondary deductive content analysis. Findings revealed that post-discharge medication management at home involved numerous stressors, often including dysfunctions in communication, collaboration, and coordination between the multiple stakeholders involved. Reconstitution strategies for safe medication management were not always successful or satisfactory and were sometimes identified as stressors themselves. Older adults, informal caregivers, and healthcare professionals' perspectives highlighted several potential opportunities for improving safe medication management through nurse-led, interprofessional, patient-centred practices.
对于出院后的居家多药治疗老年患者而言，安全用药管理极具挑战性。本研究旨在识别并分类老年患者、其非正式照护者以及医疗保健专业人员在出院后管理老年患者用药时所经历的压力源和采用的重构策略。一项初步研究采用定性描述性设计，收集了28名老年患者、17名非正式照护者和13名医疗保健专业人员的观点。纽曼系统模式被用作二次演绎性内容分析的基础。研究结果显示，出院后在家中的用药管理涉及众多压力源，通常包括多个利益相关者之间在沟通、协作和协调方面的功能失调。安全用药管理的重构策略并非总是成功或令人满意，有时其本身也被视为压力源。老年患者、非正式照护者和医疗保健专业人员的观点凸显了通过以护士为主导、跨专业、以患者为中心的实践来改善安全用药管理的若干潜在机会。
