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医院出院计划:社会工作者为促进老年患者从住院到返回社区的过渡而采取的支持措施的系统文献回顾。

Hospital discharge planning: A systematic literature review on the support measures that social workers undertake to facilitate older patients' transition from hospital admission back to the community.

机构信息

University of the Sunshine Coast, Sippy Downs, Queensland, Australia.

University of Newcastle, Kirkwood, New South Wales, Australia.

出版信息

Australas J Ageing. 2023 Mar;42(1):20-33. doi: 10.1111/ajag.13138. Epub 2022 Sep 30.

Abstract

OBJECTIVES

To systematically review the literature on measures social workers undertake to facilitate discharge planning for older people in a resource-scarce environment.

METHODS

Systematic search of electronic databases for peer-reviewed articles published in English between January 1990 and August 2020. Articles on hospital discharge planning facilitated by social workers for older patients returning home from hospital admission were included. The Mixed Method Appraisal Tool (MMAT) was used to assess quality and risk of bias. The systematic literature review protocol has been registered with PROSPERO on 27 August 2021.

RESULTS

Six studies from Canada and the United States met the eligibility criteria. The most common support measures employed by hospital social workers when discharge planning for older patients were assessment, education, care co-ordination, liaison and engagement with families and providers, conflict resolution, counselling and postdischarge follow-up. Barriers to effective discharge planning were medical complexity, lack of communication, time constraints, limited family support, availability of resources and patient safety. These studies were published between 1993 and 2014 and were not within the Australian context.

CONCLUSIONS

There are limited studies on Social Work discharge planning within the Australian context, particularly on how this important service has been impacted by recent aged care reforms. More research on the topic is necessary to fully understand how aged care reforms such as the National Prioritisation System for Home Care Packages have influenced hospital discharge planning and how social workers have adapted their practice to this challenge.

摘要

目的

系统回顾文献,了解社会工作者在资源匮乏环境下为老年人促进出院计划所采取的措施。

方法

系统检索 1990 年 1 月至 2020 年 8 月期间以英文发表的同行评议文章的电子数据库。纳入的文章为社会工作者为从医院出院返回家中的老年患者进行的医院出院计划提供便利。采用混合方法评估工具(MMAT)评估质量和偏倚风险。系统文献综述方案已于 2021 年 8 月 27 日在 PROSPERO 上注册。

结果

6 项来自加拿大和美国的研究符合入选标准。医院社会工作者在为老年患者进行出院计划时最常采用的支持措施包括评估、教育、护理协调、与家庭和提供者的联络和参与、冲突解决、咨询和出院后随访。有效的出院计划的障碍包括医疗复杂性、缺乏沟通、时间限制、有限的家庭支持、资源可用性和患者安全。这些研究发表于 1993 年至 2014 年,并不在澳大利亚的背景下。

结论

在澳大利亚背景下,关于社会工作者出院计划的研究有限,特别是关于这一重要服务如何受到最近的老年护理改革的影响。需要对这一主题进行更多的研究,以充分了解国家优先家庭护理包计划等老年护理改革如何影响医院出院计划以及社会工作者如何适应这一挑战。

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