Department of Geriatric Medicine, Concord Hospital, Sydney, New South Wales, Australia.
Faculty of Medicine and Health, The University of Sydney, Camperdown, Sydney, New South Wales, Australia.
Australas J Ageing. 2023 Sep;42(3):535-544. doi: 10.1111/ajag.13176. Epub 2023 Feb 27.
A growing proportion of older adults are undergoing surgery, but there is a paucity of patient and carer experience research in this group. This study investigated the experience of hospital care in an older vascular surgery population for patients and their carers.
This was a mixed-methods convergent design, including simultaneous collection of quantitative and qualitative research strands by combining open-ended questions with rating scales in a questionnaire. Recently hospitalised vascular surgery patients aged ≥65 years at a major teaching hospital were recruited. Carers were also approached to participate.
Forty-seven patients (mean age 77 years, 77% male, 20% with a Clinical Frailty Scale score >4) and nine carers participated. The majority of patients reported that their views were listened to (n = 42, 89%), they were kept informed (n = 39, 83%), and were asked about their pain (n = 37, 79%). Among carers, seven reported their views were listened to and that they were kept informed. Thematic analysis of patients' and carers' responses to open-ended questions about their experience of hospital care revealed four themes in terms of what mattered to them: fundamental care including hygiene and nutrition, comfort of the hospital environment such as sleep and meals, being informed and involved in health-care decision-making, and treating pain and deconditioning to help recovery.
Older adults admitted to hospital for vascular surgery and their carers, valued highly the care that met both their fundamental needs and facilitated shared decisions for care and recovery. These priorities can be addressed through Age-Friendly Health System initiatives.
越来越多的老年人接受手术,但针对该人群的患者和护理人员体验研究却很少。本研究调查了老年血管外科患者及其护理人员在医院护理方面的体验。
这是一项混合方法的收敛设计,通过在问卷中结合开放式问题和评分量表,同时收集定量和定性研究线索。在一家主要教学医院招募了最近住院的年龄≥65 岁的血管外科手术患者。也邀请了护理人员参与。
47 名患者(平均年龄 77 岁,77%为男性,20%的临床虚弱评分>4)和 9 名护理人员参与了研究。大多数患者报告说他们的意见得到了倾听(n=42,89%),他们得到了充分的信息告知(n=39,83%),他们的疼痛情况也得到了询问(n=37,79%)。在护理人员中,有 7 人报告说他们的意见得到了倾听,他们也得到了充分的信息告知。对患者和护理人员关于医院护理体验的开放式问题的回答进行主题分析,揭示了他们关注的四个主题:基本护理,包括卫生和营养;医院环境的舒适度,如睡眠和饮食;参与医疗保健决策制定;以及治疗疼痛和康复训练。
因血管外科手术住院的老年患者及其护理人员非常重视既能满足他们基本需求又能促进护理和康复的共同决策的护理。这些重点可以通过老年友善健康系统倡议来解决。