Sun Mengjie, Liu Lamei, Wang Jianan, Zhuansun Mengyao, Xu Tongyao, Qian Yumeng, Dela Rosa Ronnell
School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China.
School of Nursing, Philippine Women's University, Manila, Philippines.
Front Public Health. 2023 Feb 13;11:1047723. doi: 10.3389/fpubh.2023.1047723. eCollection 2023.
Chronic diseases are long-term, recurring and prolonged, requiring frequent travel to and from the hospital, community, and home settings to access different levels of care. Hospital-to-home transition is challenging travel for elderly patients with chronic diseases. Unhealthy care transition practices may be associated with an increased risk of adverse outcomes and readmission rates. The safety and quality of care transitions have gained global attention, and healthcare providers have a responsibility to help older adults make a smooth, safe, and healthy transition.
This study aims to provide a more comprehensive understanding of what may shape health transitions in older adults from multiple perspectives, including older chronic patients, caregivers, and healthcare providers.
Six databases were searched during January 2022, including Pubmed, web of science, Cochrane, Embase, CINAHL (EBSCO), and PsycINFO (Ovid). The qualitative meta-synthesis was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. The quality of included studies was appraised using the Critical Appraisal Skills Programme (CASP) qualitative research appraisal tool. A narrative synthesis was conducted informed by Meleis's Theory of Transition.
Seventeen studies identified individual and community-focused facilitators and inhibitors mapped to three themes, older adult resilience, relationships and connections, and uninterrupted care transfer supply chain.
This study identified potential transition facilitators and inhibitors for incoming older adults transitioning from hospital to home, and these findings may inform the development of interventions to target resilience in adapting to a new home environment, and human relations and connections for building partnerships, as well as an uninterrupted supply chain of care transfer at hospital-home delivery.
www.crd.york.ac.uk/prospero/, identifier: CRD42022350478.
慢性病具有长期性、复发性和迁延性，需要频繁往返于医院、社区和家庭环境以获得不同级别的护理。对于患有慢性病的老年患者而言，从医院到家庭的过渡是一项具有挑战性的行程。不健康的护理过渡做法可能会增加不良后果和再入院率的风险。护理过渡的安全性和质量已受到全球关注，医疗保健提供者有责任帮助老年人实现平稳、安全和健康的过渡。
本研究旨在从多个角度更全面地了解哪些因素可能影响老年人的健康过渡，这些角度包括老年慢性病患者、护理人员和医疗保健提供者。
于2022年1月检索了六个数据库，包括PubMed、科学网、考克兰图书馆、Embase、护理学与健康领域数据库（EBSCO）和心理学文摘数据库（Ovid）。按照系统评价和Meta分析的首选报告项目（PRISMA）建议进行定性Meta综合分析。使用批判性评估技能计划（CASP）定性研究评估工具对纳入研究的质量进行评估。在梅莱伊斯过渡理论的指导下进行叙述性综合分析。
17项研究确定了以个人和社区为重点的促进因素和阻碍因素，这些因素可归纳为三个主题，即老年人的恢复力、关系与联系以及不间断的护理转移供应链。
本研究确定了即将出院的老年人从医院过渡到家庭的潜在过渡促进因素和阻碍因素，这些发现可能为制定干预措施提供参考，这些干预措施旨在增强适应新家庭环境的恢复力、建立人际关系和联系以促进伙伴关系，以及在医院到家庭的护理转移过程中建立不间断的供应链。
