Department of Emergency Medicine, Hospital Sønderjylland, University Hospital of Southern Denmark, Aabenraa, Denmark.
Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.
Scand J Caring Sci. 2023 Sep;37(3):740-751. doi: 10.1111/scs.13157. Epub 2023 Mar 7.
Older adults receiving homecare have an increased risk of readmission. The transition from hospital to home can be experienced as unsafe, and older adults describe themselves as vulnerable during the post-discharge period. Thus, the objective was to explore the experiences of unplanned readmissions among older adults who receive homecare.
We conducted qualitative individual semi-structured interviews with older adults, 65 years or above, receiving homecare and being readmitted to an emergency department (ED) between August and October 2020. Data were analysed by systematic text condensation as described by Malterud.
We included 12 adults aged 67-95 years, seven were male, and eight lived alone. The analysis derived three themes: (1) Responsibility and security at home, (2) the role of family, friends and homecare and (3) the importance of trust. The older adults felt that the hospital strived for too-early discharge, as they still did not feel well. They worried about how to manage their daily life. Active involvement of their family increased their sense of security, but those living alone described feeling anxious being at home by themselves after discharge. Although older adults did not wish to go to the hospital, inadequate treatment at home and the feeling of responsibility for their illness made them feel insecure. They expressed that earlier negative experiences affected their trust in the system and their inclination to ask for help.
The older adults were discharged from the hospital despite feeling ill. They described inadequate competencies from healthcare professionals in the home as a contributing factor to their readmission. The readmission increased a sense of security. Support from the family in the process was essential and provided a sense of security, whereas older adults living alone experienced feelings of insecurity in the home environment.
接受家庭护理的老年人再次入院的风险增加。从医院到家庭的过渡可能会让人感到不安全，老年人在出院后会形容自己很脆弱。因此，本研究旨在探讨接受家庭护理的老年人中计划外再次入院的经历。
我们对 2020 年 8 月至 10 月间因计划外再次入院而被收入急诊科的 65 岁及以上接受家庭护理的老年人进行了定性个体半结构式访谈。数据采用 Malterud 描述的系统文本浓缩法进行分析。
我们纳入了 12 名年龄在 67-95 岁的成年人，其中 7 名为男性，8 人独居。分析得出了三个主题：（1）家庭中的责任和安全，（2）家庭、朋友和家庭护理的作用，（3）信任的重要性。老年人觉得医院急于让他们出院，因为他们仍然感觉不舒服。他们担心如何管理自己的日常生活。家人的积极参与增加了他们的安全感，但那些独居的老年人在出院后独自在家时感到焦虑。尽管老年人不想去医院，但在家中治疗不足和对自己疾病的责任感使他们感到不安全。他们表示，早期的负面经历影响了他们对系统的信任和寻求帮助的倾向。
尽管老年人感到不适，但他们还是从医院出院了。他们描述了家庭医疗保健专业人员能力不足是导致他们再次入院的一个因素。再次入院增加了安全感。在这个过程中，来自家人的支持是必不可少的，这提供了一种安全感，而独居的老年人则在家庭环境中感到不安。
