Sunnybrook Research Institute (Gotlib Conn, Nathens, Scales, Haas), Sunnybrook Health Sciences Centre; Departments of Anthropology (Gotlib Conn) and Surgery (Nathens, Haas), and Interdepartmental Division of Critical Care (Scales, Haas), University of Toronto, Toronto, Ont.; London Health Sciences Centre (Vogt); Department of Surgery (Vogt), Western University, London, Ont.; Li Ka Shing Knowledge Institute (Wong), St Michael's Hospital; Department of Medicine (Wong), University of Toronto, Toronto, Ont.
CMAJ Open. 2023 Apr 11;11(2):E323-E328. doi: 10.9778/cmajo.20220013. Print 2023 Mar-Apr.
Older adults (aged ≥ 65 yr) account for a substantial proportion of hospital admissions for severe injury, yet little is known about their care experiences and views regarding outcomes. We sought to characterize the acute care and early recovery experiences of older adults who had been discharged after traumatic injury, with a long-term goal to inform the selection of patient-centred process and outcome measures in geriatric trauma.
From June 2018 to September 2019, we conducted telephone interviews with adults aged 65 years or older who had been discharged after traumatic injury within 6 months from Sunnybrook or London Health Sciences Centres in Ontario, Canada. Using interpretive description and thematic analysis, we drew on social science theories of illness and aging for data interpretation. We analyzed data to the point of theoretical saturation.
We interviewed 25 trauma survivors aged 65-88 years. Most were injured in a fall. Four themes characterized participants' experiences, as follows: "I don't feel like a senior" (i.e., participants disliked being viewed as a senior or as needing senior-specific care); "don't bother telling him anything" (i.e., participants perceived ageist assumptions and treatment in acute care processes); getting back to normal (i.e., participants emphasized their active lifestyles and functional recovery as goals of care); "I have lost control of my life" (i.e., substantial social and personal losses linked to participants' experiences and adaptations to aging generally).
Findings suggest that older adults experience social and personal loss after injury, and underscore how implicit age bias may influence care experiences and outcomes. This can inform improvements in injury care and guide providers in the selection of patient-centred outcome measures.
老年人（年龄≥65 岁）在因严重伤害而住院的患者中占很大比例，但人们对他们的护理体验和对结果的看法知之甚少。我们旨在描述在创伤后出院的老年人的急性护理和早期康复经历，其长期目标是为老年创伤患者选择以患者为中心的过程和结果衡量标准提供信息。
2018 年 6 月至 2019 年 9 月，我们对在加拿大安大略省的 Sunnybrook 或伦敦健康科学中心创伤后 6 个月内出院的年龄在 65 岁或以上的成年人进行了电话采访。我们使用解释性描述和主题分析，借鉴了关于疾病和衰老的社会科学理论来解释数据。我们对数据进行了分析，直到达到理论饱和。
我们采访了 25 名 65-88 岁的创伤幸存者。大多数人是从高处坠落受伤。参与者的经历有四个主题，分别是：“我不想被当作老年人”（即，参与者不喜欢被视为老年人或需要专门针对老年人的护理）；“别跟他说任何事”（即，参与者认为在急性护理过程中存在年龄歧视的假设和治疗）；“恢复正常”（即，参与者强调积极的生活方式和功能恢复是护理目标）；“我已经失去了对生活的控制”（即，与参与者的经历和对衰老的适应相关的重大社会和个人损失）。
研究结果表明，老年人在受伤后会经历社会和个人的损失，并强调了隐性年龄偏见如何影响护理体验和结果。这可以为改善伤害护理提供信息，并指导提供者选择以患者为中心的结果衡量标准。
