慢性病老年人从医院到家庭的过渡护理：一项对老年患者和医疗保健提供者观点的定性研究。
Transition of care from hospital to home for older people with chronic diseases: a qualitative study of older patients' and health care providers' perspectives.
机构信息
School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China.
School of Nursing, Philippine Women's University, Manila, Philippines.
出版信息
Front Public Health. 2023 Apr 27;11:1128885. doi: 10.3389/fpubh.2023.1128885. eCollection 2023.
BACKGROUND
Transitional care is a critical area of care delivery for older adults with chronic illnesses and complex health conditions. Older adults have high, ongoing care needs during the transition from hospital to home due to certain physical, psychological, social, and caregiving burdens, and in practice, patients' needs are not being met or are receiving transitional care services that are unequal and inconsistent with their actual needs, hindering their safe, healthy transition. The purpose of this study was to explore the perceptions of older adults and health care providers, including older adults, about the transition of care from hospital to home for older patients in one region of China.
OBJECTIVE
To explore barriers and facilitators in the transition of care from hospital to home for older adults in China from the perspectives of older patients with chronic diseases and healthcare professionals.
METHODS
This was a qualitative study based on a semi-structured approach. Participants were recruited from November 2021 to October 2022 from a tertiary and community hospital. Data were analyzed using thematic analysis.
RESULTS
A total of 20 interviews were conducted with 10 patients and 9 medical caregivers, including two interviews with one patient. The older adult/adults patients included 4 men and 6 women with an age range of 63 to 89 years and a mean age of 74.3 ± 10.1 years. The medical caregivers included two general practitioners and seven nurses age range was 26 to 40 years with a mean age of 32.8 ± 4.6 years. Five themes were identified: (1) attitude and attributes; (2) better interpersonal relationships and communication between HCPs and patients; (3) improved Coordination of Healthcare Services Is Needed; (4) availability of resources and accessibility of services; and (5) policy and environment fit. These themes often serve as both barriers and facilitators to older adults' access to transitional care.
CONCLUSIONS
Given the fragmentation of the health care system and the complexity of care needs, patient and family-centered care should be implemented. Establish interconnected electronic information support systems; develop navigator roles; and develop competent organizational leaders and appropriate reforms to better support patient transitions.
背景
过渡护理是为患有慢性病和复杂健康状况的老年人提供护理的关键领域。老年人由于身体、心理、社会和护理负担等原因，在从医院到家庭的过渡期间存在较高的持续护理需求，但在实践中，患者的需求并未得到满足，或者他们接受的过渡护理服务与其实际需求不平等且不一致，这阻碍了他们的安全、健康过渡。本研究的目的是探讨中国某一地区老年患者和医疗保健提供者（包括老年患者）对老年患者从医院到家庭的护理过渡的看法。
目的
从慢性病老年患者和医疗保健专业人员的角度探讨中国老年患者从医院到家庭过渡护理的障碍和促进因素。
方法
这是一项基于半结构化方法的定性研究。参与者于 2021 年 11 月至 2022 年 10 月从一家三级医院和社区医院招募。使用主题分析对数据进行分析。
结果
共对 10 名患者和 9 名医疗保健提供者（包括两名患者各进行了两次访谈）进行了 20 次访谈。老年患者/成年人患者包括 4 名男性和 6 名女性，年龄在 63 岁至 89 岁之间，平均年龄为 74.3 ± 10.1 岁。医疗保健提供者包括两名全科医生和七名护士，年龄在 26 岁至 40 岁之间，平均年龄为 32.8 ± 4.6 岁。确定了五个主题：（1）态度和属性；（2）改善医护人员与患者之间的人际关系和沟通；（3）需要改进医疗服务协调；（4）资源可用性和服务可及性；（5）政策和环境适配。这些主题通常既是老年人获得过渡护理的障碍，也是促进因素。
结论
鉴于医疗保健系统的碎片化和护理需求的复杂性，应实施以患者和家庭为中心的护理。建立互联的电子信息支持系统；发展导航员角色；并培养有能力的组织领导者和进行适当的改革，以更好地支持患者过渡。
Zotero 插件