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居家患者从医院到居家护理的过渡体验:运用患者就医轨迹图的探索性研究

The hospital-to-home care transition experience of home care clients: an exploratory study using patient journey mapping.

机构信息

Lunenfeld-Tanenbaum Research Institute, Sinai Health System, 1 Bridgepoint Drive, Toronto, ON, M4M 2B5, Canada.

VHA Home HealthCare, Toronto, ON, Canada.

出版信息

BMC Health Serv Res. 2023 Aug 31;23(1):934. doi: 10.1186/s12913-023-09899-2.

Abstract

BACKGROUND

Care transitions have a significant impact on patient health outcomes and care experience. However, there is limited research on how clients receiving care in the home care sector experience the hospital-to-home transition. An essential strategy for improving client care and experience is through client engagement efforts. The study's aim was to provide insight into the care transition experiences and perspectives of home care clients and caregivers of those receiving home care who experienced a hospital admission and returned to home care services by thematically and illustratively mapping their collective journey.

METHODS

This study applied a qualitative descriptive exploratory design using a patient journey mapping approach. Home care clients and their caregivers with a recent experience of a hospital discharge back to the community were recruited. A conventional inductive approach to analysis enabled the identification of categories and a collective patient journey map. Follow-up interviews supported the validation of the map.

RESULTS

Seven participants (five clients and two caregivers) participated in 11 interviews. Participants contributed to the production of a collective journey map and the following four categories and themes: (1) Touchpoints as interactions with the health system; Life is changing; (2) Pain points as barriers in the health system: Sensing nobody is listening and Trying to find a good fit; (3) Facilitators to positive care transitions: Developing relationships and gaining some continuity and Trying to advocate, and (4) Emotional impact: Having only so much emotional capacity.

CONCLUSIONS

The patient journey map enabled a collective illustration of the care transition depicted in touchpoints, pain points, enablers, and feelings experienced by home care recipients and their caregivers. Patient journey mapping offers an opportunity to acknowledge home care clients and their caregivers as critical to quality care delivery across the continuum.

摘要

背景

护理交接对患者的健康结果和护理体验有重大影响。然而,关于在家庭护理领域接受护理的客户如何体验从医院到家庭的交接,相关研究有限。通过客户参与努力来改善客户护理和体验是一项重要策略。本研究的目的是通过主题和说明性地绘制他们的集体旅程,深入了解家庭护理客户的护理交接体验和观点,以及那些经历过住院并返回家庭护理服务的患者的照顾者的体验和观点。

方法

本研究采用定性描述性探索性设计,使用患者旅程图方法。招募了最近有出院后返回社区的住院经历的家庭护理客户及其照顾者。采用常规归纳分析方法,确定了类别和集体患者旅程图。后续访谈支持了地图的验证。

结果

七名参与者(五名客户和两名照顾者)参加了 11 次访谈。参与者为集体旅程图的制作做出了贡献,并提出了以下四个类别和主题:(1)接触点作为与卫生系统的互动:生活在改变;(2)痛点作为卫生系统的障碍:感觉没有人在倾听和试图找到合适的人选;(3)促进积极护理交接的因素:建立关系并获得一些连续性和尝试倡导;(4)情绪影响:只有这么多的情绪承受能力。

结论

患者旅程图使家庭护理接受者及其照顾者在接触点、痛点、促进因素和感受方面的护理交接情况得以集体说明。患者旅程图为承认家庭护理客户及其照顾者在整个连续护理中对提供优质护理的重要性提供了机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3e2/10469468/a2af0e602794/12913_2023_9899_Fig1_HTML.jpg

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