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农村照顾者对最近住院且有再入院风险的患者健康状况恶化迹象的察觉和应对能力准备情况的定性描述研究。

Rural caregivers' preparedness for detecting and responding to the signs of worsening health conditions in recently hospitalised patients at risk for readmission: a qualitative descriptive study.

机构信息

School of Nursing, Centre for Aging Research and Education, York University, Toronto, Ontario, Canada

School of Nursing, Centre for Aging Research and Education, York Univ, Toronto, Ontario, Canada.

出版信息

BMJ Open. 2023 Dec 28;13(12):e076149. doi: 10.1136/bmjopen-2023-076149.

Abstract

OBJECTIVES

This study aimed to explore informal rural caregivers' perceived preparedness to detect and respond to the signs of worsening health conditions in patients recently discharged from hospital and at risk for readmission.

DESIGN

A qualitative descriptive design and semistructured interviews were used. Data were thematically analysed.

SETTING

Data collection occurred in 2018 and 2019 in rural communities in Southwestern and Northeastern Ontario, Canada.

PARTICIPANTS

The study included sixteen informal caregivers who were all family members of a relative discharged from hospital at high risk for readmission following hospitalisation mostly for a medical illness (63%). Participants were mostly women (87.5%), living with their relative (62.5%) who was most often a parent (56.3%).

RESULTS

Three themes were identified: (1) warning signs and rural communities, (2) perceived preparedness, and (3) improving preparedness. The first theme elucidates informal caregivers' view that they needed to be prepared because they were taking over care previously provided by hospital healthcare professionals yet lacked accessible medical help in rural communities. The second theme captures informal caregivers' perceptions that they lacked knowledge of how to detect warning signs and how to respond to them appropriately. The last theme illuminates informal caregivers' suggestions for improving preparation related to warning signs.

CONCLUSIONS

Informal caregivers in rural communities were largely unprepared for detecting and responding to the signs of worsening health conditions for patients at high risk for hospital readmission. Healthcare professionals can anticipate that informal caregivers, particularly those whose relatives live far from medical help, need information on how to detect and respond to warning signs, and may prioritise their time to this aspect of postdischarge care for these caregivers.

摘要

目的

本研究旨在探讨非正规农村照顾者对检测和应对近期出院且有再次入院风险的患者健康状况恶化迹象的准备情况。

设计

采用定性描述设计和半结构式访谈。对数据进行主题分析。

地点

数据收集于 2018 年至 2019 年在加拿大安大略省西南部和东北部的农村社区进行。

参与者

研究包括 16 名非正规照顾者,他们均为最近因医疗疾病住院后再次入院风险较高的出院患者的家庭成员(63%)。参与者主要为女性(87.5%),与亲属同住(62.5%),亲属通常为父母(56.3%)。

结果

确定了三个主题:(1)预警信号和农村社区,(2)感知准备情况,(3)提高准备情况。第一个主题阐明了非正规照顾者的观点,即他们需要做好准备,因为他们正在接管以前由医院医疗保健专业人员提供的护理,但在农村社区缺乏可获得的医疗帮助。第二个主题反映了非正规照顾者缺乏识别预警信号的知识以及如何适当地做出回应的看法。最后一个主题阐明了非正规照顾者对改善与预警信号相关的准备情况的建议。

结论

农村社区的非正规照顾者在检测和应对高风险再次入院患者健康状况恶化迹象方面准备不足。医疗保健专业人员可以预计,特别是那些亲属居住在远离医疗帮助的地方的非正规照顾者,需要有关如何识别和应对预警信号的信息,并且可能会优先考虑将时间用于这些照顾者的出院后护理的这一方面。

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