Department of Nursing, Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, Massachusetts, USA.
J Adv Nurs. 2024 Nov;80(11):4436-4447. doi: 10.1111/jan.16078. Epub 2024 Jan 31.
AIM(S): To explore the meaning of healthcare self-management support for post-discharged stroke patients.
Rodgers' evolutionary approach was used to identify antecedents, attributes, related terms, surrogate terms and consequences.
Literature from 2012 to 2022 was searched from MEDLINE, CINAHL, PsycINFO and Google Scholar.
Three antecedents preceded healthcare self-management support for post-discharged stroke patients: loss of inpatient support, preparedness for self-management and presence of self-management support. Healthcare self-management support for post-discharged stroke patients was defined by eight attributes: pre-discharge assessment and planning; provision of continuous education and training; collaborative goal-setting; reinforcement and documentation of vital information; coordination of post-discharge care; provision of rehabilitation support and promoting community reintegration; provision of counselling support; and using clear communication, patient empowerment and promoting self-efficacy. The identified consequences of the concept were as follows: improved patient outcomes; improved life quality; decreased healthcare cost; decreased re-admission rate and inpatient care burden; and decreased complication rate.
Healthcare self-management support for post-discharged stroke patients is an emerging concept that can help to significantly improve stroke patients' health outcomes and life quality. However, its applicability is uncertain considering the workload, time and resources available to healthcare professionals. There is a need for future studies to focus on the feasibility and applicability of this concept in clinical practice and to identify any challenges healthcare providers may have in supporting stroke patients after discharge.
This concept analysis brings clarity to the concept of healthcare self-management support of post-discharged stroke patients and distinguishes it from other self-management supports. It provides an opportunity for further studies and a pathway for generalized healthcare self-management support for stroke patients after discharge to improve health outcomes and quality of life.
No patients, service users, caregivers or members of the public were involved in conducting this concept analysis.
探索出院后脑卒中患者医疗保健自我管理支持的意义。
采用罗杰斯进化方法确定先存条件、属性、相关术语、替代术语和结果。
从 MEDLINE、CINAHL、PsycINFO 和 Google Scholar 搜索了 2012 年至 2022 年的文献。
有三个先存条件预示着出院后脑卒中患者的医疗保健自我管理支持：住院支持丧失、自我管理准备和自我管理支持存在。出院后脑卒中患者的医疗保健自我管理支持由八项属性定义：出院前评估和计划；提供持续教育和培训；协作目标设定；强化和记录重要信息；协调出院后护理；提供康复支持和促进社区融入；提供咨询支持；以及使用清晰的沟通、赋予患者权力和促进自我效能。该概念的识别结果如下：改善患者结局；改善生活质量；降低医疗保健成本；降低再入院率和住院护理负担；降低并发症发生率。
出院后脑卒中患者的医疗保健自我管理支持是一个新兴概念，可显著改善脑卒中患者的健康结局和生活质量。然而，考虑到医疗保健专业人员的工作量、时间和资源，其适用性尚不确定。需要进一步研究关注这一概念在临床实践中的可行性和适用性，并确定医疗保健提供者在支持出院后脑卒中患者时可能面临的任何挑战。
本次概念分析使出院后脑卒中患者医疗保健自我管理支持的概念更加清晰，并将其与其他自我管理支持区分开来。它为进一步的研究提供了机会，并为脑卒中患者出院后的一般性医疗保健自我管理支持提供了途径，以改善健康结局和生活质量。
在进行本次概念分析时，没有患者、服务使用者、护理人员或公众参与。
