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“身为主角却并非总是参与自身的照护过渡”——一项关于老年人从住院护理出院回家经历的质性描述性研究

"Being the main character but not always involved in one's own care transition" - a qualitative descriptive study of older adults' experiences of being discharged from in-patient care to home.

作者信息

Ingvarsson Emelie, Schildmeijer Kristina, Hagerman Heidi, Lindberg Catharina

机构信息

Department of Health and Caring Sciences, Linnaeus University, Universitetsplatsen 1 392 31, Kalmar, Växjö, Sweden.

出版信息

BMC Health Serv Res. 2024 May 2;24(1):571. doi: 10.1186/s12913-024-11039-3.

Abstract

BACKGROUND

The growing number of older adults with chronic diseases challenges already strained healthcare systems. Fragmented systems make transitions between healthcare settings demanding, posing risks during transitions from in-patient care to home. Despite efforts to make healthcare person-centered during care transitions, previous research indicates that these ambitions are not yet achieved. Therefore, there is a need to examine whether recent initiatives have positively influenced older adults' experiences of transitions from in-patient care to home. This study aimed to describe older adults' experiences of being discharged from in-patient care to home.

METHODS

This study had a qualitative descriptive design. Individual interviews were conducted in January-June 2022 with 17 older Swedish adults with chronic diseases and needing coordinated care transitions from in-patient care to home. Data were analyzed using inductive qualitative content analysis.

RESULTS

The findings indicate that despite being the supposed main character, the older adult is not always involved in the planning and decision-making of their own care transition, often having poor insight and involvement in, and impact on, these aspects. This leads to an experience of mismatch between actual needs and the expectations of planned support after discharge.

CONCLUSIONS

The study reveals a notable disparity between the assumed central role of older adults in care transitions and their insight and involvement in planning and decision-making.

摘要

背景

患有慢性病的老年人数量不断增加,这给本就不堪重负的医疗保健系统带来了挑战。碎片化的系统使得医疗保健机构之间的过渡变得困难重重,在从住院治疗过渡到居家护理期间存在风险。尽管在护理过渡期间努力使医疗保健以患者为中心,但先前的研究表明这些目标尚未实现。因此,有必要研究近期的举措是否对老年人从住院护理过渡到居家护理的体验产生了积极影响。本研究旨在描述老年人从住院护理出院回家的体验。

方法

本研究采用定性描述性设计。2022年1月至6月,对17名患有慢性病且需要从住院护理协调过渡到居家护理的瑞典老年人进行了个体访谈。采用归纳定性内容分析法对数据进行分析。

结果

研究结果表明,尽管老年人理应是主要角色,但他们并不总是参与自身护理过渡的规划和决策,往往对这些方面缺乏深入了解、参与度低且影响力小。这导致了实际需求与出院后计划支持预期之间的不匹配体验。

结论

该研究揭示了老年人在护理过渡中假定的核心角色与其在规划和决策中的认知及参与度之间存在显著差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a162/11067295/6b5bccb495ac/12913_2024_11039_Fig1_HTML.jpg

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