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从医院到家庭过渡的经历:患者、家庭成员和医护人员的观点。一项定性研究的系统综述与元综合分析

Experiences with hospital-to-home transitions: perspectives from patients, family members and healthcare professionals. A systematic review and meta-synthesis of qualitative studies.

作者信息

van Grootel J W M, Collet R J, van Dongen J M, van der Leeden M, Geleijn E, Ostelo R, van der Schaaf M, Wiertsema S, Major M E

机构信息

Department of Rehabilitation Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.

Ageing and Vitality, Amsterdam Movement Sciences, Amsterdam, The Netherlands.

出版信息

Disabil Rehabil. 2025 Apr;47(7):1644-1658. doi: 10.1080/09638288.2024.2384624. Epub 2024 Aug 5.

Abstract

PURPOSE

Multiple studies have explored the needs and experiences of patients, family members, and healthcare professionals regarding hospital-to-home transitions. Our study aimed to identify, critically appraise, and summarize these studies in a qualitative meta-synthesis.

MATERIALS AND METHODS

Medline, CINAHL and Embase were systematically searched to identify eligible articles from inception to June 2024. Qualitative studies were included and critically appraised using the Critical Appraisal Skills Program. Insufficient-quality papers were excluded. We performed a meta-synthesis following (1) open coding by two independent researchers and (2) discussing codes during reflexivity meetings.

RESULTS

Ninety-eight studies were appraised, of which 53 were included. We reached thematic saturation, four themes were constructed: (1) care coordination and continuity, (2) communication, (3) patient and family involvement, and (4) individualized support and information exchange. For patients and families, tailored information and support are prerequisites for a seamless transition and an optimal recovery trajectory after hospital discharge. It is imperative that healthcare professionals communicate effectively within and across care settings to ensure multidisciplinary collaboration and care continuity.

CONCLUSIONS

This study identifies essential elements of optimal transitional care. These findings could be supportive to researchers and healthcare professionals when (re)designing transitional care interventions to ensure care continuity after hospital discharge.

摘要

目的

多项研究探讨了患者、家庭成员和医护人员在医院到家庭过渡方面的需求和经历。我们的研究旨在通过定性元综合分析来识别、批判性评估并总结这些研究。

材料与方法

对Medline、CINAHL和Embase进行系统检索,以识别从创刊到2024年6月的符合条件的文章。纳入定性研究并使用批判性评估技能计划进行批判性评估。质量不足的论文被排除。我们在(1)由两名独立研究人员进行开放式编码以及(2)在反思会议期间讨论编码之后进行了元综合分析。

结果

评估了98项研究,其中53项被纳入。我们达到了主题饱和,构建了四个主题:(1)护理协调与连续性,(2)沟通,(3)患者及家庭参与,以及(4)个性化支持与信息交流。对于患者和家庭而言,量身定制的信息和支持是顺利过渡以及出院后实现最佳康复轨迹的先决条件。医护人员必须在不同护理环境内部及之间进行有效沟通,以确保多学科协作和护理连续性。

结论

本研究确定了最佳过渡护理的基本要素。这些发现可为研究人员和医护人员在(重新)设计过渡护理干预措施以确保出院后护理连续性时提供支持。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c6b4/11974919/1ff830fae4ed/IDRE_A_2384624_F0001_B.jpg

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