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Shifting the narrative from living at risk to living with risk: validating and pilot-testing a clinical decision support tool: a mixed methods study.从处于风险中生活到与风险共存:验证和试点临床决策支持工具:一项混合方法研究。
BMC Geriatr. 2023 May 31;23(1):338. doi: 10.1186/s12877-023-04068-w.
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Patient Perspectives of the Hospital Discharge Process: A Qualitative Study.患者对医院出院流程的看法:一项定性研究。
J Patient Exp. 2023 May 2;10:23743735231171564. doi: 10.1177/23743735231171564. eCollection 2023.
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Association of cognitive impairment severity with potentially avoidable readmissions: A retrospective cohort study of 8897 older patients.认知障碍严重程度与潜在可避免再入院的关联:一项对8897名老年患者的回顾性队列研究。
Alzheimers Dement (Amst). 2021 Mar 31;13(1):e12147. doi: 10.1002/dad2.12147. eCollection 2021.
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Family Dynamics and the Alzheimer's Disease Experience.家庭动态与阿尔茨海默病体验。
J Fam Nurs. 2021 May;27(2):124-135. doi: 10.1177/1074840720986611. Epub 2021 Feb 9.
6
Impact of dementia on informal care: a systematic review of family caregivers' perceptions.痴呆症对非正式照护的影响:对家庭照护者认知的系统评价
BMJ Support Palliat Care. 2020 Oct 14. doi: 10.1136/bmjspcare-2020-002242.
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A systematic review on implementation of person-centered care interventions for older people in out-of-hospital settings.系统评价:在院外环境中实施以老年人为中心的护理干预措施
Geriatr Nurs. 2021 Jan-Feb;42(1):213-224. doi: 10.1016/j.gerinurse.2020.08.004. Epub 2020 Aug 27.
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Patient and caregiver experience in the transition from hospital to home - brainstorming results from group concept mapping: a patient-oriented study.患者及其照护者在从医院过渡到家庭过程中的体验——基于团体概念映射的头脑风暴结果:一项以患者为中心的研究。
CMAJ Open. 2020 Mar 2;8(1):E121-E133. doi: 10.9778/cmajo.20190009. Print 2020 Jan-Mar.
9
Dementia Severity Associated With Increased Risk of Potentially Preventable Readmissions During Home Health Care.痴呆严重程度与家庭医疗保健期间潜在可预防再入院风险增加相关。
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从医院到家庭过渡期间的风险管理:一项多案例研究,记录患有重度神经认知障碍的患者、其照护者及医疗保健专业人员的经历

Risk Management During the Transition From Hospital to Home: A Multiple Case Study Documenting the Experience of Patients Living With a Major Neurocognitive Disorder, Their Caregivers, and Healthcare Professionals.

作者信息

Provencher Véronique, Viscogliosi Chantal, Lacerte Julie, D'Amours Monia, Mailhot-Bisson Didier, Gagnon Lise, Lacombe Guy

机构信息

School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Canada.

Research Centre on Aging, Sherbrooke, Canada.

出版信息

J Patient Exp. 2024 Aug 5;11:23743735241259553. doi: 10.1177/23743735241259553. eCollection 2024.

DOI:10.1177/23743735241259553
PMID:39108994
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11301727/
Abstract

Understanding the risks in the months following hospital discharge is crucial for healthcare professionals to ensure the need for assistance is met. However, this may be challenging in the case of patients living with a major neurocognitive disorder (PLMNCD). Thus, it is important to incorporate patients' and caregivers' experiences of the transition from hospital to home in the risk assessment. This multiple case study comprised 7 PLMNCD, their caregivers, and occupational therapists. Fifty-four interviews, conducted just before, as well as 3 weeks and 3 to 6 months after hospital discharge, were qualitatively analyzed. Results revealed that risk management during the hospital-to-home transition is a dynamic process aimed at establishing a satisfactory routine while avoiding adverse events. This risk management process, which identifies challenges over time and between stakeholders, involves (a) determining the seriousness and acceptability of risks, (b) reflecting on ways to manage risks, and (c) taking steps to manage risks. This knowledge will help to provide more appropriate care and services that strike a balance between safety and autonomy.

摘要

了解出院后数月内的风险对于医护人员确保满足患者的援助需求至关重要。然而,对于患有重度神经认知障碍的患者(PLMNCD)而言,这可能具有挑战性。因此,在风险评估中纳入患者及其照护者从医院过渡到家庭的经历非常重要。这项多案例研究纳入了7名患有重度神经认知障碍的患者、他们的照护者以及职业治疗师。对出院前、出院后3周以及出院后3至6个月进行的54次访谈进行了定性分析。结果显示,从医院到家庭过渡期间的风险管理是一个动态过程,旨在建立令人满意的日常生活规律,同时避免不良事件。这一风险管理过程会随着时间推移并在利益相关者之间识别挑战,包括(a)确定风险的严重性和可接受性,(b)思考管理风险的方法,以及(c)采取措施管理风险。这些知识将有助于提供更合适的护理和服务,在安全与自主性之间取得平衡。