Provencher Véronique, Viscogliosi Chantal, Lacerte Julie, D'Amours Monia, Mailhot-Bisson Didier, Gagnon Lise, Lacombe Guy
School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Canada.
Research Centre on Aging, Sherbrooke, Canada.
J Patient Exp. 2024 Aug 5;11:23743735241259553. doi: 10.1177/23743735241259553. eCollection 2024.
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.
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。