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住院痴呆症成年患者的家庭照顾者在护理交接期间的需求:美国退伍军人事务部医院的一项定性研究。

Needs of family caregivers of hospitalised adults with dementia during care transitions: a qualitative study in a US Department of Veterans Affairs Hospital.

机构信息

Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center, Houston, Texas, USA

Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.

出版信息

BMJ Open. 2024 Aug 21;14(8):e087231. doi: 10.1136/bmjopen-2024-087231.

Abstract

OBJECTIVE

To identify the needs of caregivers of hospitalised adults with dementia in the hospital and during care transitions.

DESIGN

Pragmatic qualitative inquiry with semi-structured interviews.

SETTING

Michael E. DeBakey Veterans Affairs Medical Center in Houston, Texas, USA.

PARTICIPANTS

12 family caregivers (family member (n=11); friend (n=1)) and 15 health professionals (hospital medicine physicians (n=4), inpatient nurse case managers (n=2), social workers (n=4), outpatient geriatrics providers (n=2), a primary care provider (n=1), geriatric psychiatrists (n=2)) were interviewed. Caregivers were recruited while their care recipient was hospitalised and were interviewed at least 2 weeks after the care recipient was discharged from the hospital. Health professionals were eligible for the study if they provided care to patients with dementia in the inpatient or outpatient setting.

RESULTS

Four recommendations emerged from the analysis: (1) engage caregivers as partners in the care team, (2) provide dementia-specific information and training, (3) connect caregivers to home and community-based services and (4) provide care navigation and support for the caregiver posthospitalisation.

CONCLUSIONS

Hospital care transitions are challenging for caregivers of hospitalised adults living with dementia. Care transition interventions designed to support caregivers with tailored, dementia-specific information and services are needed.

摘要

目的

确定住院痴呆症成年患者及其在院期间和护理过渡期间的护理人员的需求。

设计

具有半结构化访谈的实用定性研究。

地点

美国德克萨斯州休斯顿的迈克尔·E·德贝基退伍军人事务医疗中心。

参与者

12 名家庭护理人员(家庭成员(n=11);朋友(n=1))和 15 名卫生专业人员(医院内科医生(n=4)、住院护士病例经理(n=2)、社会工作者(n=4)、门诊老年病提供者(n=2)、初级保健提供者(n=1)、老年精神病医生(n=2))接受了采访。招募护理人员时,他们的护理对象正在住院,并且在护理对象出院后至少 2 周进行了采访。如果卫生专业人员有资格在住院或门诊环境中为痴呆症患者提供护理,则有资格参加该研究。

结果

分析得出了四项建议:(1)让护理人员成为护理团队的合作伙伴,(2)提供针对痴呆症的特定信息和培训,(3)将护理人员与家庭和社区服务联系起来,以及(4)为护理人员提供出院后的护理导航和支持。

结论

医院护理过渡对住院痴呆症成年患者的护理人员来说具有挑战性。需要设计针对护理人员的过渡干预措施,提供量身定制的、针对痴呆症的信息和服务。

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