Older persons' experiences of adapting to daily life at home after hospital discharge: a qualitative metasummary.
Activities of Daily Living
/ psychology
Adaptation, Psychological
Aged
Aged, 80 and over
Attitude to Health
Caregivers
/ psychology
Communication
Continuity of Patient Care
/ organization & administration
Female
Home Care Services
/ organization & administration
Hospitalization
Hospitals
Humans
Male
Patient Discharge
Patient Participation
Professional-Patient Relations
Self Care
/ standards
Transitional Care
/ organization & administration
Communication
Informal caregiver
Metasummary
Older people
Patient involvement
Qualitative research
Transition
Journal
BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677
Informations de publication
Date de publication:
11 Apr 2019
11 Apr 2019
Historique:
received:
01
11
2017
accepted:
24
03
2019
entrez:
13
4
2019
pubmed:
13
4
2019
medline:
8
6
2019
Statut:
epublish
Résumé
Researchers have shown that hospitalisation can decrease older persons' ability to manage life at home after hospital discharge. Inadequate practices of discharge can be associated with adverse outcomes and an increased risk of readmission. This review systematically summarises qualitative findings portraying older persons' experiences adapting to daily life at home after hospital discharge. A metasummary of qualitative findings using Sandelowski and Barroso's method. Data from 13 studies are included, following specific selection criteria, and categorised into four main themes. Four main themes emerged from the material: (1) Experiencing an insecure and unsafe transition, (2) settling into a new situation at home, (3) what would I do without my informal caregiver? and (4) experience of a paternalistic medical model. The results emphasise the importance of assessment and planning, information and education, preparation of the home environment, the involvement of the older person and caregivers and supporting self-management in the discharge and follow-up care processes at home. Better communication between older persons, hospital providers and home care providers is needed to improve the coordination of care and facilitate recovery at home. The organisational structure may need to be redefined and reorganised to secure continuity of care and the wellbeing of older persons in transitional care situations.
Sections du résumé
BACKGROUND
BACKGROUND
Researchers have shown that hospitalisation can decrease older persons' ability to manage life at home after hospital discharge. Inadequate practices of discharge can be associated with adverse outcomes and an increased risk of readmission. This review systematically summarises qualitative findings portraying older persons' experiences adapting to daily life at home after hospital discharge.
METHODS
METHODS
A metasummary of qualitative findings using Sandelowski and Barroso's method. Data from 13 studies are included, following specific selection criteria, and categorised into four main themes.
RESULTS
RESULTS
Four main themes emerged from the material: (1) Experiencing an insecure and unsafe transition, (2) settling into a new situation at home, (3) what would I do without my informal caregiver? and (4) experience of a paternalistic medical model.
CONCLUSIONS
CONCLUSIONS
The results emphasise the importance of assessment and planning, information and education, preparation of the home environment, the involvement of the older person and caregivers and supporting self-management in the discharge and follow-up care processes at home. Better communication between older persons, hospital providers and home care providers is needed to improve the coordination of care and facilitate recovery at home. The organisational structure may need to be redefined and reorganised to secure continuity of care and the wellbeing of older persons in transitional care situations.
Identifiants
pubmed: 30975144
doi: 10.1186/s12913-019-4035-z
pii: 10.1186/s12913-019-4035-z
pmc: PMC6460679
doi:
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
224Subventions
Organisme : Norges Forskningsråd
ID : 256644/H10
Références
J Adv Nurs. 2001 Aug;35(4):571-81
pubmed: 11529957
J Am Geriatr Soc. 2003 Apr;51(4):549-55
pubmed: 12657078
Lippincotts Case Manag. 2004 May-Jun;9(3):147-51
pubmed: 15252366
Med Care Res Rev. 2005 Oct;62(5):601-16
pubmed: 16177460
Scand J Caring Sci. 2006 Mar;20(1):68-78
pubmed: 16489962
J Gen Intern Med. 2006 Apr;21(4):298-303
pubmed: 16686804
Int J Integr Care. 2002;2:e02
pubmed: 16896392
Qual Saf Health Care. 2007 Feb;16(1):17-22
pubmed: 17301197
J Clin Nurs. 2007 Mar;16(3):469-76
pubmed: 17335522
BMC Health Serv Res. 2007 Apr 04;7:47
pubmed: 17408472
J Gen Intern Med. 2007 May;22(5):668-74
pubmed: 17443376
Health Aff (Millwood). 2007 May-Jun;26(3):716-25
pubmed: 17485749
Accid Emerg Nurs. 2007 Jul;15(3):134-40
pubmed: 17681763
Chest. 2008 Feb;133(2):377-85
pubmed: 17925419
J Clin Nurs. 2009 Jan;18(2):199-209
pubmed: 18702620
J Clin Nurs. 2009 Sep;18(18):2539-46
pubmed: 19374695
Clin Rehabil. 2009 Nov;23(11):973-85
pubmed: 19675115
Int J Nurs Stud. 2010 Jan;47(1):89-107
pubmed: 19854441
Patient Educ Couns. 2010 Aug;80(2):233-40
pubmed: 19945814
BMC Health Serv Res. 2010 Jan 04;10:1
pubmed: 20044945
J Gerontol Nurs. 2010 Oct;36(10):20-8; quiz 30-1
pubmed: 20438010
Patient Educ Couns. 2011 Oct;85(1):68-73
pubmed: 20884160
Int J Older People Nurs. 2010 Dec;5(4):254-64
pubmed: 21083804
Health Expect. 2013 Sep;16(3):277-91
pubmed: 21838834
J Rehabil Med. 2011 Oct;43(10):916-22
pubmed: 21915586
Int J Qual Health Care. 2012 Feb;24(1):39-48
pubmed: 22146566
Work. 2012;41 Suppl 1:2915-24
pubmed: 22317162
BMJ Open. 2012 May 31;2(3):null
pubmed: 22654092
Qual Health Res. 2012 Nov;22(11):1513-23
pubmed: 22910589
Contemp Nurse. 2012 Oct;42(2):280-8
pubmed: 23181378
Rehabil Nurs. 2012 Nov-Dec;37(6):277-85
pubmed: 23212952
J Clin Nurs. 2013 Feb;22(3-4):445-55
pubmed: 23301580
Med Decis Making. 2014 Feb;34(2):216-30
pubmed: 24106235
Res Social Adm Pharm. 2014 Sep-Oct;10(5):791-800
pubmed: 24268364
Health Expect. 2015 Dec;18(6):1827-43
pubmed: 24611995
BMC Health Serv Res. 2014 Aug 15;14:346
pubmed: 25128468
BMC Health Serv Res. 2014 Sep 13;14:389
pubmed: 25218406
Can J Aging. 2015 Mar;34(1):90-9
pubmed: 25547021
Neurohospitalist. 2015 Jan;5(1):35-42
pubmed: 25553228
Int J Qual Stud Health Well-being. 2015 Jun 01;10:27370
pubmed: 26037333
Int J Orthop Trauma Nurs. 2015 Aug;19(3):131-9
pubmed: 26122594
PLoS Med. 2015 Oct 27;12(10):e1001895
pubmed: 26506244
Scand J Caring Sci. 2016 Dec;30(4):749-756
pubmed: 26662180
Patient Prefer Adherence. 2016 May 12;10:769-79
pubmed: 27274204
Qual Health Res. 2017 Jan;27(1):24-36
pubmed: 27469975
JBI Libr Syst Rev. 2009;7(24):1036-1090
pubmed: 27820495
BMC Nurs. 2016 Dec 1;15:70
pubmed: 27980452
CMAJ. 1995 May 1;152(9):1423-33
pubmed: 7728691
Arch Intern Med. 1997 May 12;157(9):1026-30
pubmed: 9140275