Chinese General Practice ›› 2023, Vol. 26 ›› Issue (28): 3565-3572.DOI: 10.12114/j.issn.1007-9572.2022.0654

• Evidence-based Medicine • Previous Articles     Next Articles

A Meta-synthesis of Qualitative Studies on the Real Experiences and Care Experience during Hospital-to-home Transition for Elderly Patients with Chronic Diseases

  

  1. 1. School of Nursing and Health, Zhengzhou University, Zhengzhou 450000, China
    2. Clinical Teaching and Research Department, Nursing and Health, Zhengzhou University, Zhengzhou 450000, China
  • Received:2022-09-08 Revised:2023-01-28 Published:2023-10-05 Online:2023-06-26
  • Contact: LIU Lamei

老年慢性病患者医院-家庭过渡期真实经历与护理体验质性研究的Meta整合

  

  1. 1.450000 河南省郑州市,郑州大学护理与健康学院
    2.450000 河南省郑州市,郑州大学护理与健康学院临床教研室
  • 通讯作者: 刘腊梅
  • 作者简介:
    作者贡献:孙梦杰、刘腊梅、王佳南负责文章的构思与设计、文献/资料收集与整理、论文的修订;刘腊梅、王鹏、张振香负责文章的可行性分析;孙梦杰、刘腊梅负责论文的撰写、英文修订、文章的质量控制及审校,并对文章整体负责,监督管理。
  • 基金资助:
    河南省2021年科技发展计划项目(202102310665); 2020年度河南省高等学院青年骨干教师培养计划(2020GGJS001); 郑州大学2021年度校级教育教学改革研究与实践项目(2021ZZUJGLX065); 2019年度郑州大学青年骨干教师培养计划(2019ZDGGJS012)

Abstract:

Background

Understanding the real experiences of elderly patients with chronic diseases during hospital-to-home transition and their expectations of care services can help promote the quality improvement of care services during the transition. In recent years, qualitative studies on real experiences of elderly patients with chronic diseases during the hospital-to-home transition and their experience of care services have gradually increased, however, the results of single qualitative study may not be generalizable and representative.

Objective

To systematically evaluate qualitative studies on the real experiences of elderly patients with chronic diseases during the hospital-to-home transition and their experience of care services.

Methods

In May 2022, PubMed, Web of Science Core Collection, EmBase, CINAHL, CNKI, and Wanfang Data Knowledge Service Platform were searched for the qualitative studies on the real experiences of elderly patients with chronic diseases during hospital-to-home transition and their experience of care services from inception to May 2022. Two researchers separately screened the literature and extracted data, evaluated the quality of included studies according to the Critical Appraisal Skills Programme (CASP) developed by evidence-based medicine center of University of Oxford. Meta synthesis was applied to integrate the results of the studies.

Results

A total of 13 studies were included with 45 research results extracted, and 3 synthesized findings were integrated from 8 categories grouped by similar findings, including barriers to care services during hospital-to-home transition for elderly patients with chronic diseases; facilitators of care services during hospital-to-home transition for elderly patients with chronic diseases; expectations of elderly patients with chronic diseases for care services during hospital-to-home transition.

Conclusion

Hospital-to-home transition of elderly patients with chronic diseases is a challenging process, and there is still much room for improvement in the quality of care services during the transition. Families, communities, medical institutions, government, and society should actively improve the transition conditions for elderly patients at the individual, community, and social levels. The safe hospital-to-home transition of elderly patients with chronic diseases can be promoted by enhancing education for patients during transition, improving self-management abilities of patients, and providing nurse-led care services during transition.

Key words: Aged, Chronic disease, Hospital to home transition, Transitional care, Experience, Qualitative research, Meta synthesis

摘要:

背景

了解老年慢性病患者在医院-家庭过渡期的真实经历和对护理服务的体验与期望,可以促进过渡期护理服务的改善和质量的提升。近年来,有关老年慢性病患者医院-家庭过渡期真实经历和对护理服务体验的质性研究逐渐增多,但单一的质性研究结果可能不具有概括性和代表性。

目的

系统评价老年慢性病患者从医院到家庭的过渡时期的真实感受和对护理服务的体验。

方法

于2022年5月,计算机检索PubMed、Web of Science核心合集、EmBase、CINAHL、中国知网和万方数据知识服务平台等中英文数据库,搜索关于老年慢性病患者医院-家庭过渡期真实感受和对护理服务体验的质性研究,检索时限均为建库至2022年5月。由两名研究者独立筛选文献、提取资料,并根据英国牛津大学循证医学中心制定的文献质量评价项目(CASP)对纳入文献质量进行评价,运用Meta整合法对研究结果进行整合。

结果

共纳入13篇文献,提炼出45个研究结果,将相似的研究结果归纳为8个类别,并综合得出3个整合结果,分别为:老年慢性病患者医院-家庭过渡期护理的障碍因素;老年慢性病患者医院-家庭过渡期护理的促进因素;老年慢性病患者对医院-家庭过渡期护理的期待。

结论

老年慢性病患者从医院到家庭的过渡是一个充满挑战的过程,过渡期护理服务质量仍有较大的提升空间。家庭、社区、医疗机构、政府、社会应积极改善老年慢性病患者在个人、家庭、社区、社会等层面的过渡条件。可通过强化对过渡期患者的教育、提升患者自我管理能力、提供护士主导的过渡期护理服务等举措,帮助老年慢性病患者实现从医院到家庭的安全过渡。

关键词: 老年人, 慢性病, 医院到家庭的过渡, 过渡期护理, 体验, 质性研究, Meta整合