Experiences of interventions to reduce hospital stay for older adults following elective treatment: Qualitative evidence-synthesis

IF 1.6 4区 医学 Q4 GERIATRICS & GERONTOLOGY International Journal of Older People Nursing Pub Date : 2024-01-30 DOI:10.1111/opn.12602
Debbie Kinsey PhD, Daniele Carrieri PhD, Simon Briscoe PhD, Sam Febrey BSc, Dylan Kneale PhD, Chris Lovegrove MClinRes, BSc, Michael Nunns PhD, Jo Thompson Coon PhD, John McGrath BM, BS, FRCS, MD, Anthony Hemsley BMedSci, MD, FRCP, Liz Shaw DClinPsy
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Abstract

Background and Objectives

Hospitals streamline treatment pathways to reduce the length of time older adults admitted for planned procedures spend in hospital. However patient perspectives have been poorly evaluated. This systematic review aimed to understand the experiences of older patients, carers, families and staff of multi-component interventions intended to improve recovery following elective treatment.

Research Design and Methods

Bibliographic databases searched in June 2021 included MEDLINE ALL, HMIC, CENTRAL, CINAHL, AMED and ProQuest Dissertations and Theses. We conducted citation searching and examined reference lists of reviews. Two reviewers independently undertook screening and data extraction, resolving disagreements through discussion. We used an adapted Wallace checklist for quality appraisal and meta-ethnography to synthesise data. Clinician, carer and patient views were incorporated throughout the review.

Results

Thirty-five papers were included in the synthesis. Thirteen studies were conducted in the UK, with patient views the most frequently represented. We identified six overarching constructs: ‘Home as preferred environment for recovery’, ‘Feeling safe’, ‘Individualisation of structured programme’, ‘Taking responsibility’, ‘Essential care at home’ and ‘Outcomes’.

Discussion and Implications

Findings explore the support patients, families and carers need throughout hospital admission, and may inform commissioning of services to ensure patients and carers receive appropriate follow-up support after hospital discharge. The findings may help hospital and community-based health and social care staff provide person-centred care based upon assessments of emotional and physical wellbeing of patients and family/carers. Research is needed to establish a core-set of patient-reported outcome measures which capture aspects of recovery which are meaningful to patients.

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减少老年人选择性治疗后住院时间的干预经验:定性证据综述
背景和目的 医院简化治疗路径,以缩短老年人因计划程序而入院的住院时间。然而,对患者观点的评估却很少。本系统性综述旨在了解老年患者、照护者、家属和工作人员对旨在改善择期治疗后康复的多成分干预措施的体验。 研究设计与方法 2021 年 6 月检索的文献数据库包括 MEDLINE ALL、HMIC、CENTRAL、CINAHL、AMED 和 ProQuest Dissertations and Theses。我们对综述进行了引文检索并检查了参考文献目录。两名审稿人独立进行筛选和数据提取,并通过讨论解决分歧。我们使用经过改编的华莱士质量评估核对表和元人种学方法来综合数据。临床医生、护理人员和患者的意见被纳入整个综述。 结果 35 篇论文被纳入综述。其中 13 项研究在英国进行,患者的观点最常被引用。我们确定了六个总体构架:家庭作为康复的首选环境"、"安全感"、"结构化方案的个性化"、"承担责任"、"家庭基本护理 "和 "结果"。 讨论和启示 研究结果探讨了患者、家属和照护者在整个入院过程中所需的支持,可为服务委托提供参考,以确保患者和照护者在出院后获得适当的后续支持。研究结果可帮助医院和社区的医疗及社会护理人员在评估病人及其家人/照护者的情绪和身体健康的基础上,提供以人为本的护理服务。需要开展研究来建立一套患者报告的核心结果测量方法,这些测量方法可以捕捉到对患者有意义的康复方面。
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来源期刊
CiteScore
3.60
自引率
9.10%
发文量
77
期刊介绍: International Journal of Older People Nursing welcomes scholarly papers on all aspects of older people nursing including research, practice, education, management, and policy. We publish manuscripts that further scholarly inquiry and improve practice through innovation and creativity in all aspects of gerontological nursing. We encourage submission of integrative and systematic reviews; original quantitative, qualitative, and mixed methods research; secondary analyses of existing data; historical works; theoretical and conceptual analyses; evidence based practice projects and other practice improvement reports; and policy analyses. All submissions must reflect consideration of IJOPN''s international readership and include explicit perspective on gerontological nursing. We particularly welcome submissions from regions of the world underrepresented in the gerontological nursing literature and from settings and situations not typically addressed in that literature. Editorial perspectives are published in each issue. Editorial perspectives are submitted by invitation only.
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