Exploring Older People's Experiences and Factors Associated With 30-Day Hospital Readmission: A Qualitative Study Using Interpretive Phenomenological Analysis

IF 1.6 4区 医学 Q4 GERIATRICS & GERONTOLOGY International Journal of Older People Nursing Pub Date : 2024-11-02 DOI:10.1111/opn.12662
Fanis Stavrou, Jo Adams, Harnish P. Patel, Ivaylo Vassilev, Dinesh Samuel
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Abstract

Introduction

Hospital readmission has a negative impact on older people and the healthcare system. Current hospital readmission research predominantly reports on clinical outcomes based on cross-sectional data. Research exploring patients' experiences and priorities is limited. This study aimed to explore older people's experiences of hospital readmission in order to develop an understanding of what matters most to them.

Methods

Semi-structured qualitative interviews were conducted to generate data that were analysed using principles of interpretative phenomenological analysis.

Results

Ten participants over 65 years old, who had experienced unplanned hospital readmission within a period of 30 days, were recruited from a large single tertiary referral centre. Four themes emerged: ‘All about me without me’, ‘Fragmented and ad hoc post-discharge support’, ‘My readmission experience and what led me back’ and ‘Segregated health and social services that are detached from people's needs’.

Conclusion

The study findings suggest that patients should be more involved in decisions about their care, and health professionals should endeavour to better understand the contexts, resources and access to formal and informal support of patients. Effective communication and stronger continuum of care could be a key to patients' recovery and avoidance of hospital readmission. This research highlights the importance of shared decision-making and patient-centred care to improve quality of care, maintain independence and preserve older adult's right to feel valued.

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探索老年人的经历以及与 30 天再入院相关的因素:使用解释性现象学分析的定性研究。
简介再次入院对老年人和医疗系统都有负面影响。目前的再入院研究主要是基于横断面数据报告临床结果。对患者的经历和优先考虑事项的研究十分有限。本研究旨在探讨老年人再入院的经历,以了解什么对他们最重要:方法:进行半结构化定性访谈,得出数据,并采用解释现象学分析原则对数据进行分析:从一家大型三级转诊中心招募了 10 名 65 岁以上的参与者,他们都曾在 30 天内经历过意外再入院。研究发现了四个主题:"只有我而没有我"、"出院后零散和临时性的支持"、"我的再入院经历和导致我再次入院的原因 "以及 "脱离患者需求的医疗和社会服务":研究结果表明,患者应更多地参与有关其护理的决策,医护人员应努力更好地了解患者的背景、资源以及获得正规和非正规支持的途径。有效的沟通和更有力的持续护理是患者康复和避免再次入院的关键。这项研究强调了共同决策和以患者为中心的护理对于提高护理质量、保持独立性和维护老年人感受到自身价值的权利的重要性。
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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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