The Complexity of the NICU-to-Home Experience for Adolescent Mothers: Meleis' Transitions Theory Applied

Patients' transition experience and care from predialysis to dialysis: a theory-guided integrative review

BACKGROUND

A smooth transition to dialysis is essential for survival and quality of life in patients with advanced chronic kidney disease (CKD).

OBJECTIVE

To develop a transition framework for patients with advanced CKD based on the existing research and transition theory, which aims to illuminate patients' transition experience and provide potential intervention strategies.

METHODS

An integrative review methodology was employed, with searches conducted in ten Chinese and English databases (PubMed, Web of Science, CINAHL, Embase, etc.). Articles were screened and selected based on predefined criteria independently by two authors, with reference lists of included studies reviewed for further studies. Data analysis followed the approach proposed by Whittemore and Knafl.

RESULTS

13 qualitative, 7 quantitative and 1 mixed methods articles were extracted and evaluated. This review develops the transition framework for patients with advanced CKD, including the concepts of transition nature, conditions, intervention strategies, and response patterns. It provides a comprehensive understanding of how personal, dialysis-related, interpersonal, community, and societal factors shape patients' transition experiences and identifies actionable strategies to enhance transitional care.

CONCLUSION

The transition of patients with advanced CKD from predialysis to dialysis is multiple and dynamic. Healthcare professionals should take into account diverse factors influencing this process and formulate tailored strategies to support patients in achieving a smooth and healthy transition.

CLINICAL TRIAL NUMBER

Not applicable.

Experiences of family caregivers of patients with end-of-life cancer during the transition from hospital to home palliative care: a qualitative study

BACKGROUND

The transition of family caregivers of patients with end-of-Life cancer receiving palliative care from hospital to home is a complex and challenging process. This phase of care involves not only the physical and psychological health of the patient but also the role adaptation and emotional support of the family caregivers. To gain a deeper understanding of the various experiences and feelings during this process, we conducted a qualitative study.

METHODS

This study employed a descriptive phenomenological research method. The interviews focused on the specific experiences, challenges faced, support received, and coping strategies of family caregivers of patients with end-of-life cancer during the transition from hospital to home palliative care. All data were treated with strict confidentiality, and recordings and transcriptions were made with the participants' consent.

RESULTS

A total of 15 family caregivers participated. Four main themes and nine sub-themes were identified: complex transition process (anxiety about uncertainty, resistance to transition), discontinuity in care (insufficient discharge guidance, lack of continuous communication mechanisms), post-discharge continuous care needs (need for home care knowledge and skills, social and emotional support, grief counselling and death education), and personal growth and gains (enhanced coping ability, increased psychological resilience).

CONCLUSION

Family caregivers face numerous emotional, cognitive, practical, and social support challenges during the transition from hospital to home care. To improve the caregiving experience and quality of life, appropriate training and support should be provided to better meet the caregivers' needs.

Resilient Mothering: An Application of Transitions Theory From Pregnancy to Motherhood Among Women Living With HIV in Western Kenya

Efficacious strategies can now prevent the transmission of HIV from mother to child. However, transmission rates remain unacceptably high, especially in sub-Saharan Africa. Understanding women's perinatal transitions can inform interventions to support adherence to preventive strategies. Therefore, we applied Transitions Theory in a longitudinal qualitative study to explore perinatal transitions among women living with HIV in western Kenya. We conducted in-depth interviews with 30 women living with HIV at 3 key time points and, using our findings, described the theory's concepts in terms of participants' experiences. We then proposed theory-based interventions that could support smooth transition processes and positive outcomes.

Transitions and empowerment theory: A framework for nursing interventions during intensive care unit patient transition

OBJECTIVES

1) To explore the main characteristics of intensive care unit transition according to patients' lived experience and 2) To identify nursing therapeutics to facilitate patients' transition from the intensive care unit to the inpatient unit.

METHODOLOGY

Secondary Analysis (SA) of the findings of a descriptive qualitative study on the experience of patients admitted to an ICU during the transition to the inpatient unit, based on the Nursing Transitions Theory. Data for the primary study were generated from 48 semi-structured interviews of patients who had survived critical illness in 3 tertiary university hospitals.

RESULTS

Three main themes were identified during the transition of patients from the intensive care unit to the inpatient unit: 1) nature of ICU transition, 2) response patterns and 3) nursing therapeutics. Nurse therapeutics incorporates information, education and promotion of patient autonomy; in addition to psychological and emotional support.

CONCLUSIONS

Transitions Theory as a theoretical framework helps to understand patients' experience during ICU transition. Empowerment nursing therapeutics integrates the dimensions aimed at meeting patients' needs and expectations during ICU discharge.

Mobilizing Forward: An Interpretive Description of Supporting Successful Neonatal Intensive Care Unit-To-Home Transitions for Adolescent Parents

Pregnancy and parenting in adolescence and the transition home following the hospitalization of an infant in the neonatal intensive care unit (NICU) are two relatively complex phenomena; and whilst each have been consistently explored within the relevant literature, little is understood about the care required when they intersect. Using interpretive description methodology to guide our exploration, we conducted semi-structured interviews with 23 expert providers caring for adolescent parents involved in NICU-to-home transitions to describe this process in their practice. Findings suggest that supporting successful NICU-to-home transitions for adolescent parents relied strongly on understanding the impact of the NICU experience, establishing therapeutic relationships and facilitating supportive partnerships between the NICU and parents as well as the NICU and supportive services post-discharge. Findings highlight the opportunity for more integrated models of care within the NICU and extending into the community to address the complex biopsychosocial care needs of this parent population.