[Using lived experiences and theoretical insights to gain a better understanding of the adaptation difficulties encountered by elderly patients with chronic heart failure during the hospital-to-home transition]

Patient and family caregiver adaptation during hospital-home transition: a concept analysis

OBJECTIVE

To analyze the concept of "Adaptation of the patient and his family caregiver" during the hospital-home transition".

METHOD

The Walker and Avant method was followed. This included a scoping review following the Joanna Briggs Institute (JBI) parameters conducted in the Dimensions and Eureka metasearch engines and the PubMed, Embase, Scielo, CINAHL, and ScienceDirect databases.

RESULTS

Of 6073 articles, 85 met inclusion criteria. The transition from hospital to home of the patient and his/her family caregiver after discharge from the hospital requires them to take on care tasks for which they are not always prepared. Adapting to this transition involves understanding it, coping with it; having support; anticipating risks; transferring instructions; adhering to therapy; and monitoring and recording the health condition.

CONCLUSION

The adaptation of the patient and his/her family caregiver during the hospital-home transition is a comprehensive response to the responsibility of caring for his/her health. Adapting means being able to reestablish routines, maintain or improve quality of life, strengthen autonomy and have a sense of achievement and control over the situation.

[Learning to think like a nurse: teaching theories of care]

As nursing sciences develop in France, the teaching of nursing theories in initial training and at university enables nurses to apply their own clinical judgment. Learning and mobilizing several theories, both broad-spectrum and intermediate, encourages critical analysis of care situations, the development of nursing thinking and, ultimately, improved quality of care.

[Meleis theory: a tool for better understanding city-hospital transitions]

Meleis' theory: a tool for better understanding the hospital/town transitions. The purpose of this article is to provide a critique of the transition theory conceptualized by Afaf Meleis. A clinical vignette is used to highlight the strengths and limitations of the theory in the care of elderly people returning home after hospitalization for heart failure. The discussion is based on Peggy Chinn and Maeona Kramer's method of critical analysis.

Facilitators and inhibitors in hospital-to-home transitional care for elderly patients with chronic diseases: A meta-synthesis of qualitative studies

Background

Chronic diseases are long-term, recurring and prolonged, requiring frequent travel to and from the hospital, community, and home settings to access different levels of care. Hospital-to-home transition is challenging travel for elderly patients with chronic diseases. Unhealthy care transition practices may be associated with an increased risk of adverse outcomes and readmission rates. The safety and quality of care transitions have gained global attention, and healthcare providers have a responsibility to help older adults make a smooth, safe, and healthy transition.

Objective

This study aims to provide a more comprehensive understanding of what may shape health transitions in older adults from multiple perspectives, including older chronic patients, caregivers, and healthcare providers.

Methods

Six databases were searched during January 2022, including Pubmed, web of science, Cochrane, Embase, CINAHL (EBSCO), and PsycINFO (Ovid). The qualitative meta-synthesis was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. The quality of included studies was appraised using the Critical Appraisal Skills Programme (CASP) qualitative research appraisal tool. A narrative synthesis was conducted informed by Meleis's Theory of Transition.

Results

Seventeen studies identified individual and community-focused facilitators and inhibitors mapped to three themes, older adult resilience, relationships and connections, and uninterrupted care transfer supply chain.

Conclusion

This study identified potential transition facilitators and inhibitors for incoming older adults transitioning from hospital to home, and these findings may inform the development of interventions to target resilience in adapting to a new home environment, and human relations and connections for building partnerships, as well as an uninterrupted supply chain of care transfer at hospital-home delivery.

Systematic review registration

www.crd.york.ac.uk/prospero/, identifier: CRD42022350478.