Factors predicting a successful post-discharge outcome for individuals aged 80 years and over

Bragstad, Line Kildal; Kirkevold, Marit; Hofoss, Dag; Foss, Christina

doi:10.5334/ijic.691

Cited by 30 publications

(41 citation statements)

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“…In accordance with previous research focusing on older people in transition, this study shows that the patients wish to be involved and participate in the discharge process [9] [10] [15] [16]. Yet, lack of information and participation in the discharge process are reported in a range of studies [3] [11] [17] [23]- [25], supporting the findings in the current study. However, although the patients missed information and the chance to being better prepared before discharge from hospital, the older persons in our study accepted their situation and were grateful for the treatment they received.…”

Section: Discussionsupporting

confidence: 91%

“…These findings were supported by Foss et al [16], who also indicate major shortcomings in participation, information and education in the discharge process. In a study of factors predicting successful post-discharge outcome, Bragstad et al [17] found that having someone at home upon return from the hospital and during formal home care services was significantly associated with patient-reported success in managing own health.…”

Section: Introductionmentioning

confidence: 99%

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The Transition from Hospital to Home: Older People’s Experiences

Hvalvik¹,

Dale²

2015

OJN

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The amount of older patients who are discharged from hospitals while continuing to need care is increasing in Norway. The transition between different care services has the potential for high rates of medication errors, incomplete or inaccurate information transfer, and lack of appropriate follow-up care. Thus, insight into the transition process is vital to understanding the complexity and vulnerability the patients are exposed to in this process. The aim of this phenomenological hermeneutic study was to describe and illuminate the lived experiences of older home residents during the transitions from hospital to home. Data were collected through narrative interviews, and an interpretation analysis based on a method developed by Lindseth and Norberg was conducted. Two themes and four subthemes, closely related to each other emerged from the structural analysis of the text: The theme "Relating to different systems of care" with the two subthemes "feeling disregarded" and "being humble"; and the theme "Adapting to life conditions" with the two subthemes "feeling vulnerable" and "coping with alterations". The older people miss being seen as human beings as well as patients during the transition process. Despite the lack of information and participation in the transition process, they were grateful and humble to the systems of care they were a part of. This, however, also encompassed rejections of own needs. It is urgent that health care professionals focus on the older person's individual needs and preferences. This means that care must be considered from the perspectives of the older person's biographical as well as medical history, and the complexity of the situation.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

The Transition from Hospital to Home: Older People’s Experiences

Hvalvik¹,

Dale²

2015

OJN

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“…The patient questionnaire and Patients' perspectives have been reported elsewhere (Foss & Hofoss , Bragstad et al . ).…”

Section: Methodsmentioning

confidence: 97%

Informal caregivers' participation when older adults in Norway are discharged from the hospital

Bragstad

Kirkevold

Hofoss

et al. 2013

Health Soc Care Community

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This paper describes the participation of informal caregivers in the discharge process when patients aged 80 and over who were admitted from home to different hospitals in Norway were discharged to long‐term community care. Data for this cross‐sectional survey were collected through telephone interviews with a consecutive sample of 262 caregivers recruited between October 2007 and May 2009. The Discharge of Elderly Questionnaire was developed by the research team and was designed to elicit data concerning informal caregivers' self‐reported perceptions on participation in the discharge process. A descriptive and comparative analysis of Thompson's levels of participation reported by the older generation (spouses and siblings) and the younger generation (adult children and children‐in‐law, nieces and grandchildren) was undertaken using bivariate cross‐tabulations and chi‐square tests for association and trend. Analyses showed that the younger generation of caregivers received and provided information to hospital staff to a greater degree than the older generation. Overall, 52% of the informal caregivers reported co‐operating with the staff to a high or to some degree. A multivariate logistic regression analysis was used to analyse factors predicting the likelihood of informal caregivers reporting co‐operation with hospital staff. The odds of younger generation caregivers reporting co‐operation were more than twice as high (OR = 2.121, P = 0.045) as the odds of the older generation. Caregivers of patients with a hearing impairment had higher odds of reporting co‐operation (OR = 1.722, P = 0.049) than caregivers of patients with no such impairment. The length of hospital stay, the caregiver's and patient's gender and education level were not significantly associated with caregiver's co‐operation. The informal caregivers' experiences with information practices and user participation in hospitals highlight important challenges that must be taken seriously to ensure co‐operation between families and hospitals when elderly patients are discharged back to the community.

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“…Current evidence suggests that older people at hospital discharge would benefit from better communication and more active participation of relatives in the discharge planning and that the discharge planning should start well ahead of the time of discharge (Bauer, Fitzgerald, Haesler, & Manfrin, 2009). Furthermore, it appears that the participation of relatives is a factor contributing to successful return to home (Bragstad, Kirkevold, Hofoss, & Foss, 2012). Little research has been carried out on the experiences of relatives in connection with the discharge from hospital of elderly family members, particularly to their own homes (Hvalvik & Reierson, 2015).…”

mentioning

confidence: 99%

User participation is a family matter: A multiple case study of the experiences of older, hospitalised people and their relatives

Nyborg

Danbolt

Kirkevold

2017

Journal of Clinical Nursing

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Aims and objectives: The purpose of this multiple case study was to compare and contrast older people's and their relatives' experiences of participation in decision-making processes regarding the planning of everyday life after discharge from hospital.Background: Internationally, patient involvement in health services is established to benefit patient health and to improve quality of the services. The literature shows that at hospital discharge, older people would benefit from better communication and more active participation of relatives in the discharge planning. Little research has been carried out on the experiences of patients and relatives as a family in this context, and even less has investigated their participation.Design: This study used a qualitative design with a comparative multicase approach.Participants were recruited from two hospitals in Norway using a purposive sampling strategy.Methods: Semi-structured interviews were conducted with five patients and with six of their relatives.Results: Three patterns of experiences were identified: contradicting experiences; consistent experiences of nonpreferred participation; similar, but separate experiences of user participation.Conclusions: User participation in the planning of everyday life following discharge appeared to be random and limited for both patients and their relatives, and conflicting for the families as a whole. The decision-making processes seemed to be limited to the hospital context and did not include the broader context of everyday life following discharge.Relevance to clinical practice: The results underscore the importance of taking a family perspective when caring for older people. Family meetings might be a useful tool to ensure systematic assessment and integration of the perspectives of both older people and their family in the planning of follow-up care.case study research, decision-making, family, hospital, older people, patient participation,This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. • User participation is a family matter when decisions made in hospital affect the family;• Older people and their relatives generally experience limited user participation;• Experiences of user participation among older people and their relatives may be conflicting;• Institutionalising participation of older patients and their relatives is necessary to improve this aspect of care.of patients' participation in hospital admission and discharge processes, it was found that next of kin were information providers and advocates for the patient during admission, and provided moral and practical support throughout stay (Dyrstad, Laugaland, & Storm, 2015). Studies that examined family participation in discharge processes also found that relatives were given wide-ranging roles, they struggled to gain influence, and they often acted as intermedi...

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Factors predicting a successful post-discharge outcome for individuals aged 80 years and over

Cited by 30 publications

References 37 publications

The Transition from Hospital to Home: Older People’s Experiences

The Transition from Hospital to Home: Older People’s Experiences

Informal caregivers' participation when older adults in Norway are discharged from the hospital

User participation is a family matter: A multiple case study of the experiences of older, hospitalised people and their relatives

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