Returning to everyday life after discharge from a short-stay unit at the Emergency Department—a qualitative study of elderly patients’ experiences

Nielsen, Louise; Østergaard, Lisa Gregersen; Maribo, Thomas; Kirkegaard, Hans; Petersen, Kristian Kjær

doi:10.1080/17482631.2018.1563428

Cited by 21 publications

(34 citation statements)

References 35 publications

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“…Moreover, elderly patients commonly experienced issues of decreased ability to perform daily activities and difficulty with self-care, which leads to reluctance to discharge, even if the criteria are met. 19,20 Although there was relatively sufficient preoperative education in our study, some elderly patients still had deviations in understanding of the ERAS items and difficulties in early recovery. Therefore, it is necessary to communicate effectively with care-givers and provide elderly patients with various forms of education including handouts preoperatively.…”

Section: Discussionmentioning

confidence: 87%

Impact of Compliance with an Enhanced Recovery After Surgery Program on the Outcomes Among Elderly Patients Undergoing Lumbar Fusion Surgery

Li¹,

Lu²,

Kong³

et al. 2020

CIA

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Background and Aim The benefits of the enhanced recovery after surgery (ERAS) program to elderly patients have not been evaluated in lumbar fusion surgery. Compliance with the ERAS program is associated with prognosis. There is currently no adequate assessment about the importance of the individual components of ERAS program in lumbar fusion surgery. The aim of the study was to analyze the effect of compliance with our ERAS program and the relative importance of the individual ERAS program components among elderly patients undergoing lumbar fusion surgery. Methods A retrospective case-review study was conducted from March 2018 to March 2020. The ERAS program for lumbar fusion surgery at our department was implemented. Overall compliance was found to be 92.9%, and this was used as a cutoff for dividing patients into higher compliance and lower compliance groups. Patient characteristics and clinical outcomes were compared between groups. Results The overall compliance rate was 92.9%, distributing 91 patients into the higher compliance group and 169 patients into the lower compliance group. Patients with higher compliance were younger (p=0.045). The length of stay (LOS) of patients with higher compliance was significantly shorter than that of patients with lower compliance. Patients with higher compliance had significantly fewer complications (p=0.031). A multivariate analysis showed that surgical time (p=0.029), lower compliance (p=0.034), and early oral feeding (p=0.026) were predictors of any postoperative complications. On multivariate analysis, the following items remained correlated with prolonged LOS (LOS≥12 days): older age (p=0.010), lower compliance (p<0.0001), early ambulation (p=0.018), and stick to discharge criteria (p=0.040). Conclusion Low compliance with ERAS program among elderly patients undergoing lumbar fusion surgery was associated with a higher incidence of complications and prolonged LOS. The failure of early oral feeding was associated with increased complications, and the failure of early ambulation or sticking to discharge criteria was significantly more influential on prolonged LOS.

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Section: Discussionmentioning

confidence: 87%

Impact of Compliance with an Enhanced Recovery After Surgery Program on the Outcomes Among Elderly Patients Undergoing Lumbar Fusion Surgery

Li¹,

Lu²,

Kong³

et al. 2020

CIA

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“…33 However, it must be taken into account that older people's complex health condition entails a higher risk of complications after discharge compared to their younger counterparts. 34 Another possible reason for the variation in our study is that there may be a greater difference in physical and psychological functioning among older patients that increases the risk of surgical complications. Several studies have confirmed that frail older people treated for CRC are especially vulnerable.…”

Section: Discussionmentioning

confidence: 91%

Experiences of recovery from colorectal cancer surgery after hospital discharge among the oldest old: A qualitative study

Eriksen

Husebø

Kørner

et al. 2021

Nordic Journal of Nursing Research

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Colorectal cancer affects a large number of people aged ≥80 years. Little is known about how they manage after discharge from hospital. The aim of this study was to explore the experiences of individuals aged ≥80 years recovering from surgery for colorectal cancer, and the challenges they may encounter after discharge from hospital. Data were collected between January and March 2016 through in-depth interviews with ten participants approximately one month after surgery. Inductive thematic analysis was employed to analyse the data. The COREQ checklist was used in reporting this study. Two themes were identified: Managing the recovery from CRC surgery, and Insufficient follow-up from the healthcare services after CRC surgery. The findings indicate that older people treated for colorectal cancer manage surprisingly well after discharge despite challenges in their recovery; however, there are seemingly areas of improvement in their follow-up healthcare.

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“…They all agreed to be discharged, but found it very di cult to manage the transition to home life. They found their ED visit stressful [33] and did not receive the information they needed at discharge [34]. Especially in older patients with limited health literacy, incomplete information at discharge may not meet the patient's needs [35].…”

Section: Discussionmentioning

confidence: 99%

Older Patients’ Perspectives on Factors Contributing to Frequent Visits to the Emergency Department: A Qualitative Interview Study

Kolk

Kruiswijk²,

Vroomen

et al. 2020

Preprint

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Background: Older patients are at high risk of unplanned revisits to the emergency department (ED) because of their medical complexity. To reduce the number of ED visits, we need more knowledge about the patient-level, environmental, and healthcare factors involved. The aim of this study was to collect older patients’ perspectives and experiences before and after an ED visit, and to identify factors that possibly contribute to frequent ED revisits.Methods: We performed semi-structured interviews with older patients who frequently visited the ED and were discharged home after an acute visit. Patients were enrolled in the ED of a university medical centre using purposive sampling to achieve maximum variation in heterogeneity. Interviews were recorded, transcribed, and coded independently by two researchers. Theoretical analysis was used to identify recurring patterns and themes in the data. Interviews were conducted until thematic saturation was reached.Results: In-depth interviews were completed with 13 older patients. Three main themes emerged: 1) medical events leading to feelings of crisis, 2) patients’ untreated health problems, and 3) persistent problems in health and daily functioning post discharge. Participants identified problems before and after their ED visit that possibly contributed to further ED visits. These problems included increasing symptoms leading to feelings of crisis, the relationship with the general practitioner, incomplete discharge information at the ED, and inadequate follow-up and lack of recovery after an ED visit.Conclusions: This qualitative study identified multiple factors that may contribute to frequent ED visits among older patients. Older patients in need of acute care might benefit from hospital-at-home interventions, or acute care provided by geriatric emergency teams in the primary care setting. Identifying frailty in the ED is needed to improve discharge communication and adequate follow-up is needed to improve recovery after an acute ED visit.

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Returning to everyday life after discharge from a short-stay unit at the Emergency Department—a qualitative study of elderly patients’ experiences

Cited by 21 publications

References 35 publications

Impact of Compliance with an Enhanced Recovery After Surgery Program on the Outcomes Among Elderly Patients Undergoing Lumbar Fusion Surgery

Impact of Compliance with an Enhanced Recovery After Surgery Program on the Outcomes Among Elderly Patients Undergoing Lumbar Fusion Surgery

Experiences of recovery from colorectal cancer surgery after hospital discharge among the oldest old: A qualitative study

Older Patients’ Perspectives on Factors Contributing to Frequent Visits to the Emergency Department: A Qualitative Interview Study

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