Significant others’ experience of hospitalized patients’ transfer to home: A systematic review and meta-synthesis

Abstract

Background: Significant others are individuals representing family members or neighbors, friends, colleagues or members of the same household, who act as relatives or surrogates. Significant others play an important role when patients are transferred or discharged after hospitalization. Objective: The objective of this review is to identify, appraise and synthesize the best available evidence exploring significant others' experiences of the discharge or transfer of adult patients after hospitalization. Methods: A qualitative comprehensive systematic review and meta aggregation.Types of participants: Participants of this review are the 'significant other(s)'; persons who are important or influential to the patient's life. Phenomena of interest: How the significant others' experience hospitalized patients' transitions and the psychosocial and existential issues during transfer from hospital to home. Context: Studies that investigate the organizational culture during hospitalization. Types of studies: Studies that focus on qualitative data including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research and feminist research. Search Strategy: The search aimed at finding published and unpublished studies in English, German, Danish, Swedish and Norwegian, and was unrestricted by time. Eleven electronic databases and eleven websites were searched. Critical appraisal: Methodological validity of the qualitative papers was assessed independently by two reviewers using the standardized critical appraisal instruments from the Joanna Briggs Institute Qualitative Assessment and Review Instrument. Data Extraction: Data were extracted from papers included in the review using the standardized data extraction tool from the Joanna Briggs Institute Qualitative Assessment and Review Instrument. Data Synthesis: Qualitative research findings were synthesized. Results: A total of 189 findings from twelve studies were aggregated into three categories. An aggregated finding was generated based on the primary studies: SOs existential strength is linked to preparations for the discharge including care planning meeting(s) and learning-by-doing care activities led by health care providers during hospitalizations. Conclusions:The studies in this review provided useful and credible statements from caregivers' voices that are not previously aggregated nor presented. The findings enlighten both positive and burdensome experiences in the everyday life of caring for a significant other after discharge.

Balancing one's mood: experiences of physical activity in adults with severe obesity 18 months after lifestyle intervention

“…The gendered findings of this study are thought useful and credible for future qualitative systematic reviews and meta-synthesis [24] regarding PA among individuals with severe obesity.…”

Caring responsibility from the perspectives of older persons whose adult children are their caregivers

“…Bower's theory was later extended by Nolan et al (1995) with three categories; preservative caregiving, re-constructive caregiving and reciprocal caregiving. These categorisations are more or less recognisable in other research that focuses on informal caregivers as a homogeneous group within, for example, a hospital setting (Lindhardt et al, 2006;Uhrenfeldt et al, 2018), within home care (Andersen, Hoeck, Nielsen, Ryg, & Delmar, 2020;Jarling, Rydstrom, Ernsth-Bravell, Nystrom, & Dalheim-Englund, 2019;Lewinter, 2003;Søvde et al, 2019) or nursing homes (Ekström et al, 2019).…”

Being well? A meta-ethnography of older patients and their relatives' descriptions of suffering and well-being in the transition from hospital to home

“…However, effective continuity of care is essential to ensure well-being as well as to avoid unnecessary early readmissions after hospital discharge [3,4]. Further, the demand for support, mainly through family members, may increase even more in the transition from hospital to home due to the decrease of the average length of hospital stay over the last years [5]. This is especially the case for older patients (65 years and older), who often suffer from chronic conditions and need medical and social support [6].…”

“…This emphasizes that a supportive network highly in uences the well-being of older patients after discharge. However, research has also documented that the relatives' daily lives are often highly affected by a transition from hospital to home care [5]. These changes in the daily routine may include giving up or decreasing their job in order to be able to support the older patients [5], di culties with taking over care responsibilities due to their own health status [6], and feelings of being alone with the organization of and transportation to follow-up services [11].…”

“…However, research has also documented that the relatives' daily lives are often highly affected by a transition from hospital to home care [5]. These changes in the daily routine may include giving up or decreasing their job in order to be able to support the older patients [5], di culties with taking over care responsibilities due to their own health status [6], and feelings of being alone with the organization of and transportation to follow-up services [11]. Similarly therefore to the issues shared by the older people, research on relatives' experiences with the transition process also shows that an unexpected and poorly communicated discharge may contributes to their suffering, whereas being prepared for as well as being involved in the discharge process may contributes to their well-being.…”