Transition of care from hospital to home for older people with chronic diseases: a qualitative study of older patients' and health care providers' perspectives

Abstract

BackgroundTransitional care is a critical area of care delivery for older adults with chronic illnesses and complex health conditions. Older adults have high, ongoing care needs during the transition from hospital to home due to certain physical, psychological, social, and caregiving burdens, and in practice, patients' needs are not being met or are receiving transitional care services that are unequal and inconsistent with their actual needs, hindering their safe, healthy transition. The purpose of this study was to explore the perceptions of older adults and health care providers, including older adults, about the transition of care from hospital to home for older patients in one region of China.ObjectiveTo explore barriers and facilitators in the transition of care from hospital to home for older adults in China from the perspectives of older patients with chronic diseases and healthcare professionals.MethodsThis was a qualitative study based on a semi-structured approach. Participants were recruited from November 2021 to October 2022 from a tertiary and community hospital. Data were analyzed using thematic analysis.ResultsA total of 20 interviews were conducted with 10 patients and 9 medical caregivers, including two interviews with one patient. The older adult/adults patients included 4 men and 6 women with an age range of 63 to 89 years and a mean age of 74.3 ± 10.1 years. The medical caregivers included two general practitioners and seven nurses age range was 26 to 40 years with a mean age of 32.8 ± 4.6 years. Five themes were identified: (1) attitude and attributes; (2) better interpersonal relationships and communication between HCPs and patients; (3) improved Coordination of Healthcare Services Is Needed; (4) availability of resources and accessibility of services; and (5) policy and environment fit. These themes often serve as both barriers and facilitators to older adults' access to transitional care.ConclusionsGiven the fragmentation of the health care system and the complexity of care needs, patient and family-centered care should be implemented. Establish interconnected electronic information support systems; develop navigator roles; and develop competent organizational leaders and appropriate reforms to better support patient transitions.

Examining the Role of Third Sector Organization Volunteers in Facilitating Hospital-to-Home Transitions for Older Adults – a Collective Case Study

“…Therefore, these results provide an opportunity to discuss the role of TSOs in transitional care, bridging the gap between hospital and home and/ or community and the benefits to older adults, their families, and the health care systems. Intersecting health and social issues often complicate the transition process and adversely affect physical recovery, mood, social participation, quality of life and ultimately, the self-management and self-care capacity of patients and caregivers [29,[48][49][50]. Clients benefited from various instrumental activity supports, such as transportation, grocery shopping, and light housekeeping.…”

‘Hearing silences’: Exploring culturally safe transitional care: A qualitative study among Turkish‐speaking migrant frail older adults

“…To the best of our knowledge, this was the first study in which The (Statista, 2023). In addition, our study recruited participants who had been discharged from the hospital within the past year, which may result in the possibility of recall bias.…”

The Needs of Patients With Chronic Disease in Transitional Care From Hospital to Home in Sudan: A Qualitative Study

“… 19 , 20 Studies show that multiple factors, including social and ecological conditions and societal upheavals, contributed to the sustainability of interventions in sub-Saharan Africa. 21 Although there has been an increase in qualitative research examining the challenges faced by patients with chronic diseases and shortcomings in transitional care, 17 , 22 - 24 there is still a significant knowledge gap when it comes to understanding the post-discharge experiences of patients in low-income countries. Effective transitional care strategies must take into account differences in healthcare resources and cultural factors while balancing local policy development and standardization.…”