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Outcomes as experienced by older patients after hospitalisation: satisfaction, acceptance, frustration and hope—a grounded theory study
Age and Ageing ( IF 6.0 ) Pub Date : 2022-07-24 , DOI: 10.1093/ageing/afac166
Maria Johanna van der Kluit 1 , Geke J Dijkstra 2, 3
Affiliation  

Background outcomes of hospitalisation are often described in quantitative terms. It is unknown how older frail patients describe their own outcomes. Objective to discover how older frail persons describe their own hospitalisation outcomes and the meaning of these outcomes for their daily lives. Design Constructivist Grounded Theory approach. Participants frail older people discharged from hospital. Methods Open interviews in the participant’s home. Transcripts were coded inductively according to the Constructivist Grounded Theory approach. Results Twenty-four interviews were conducted involving 20 unique participants. Although for some participants hospitalisation was just a ripple, for others, it was a turning point. It could have positive or negative impacts on outcomes, including remaining alive, disease, fatigue/condition, complaints, daily functioning, social activities and intimate relationships, hobbies, living situation and mental well-being. Few participants were completely satisfied, but for many, a discrepancy between expectation and reality existed. Some participants could accept this, others remained hopeful and some were frustrated. Factors associated with these categories were research and treatment options, (un)clarity about the situation, setting the bar too high or pushing boundaries, confidence in physicians, character traits and social factors. Conclusions of the persons whose outcomes did not meet their expectations, some were frustrated, others hopeful and others accepted the situation. The following interventions can help patients to accept: clear communication about options and expectations before, during and after hospitalisation; giving room for emotions; help finding social support, encouragement to engage in pleasant activities and find meaning in small things. For some patients, psychological treatment may be needed.

中文翻译:

老年患者住院后的结果:满意、接受、挫折和希望——一项扎根的理论研究

住院的背景结果通常以定量的方式描述。目前尚不清楚年长体弱的患者如何描述自己的结果。目的是了解年长体弱的人如何描述他们自己的住院结果以及这些结果对他们日常生活的意义。设计建构主义扎根理论方法。参与者身体虚弱的老年人出院。方法 在参与者家中公开访谈。成绩单是根据建构主义扎根理论方法进行归纳编码的。结果 进行了 24 次访谈,涉及 20 名独特的参与者。虽然对一些参与者来说,住院只是一个涟漪,但对另一些人来说,这是一个转折点。它可能对结果产生积极或消极的影响,包括活着、疾病、疲劳/状况、抱怨、日常功能、社交活动和亲密关系、爱好、生活状况和心理健康。很少有参与者完全满意,但对许多人来说,期望与现实之间存在差异。一些参与者可以接受这一点,其他人仍然充满希望,而另一些人则感到沮丧。与这些类别相关的因素是研究和治疗选择、(不)对情况的明确性、设置过高或突破界限、对医生的信心、性格特征和社会因素。结果未达到预期的人的结论,有些人感到沮丧,有些人充满希望,而其他人则接受了这种情况。以下干预措施可以帮助患者接受: 住院前、住院期间和住院后关于选择和期望的清晰沟通;给情绪腾出空间;帮助寻找社会支持、鼓励从事愉快的活动并在小事中寻找意义。对于一些患者,可能需要心理治疗。
更新日期:2022-07-24
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