"Because I Was Sick": Seriously Ill Veterans' Perspectives on Reason for 30-Day Readmissions
"Because I Was Sick": Seriously Ill Veterans' Perspectives on Reason for 30-Day Readmissions
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DOI：
10.1111/jgs.13238
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发表时间：
2015-03-01
影响因子：
6.3
通讯作者：
Lorenz, Karl
中科院分区：
文献类型：
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作者：
Enguidanos, Susan;Kogan, Alexis M. Coulourides;Lorenz, Karl
目的：确定重病患者对30岁以下的原因的看法。一项前瞻性定性研究采用在床边进行的个人访谈进行。设置退伍军人事务部大洛杉矶医疗保健系统。病人招募接受住院姑息治疗并在出院后30天内再次入院的心力衰竭或癌症重病患者，参加九人进行了采访。MeasurementsA semi-structured采访协议被用来引出参与者的观点再入院causes.ResultsAll参与者均为男性，平均年龄为70.19.5。参与者种族多样（三名非洲裔美国人，三名高加索人，三名西班牙裔或混合种族背景）。六个人独自生活，四个人没有照顾者支持。成绩单的定性分析揭示了三个主题有关的原因再入院：缺乏照顾者的支持和动机，提供自我护理，接受条件和积极的护理的愿望，并获得护理和护理质量差care.ConclusionParticipants确定潜在的可避免的原因再入院以及原因，需要重新思考如何社区支持的目标和交付。参与者对积极护理的偏好，无法提供自我护理，以及缺乏护理人员的支持，表明需要新的和创新的机制来支持社区居住的重病患者。
ObjectivesTo determine the perspectives of seriously ill individuals on reasons for 30-day hospital readmission.DesignA prospective qualitative study was conducted employing individual interviews conducted at bedside.SettingDepartment of Veterans Affairs Greater Los Angeles Healthcare System.ParticipantsSeriously ill individuals with heart failure or cancer receiving inpatient palliative care and readmitted to the hospital within 30days of hospital discharge were recruited to participate. Nine were interviewed.MeasurementsA semistructured interview protocol was used to elicit participant perspectives on readmission causes.ResultsAll participants were male and had a mean age of 70.19.5. Participants were ethnically diverse (three African Americans, three Caucasians, three Hispanic or mixed ethnic background). Six lived alone, and four did not have caregiver support. Qualitative analysis of transcripts revealed three themes relating to reasons for hospital readmission: lack of caregiver support and motivation to provide self-care, acceptance of condition and desire for aggressive care, and access to care and poor quality of care.ConclusionParticipants identified potentially avoidable reasons for hospital readmission as well as causes that require rethinking regarding how community support is targeted and delivered. Participant preference for aggressive care, inability to provide self-care, and lack of caregiver support suggest the need for new and innovative mechanisms to support seriously ill community-dwelling individuals.