Discharge care transitions for patients with dementia: a qualitative study of Hispanic patients' and families' experiences in the ED.

项目摘要： 美国的老年人口正变得越来越多样化，更多的人寻求ED- 痴呆症的基础护理、检测和记录正在改善，非正式的家庭照顾者正在发挥作用 在医疗保健系统中发挥更大的作用，特别是在小规模人口中。由于这些原因 变化，因此，至关重要的是确定独特的挑战微型化的痴呆症患者和他们的 急诊科护理过渡期间的家庭体验。许多研究都证明了痴呆症的不同 在美国的种族和民族中流行，并发现黑人和西班牙裔/拉丁裔 与白人人口相比，人口患痴呆症的风险更高。因此，理解 患者及其家属的观点，以更好地了解因素和 关系影响代表不足的患者的急诊出院护理过渡体验 痴呆症。 本副刊试图通过探索EDI的方法来填补文献中的一个重大空白 西班牙裔痴呆症患者出院护理过渡经验。使用参与者调查和 定性访谈，补充将遵循以下目标：研究目标1：我们将探索 西班牙裔痴呆症患者和患者家属如何处理急诊出院护理决定 进程。具体地说，我们试图了解使患者目标一致的促进者和障碍 关爱决定。研究目标2：我们将探索痴呆症患者的知觉ED体验 以及他们的家人在病人出院后。具体来说，我们将检查出院情况 路径、感知的通信质量和对ED环境的感知。研究设计将是一项 定性探究性学习。符合条件的受试者将从急诊室招募，包括患者&>65 年龄，有记录的痴呆症诊断，并从急诊室出院。患者和二人组(患者和 他们确定的护理合作伙伴)将被同意并登记以完成In-ED调查问卷并参与 在随后的定性访谈中。结果将解决对紧急护理的理解上的差距 在急诊室看到的痴呆症患者的过渡、沟通和共同决策障碍 可能服务不足，并被认为是西班牙裔/拉丁裔(A)。该副刊将提供培训机会和 桑多瓦尔女士的经验性研究将使她成为强有力的博士申请者 项目和未来的调查员。

Project Abstract: The older adult population in the United States is becoming increasingly diverse, more are seeking ED- based care, detection and documentation of dementia is improving, and informal family caregivers are playing a greater role in navigating the healthcare system, particularly within minoritized populations. Due to these changes, it is therefore critical to identify the unique challenges minoritized patients with dementia and their families experience during ED care transitions. Numerous studies have documented differences in dementia prevalence among racial and ethnic groups in the US and have found that Black and Hispanic/Latinx populations have a higher risk of dementia compared to White populations. Thus, it is critical to understand the perspectives of patients and their family members to gain a better understanding of the factors and relationships influencing ED discharge care transition experiences for underrepresented patients with dementia. This supplement seeks to fill a significant gap in the literature by exploring approaches to ED discharge care transition experiences for Hispanic patients with dementia. Using participant surveys and qualitative interviews, the supplement will be guided by the following aims: Research Aim 1: We will explore how Hispanic patients with dementia, and patient family members approach the ED discharge care decision process. Specifically, we seek to understand the facilitators and barriers for making patient goal-concordant care decisions. Research Aim 2: We will explore the perceived ED experiences of persons living with dementia and their family members after the patients have been discharged. Specifically, we will examine discharge pathways, perceived communication quality, and perceptions of ED environments. The study design will be a qualitative exploratory study. Eligible subjects will be recruited from the ED setting and include patients >65 age, with a documented dementia diagnosis, and discharged from the ED. Patients and dyads (patients and their identified care partner) will be consented and enrolled to complete an in-ED questionnaire and participate in a subsequent qualitative interview. Results will address gaps in understanding about emergency care transitions and communication and shared decision-making barriers for dementia patients seen in the ED that may be underserved and identify as Hispanic/Latino(a). The supplement will provide training opportunities and experiential research for Ms. Sandoval that will equip and position her well as a strong applicant to doctoral programs and future investigator.