Autism spectrum disorder(ASD)poses significant challenges for families,with limited access to specialized care being a critical concern.The coronavirus disease 2019 pandemic has accelerated the adoption of remote supp...Autism spectrum disorder(ASD)poses significant challenges for families,with limited access to specialized care being a critical concern.The coronavirus disease 2019 pandemic has accelerated the adoption of remote support,highlighting its potential to enhance family-centered care for children with ASD.In this editorial,we comment on the article by Lu et al,emphasizing the effectiveness of integrating remote support courses with traditional caregiver-mediated interventions.We further explore the benefits of remote support in delivering family-centered care,summarize the essential components of effective family-centered remote support,outline key considerations for implementation,and discuss potential future research directions.We conclude that family-centered remote support has the potential to significantly improve outcomes and quality of life for individuals with ASD and their families.展开更多
Objective:This article employs a scoping review methodology,integrates knowledge and information about current pediatric nurses'practices and perceptions regarding family-centered care in pediatric settings.Method...Objective:This article employs a scoping review methodology,integrates knowledge and information about current pediatric nurses'practices and perceptions regarding family-centered care in pediatric settings.Methods:Published articles were retrieved from databases including EBSCO host,PubMed,Springer,Science Direct,Ovid,and CINAHL between 2013 and 2023.Results:The finding shows a better understanding of pediatric nurses'perceptions of family-centered care in association with their clinical settings.However,the evidence indicates that integrating family-centered care components into health care services is difficult and confusing to nurses and is often not implemented in a clinical setting.As evidenced by this review,studies have consistently reported similar results;family-centered care was a good perception and understood by pediatric nurses as a concept but inconsistently used in a daily practice setting.Conclusions:This scoping review is the first phase in promoting a strategic plan to provide educational interventions for pediatric nurses to implement family-centered care in their daily practice settings.It's necessary to recognize pediatric nurses'perceptions and practices concerning family-centered care to provide optimal healthcare services in pediatric settings.展开更多
Objective:To explore the application effect of continuous nursing in elderly patients with chronic diseases.Methods:A total of 100 elderly patients with chronic diseases were selected and randomly divided into experim...Objective:To explore the application effect of continuous nursing in elderly patients with chronic diseases.Methods:A total of 100 elderly patients with chronic diseases were selected and randomly divided into experimental group and control group,50 cases in each group.Patients in the experimental group received continuous nursing,while patients in the control group received routine nursing.Comparison of two groups of patients’quality of life,health and nursing satisfaction.Results:the patient’s quality of life,health and nursing satisfaction were significantly higher than control group(p<0.05).Conclusion:Continuous nursing has a significant application effect in elderly patients with chronic diseases,which is worthy of further promotion and application.展开更多
Background:The Transitional Care Model(TCM)for nursing care has yet to be implemented in China despite its success in Western countries.However,rapid social changes have demanded an upgrade in the quality of nursing c...Background:The Transitional Care Model(TCM)for nursing care has yet to be implemented in China despite its success in Western countries.However,rapid social changes have demanded an upgrade in the quality of nursing care;in 2010,the Chinese government has acknowledged the need to implement the TCM in China.Objective:This study has the following objectives:(1)perform a thorough review of the literature regarding the development and implementation of the TCM in China's Mainland within the past 5 years;(2)provide a comprehensive discussion of the current status,problems,and strategies related to the implementation of the TCM in China's Mainland;and(3)suggest strategies pertaining to the future of the TCM in China.Design:The current pertinent literature is systematically reviewed.Data sources:Systematic and manual searches in computerized databases for relevant studies regarding the TCM led to the inclusion of 26 papers in this review.Review methods:Abstracts that satisfied the inclusion criteria were reviewed independently by the two authors of this manuscript,and discrepancies were resolved through discussion.The same reviewers independently assessed the paper in its entirety for selected abstracts.Results:The present English literature reviewrevealed a paucity of updated information about the development and implementation of the TCM in China's Mainland.Nevertheless,the dramatic growth of the TCM in the past 5 years has had a vital impact within the society and in nursing development.This review also revealed numerous issues regarding the focus of the TCM.Overall implications for practiceandrecommendations for future researchare discussed.Conclusion:Despite the potential of this nursing model to have a successful and beneficial impact in China's Mainland,it remains an under-researched topic.Further research on education and training as well as premium policies for nurses under the TCM are needed.展开更多
Objectives:This study was conducted to examine the differences between perceptions and practices of family-centered care among Thai pediatric nurses.Methods:This mixed-methods study consisted of two phases,in the firs...Objectives:This study was conducted to examine the differences between perceptions and practices of family-centered care among Thai pediatric nurses.Methods:This mixed-methods study consisted of two phases,in the first phase,a descriptive comparative design using the Family-Centered Care Questionnaire-Revised(FCCQ-R)was administered to 142 pediatric nurses from a university hospital in Bangkok,Thailand.in the second phase,qualitative interviews were conducted with 16 pediatric nurses to gather complementary information regarding the major findings from the first phase.Results:The results revealed that family strengths and individuality were rated the highest as the most important elements and the most frequent practices.Parent/professional collaboration was perceived as the least important element,while the design of the heath care delivery system was rated as the least frequent practice.The qualitative data revealed that the major reasons for suboptimal implementation included a common perception that family-centered care is a Western concept,nurses'weak attitudes towards their roles,and a shortage of nurses.Conclusions:Nurses agreed that the identified elements of family-centered care were necessary but that they did not incorporate the concepts into their daily nursing practice to maintain their endorsement of the family-centered care model.Further study is needed to explore how family-centered care is understood and operationalized by Thai nurses and how hospital administration and environments can be modified to support this care model.展开更多
Background： The world is facing increasing pressure with the continuous growth of the older population. Older patients are usually discharged with complex medical problems, high stress and vulnerability, and these fa...Background： The world is facing increasing pressure with the continuous growth of the older population. Older patients are usually discharged with complex medical problems, high stress and vulnerability, and these factors place the elderly at risk for poor outcomes. Purpose： The present review summarizes a method for providing appropriate and affordable health services by nursing professionals to meet older patient＇s health care needs during their transitional period which is defined as a period from discharge after hospitalization for a major disorder to recovery in a home setting. Summary： Older patients with chronic diseases need seamless health care during a transitional period-a highly stressful and vulnerable period for them. Nurse professionals can conduct decent discharge planning to assist older patients with transitional problems through continuous healthcare. This review summarized the need of continuing care for older patients during the transitional period, the definition of discharge planning, the conceptual framework of discharge planning, and the professionals involved in discharge planning. It also highlighted the problems of discharge planning and follow-up intervention implementation in the mainland of China. Clinical implications： Inadequate discharge planning and follow-up were leading factors associ- ated with the readmission of discharged older patients. Further nursing-led discharge planning should be reinforced in China.展开更多
Objectives:To observe the effects of transitional care on the quality of life of chronic obstructive pulmonary disease(COPD)patients.Methods:A total of 114 COPD patients were recruited from the First Affiliated Hospit...Objectives:To observe the effects of transitional care on the quality of life of chronic obstructive pulmonary disease(COPD)patients.Methods:A total of 114 COPD patients were recruited from the First Affiliated Hospital,Sun Yat-sen University,Guangzhou,China and divided equally into an intervention group and control group.Following discharge,patients from the intervention group recieved threemonths intervention in addition to regular nursing care,while control group patients received regular nursing care only.Patients’quality of life was measured using the St.George’s respiratory questionnaire(SGRQ),the 12-item General Health Questionnaire(GHQ-12)and body mass index(BMI).Results:The symptoms section score,the activity section score,the impacts section score,the total score and the rate of mental disorders were significantly changed after the intervention while there was no statistical difference in BMI between groups.Conclusions:Transitional care can improve health-related quality of life in COPD patients who have recently suffered an exacerbation.展开更多
Objective: To explore the effects of “hospital–community integrated transitional care” model on quality of life in patients with chronic obstructive pulmonary disease (COPD). Methods: A total of 117 inpatients with...Objective: To explore the effects of “hospital–community integrated transitional care” model on quality of life in patients with chronic obstructive pulmonary disease (COPD). Methods: A total of 117 inpatients with COPD from the Department of Respiratory Medicine in a tertiary general hospital in Nanjing were enrolled by convenience sampling from January to December in 2016 and then were divided into intervention group (n = 60) and control group (n = 57) by random number table. Patients in the intervention group accepted both routine care and hospital– community integrated transitional care for 3 months after discharge. Assessment of quality of life by telephone follow-up or interview within a week before discharge and 1, 3, and 6 months after discharge was evaluated using the Short Form-36 (SF-36) health survey questionnaire. Results: For a total score of quality of life, there was a significant difference between the two groups (P < 0.05): 1, 3, and 6 months after discharge. In addition, for each dimension score of quality of life, there were no significant differences (P > 0.05) except vitality dimension, 1 month after discharge, and there were significant differences in all dimensions, 3 and 6 months after discharge (P < 0.05) Conclusions: Hospital–community integrated transitional care model can improve the quality of life of patients with COPD.展开更多
Objective：To objectively assess the effect of transitional care on readmission for patients with chronic obstructive pulmonary disease.Methods：The PubMed,Science Direct,Web of Science,Cochrane Library,CNKI,and Wanfa...Objective：To objectively assess the effect of transitional care on readmission for patients with chronic obstructive pulmonary disease.Methods：The PubMed,Science Direct,Web of Science,Cochrane Library,CNKI,and Wanfang databases were searched for relevant randomized controlled trials（RCTs） published from January 1990 through April 2016.The quality of eligible studies was assessed by two investigators.The primary outcome assessed was readmission for COPD and all-cause readmission.The pooled effect sizes were expressed as the relative risk and standard mean difference with 95%confidence intervals.Heterogeneity among studies was assessed using the Cochrane Handbook for Systematic Reviews of Interventions（Version5.1.0） and determined with an I^2 statistic.Results：A total of seven RCTs that included 1879 participants who met the inclusion criteria were analyzed.The results of subgroup analysis showed significant differences in readmission for COPD at the6 month and 18 month time points and all-cause readmission at the 18 month follow-up.Transitional care could reduce readmission for COPD at the 6 month[RR = 0.51,95%CI（0.38,0.68）,P 〈 0.00001]and18 month time points[RR = 0.56,95%CI（0.45,0.69）,P 〈 0.00001,and also reduce all-cause readmission after 18 months[RR = 0.72,95%CI（0.62,0.84）,P 〈 0.0001].The reduction of all-cause readmission between the intervention and control groups in the 2nd year,however,was less than that in the 1st year.Conclusions：Transitional care is beneficial to reducing readmission for patients with COPD.Duration of≥ 6 and ≤ 18 months are more effective,and the effect weakens over intervention time,especially after the end of intervention.Both durations point to the importance of ongoing intervention and reinforcement after the end of intervention.展开更多
Adolescence and the journey to adulthood involves exciting opportunities as well as psychosocial stress for young people growing up.These normal experiences are potentially magnified for teenagers living with chronic ...Adolescence and the journey to adulthood involves exciting opportunities as well as psychosocial stress for young people growing up.These normal experiences are potentially magnified for teenagers living with chronic illness or disability and their families.Advances in care have improved survival for children with a variety of serious chronic medical conditions such that many who may once have died in childhood now survive well into adulthood with ongoing morbidity.For those with highly complex needs,care is often provided at major paediatric hospitals with expertise,specially trained personnel,and resources to support young people and their families for the first decades of life.At the end of adolescence,however,it is generally appropriate and necessary for young adults and their caregivers to transition to the care of clinicians trained in the care of adults at general hospitals.While there are some well-managed models to support this journey of transition,these are often specific to certain conditions and usually do not involve intensive care.Many patients may encounter considerable challenges during this period.Difficulties may include the loss of established therapeutic relationships,a perception of austerity and reduced amenity in facilities oriented to caring for adult patients,and care by clinicians with less experience with more common paediatric conditions.In addition,there is a risk of potential conflict between clinicians and families regarding goals of care in the event of a critical illness when it occurs in a young adult with major disability and long-term health issues.These challenges present genuine opportunities to better understand the transition from paediatric to adult-based care and to improve processes that assist clinicians who support patients and families as they shift between healthcare settings.展开更多
Objective： We sought to determine any benefits of applying a transitional care model in the continuum of cancer pain management, especially after patients＇ discharge from the hospital. Methods： A total of 156 eligi...Objective： We sought to determine any benefits of applying a transitional care model in the continuum of cancer pain management, especially after patients＇ discharge from the hospital. Methods： A total of 156 eligible participants were recruited and randomly assigned into intervention or control groups. The control group received standard care, while the intervention group received extra, specialized transitional care of pain management. Outcomes were measured at weeks 0 and 2-4 and included demographic data, the Brief Pain Inventory, Global Quality of Life Scale, and Satisfaction Degree of Nursing Service. Adequacy of analgesia and severity of pain were assessed with the Pain Management Index and interview findings. Results： After 2-4 weeks of intervention, there was a significant difference in the change in average pain score between intervention and control groups （P 〈 0.05）. Reductions in pain scores were significantly greater in the intervention group than in the control group （difference： 0.98, P 〈 0.05）. Regarding pain management outcomes, there was a significantly better condition in the intervention group compared with the control group; in the intervention group, 79% of patients had adequate opioids, whereas in the control group, only 63% of patients reported having adequate opioids. Furthermore, there was a signif- icant difference between the two groups in quality of life （QOL） scores （P 〈 0.05）; the intervention group had significantly higher quality of life than the control group （difference： 1.06）. Finally, there was a significant difference in the degree of satisfaction with the home nursing service; the intervention group had a significantly higher degree of satisfaction with the home nursing service in three aspects： quality, content, and attitude of service. Conclusions： The application of a transitional care model in cancer pain management after discharge could help patients to improve their cancer pain management knowledge and analgesics compliance. In addition, the continuum of care service will contribute to effective communication between health care providers and patients, which could further improve their relationship.展开更多
BACKGROUND Intervention to improve outcomes in cirrhotic patients (CP) after hospital discharge often focus on 30 d readmission rate (RR). However, recent studies suggest dissociation between RR and survival. At our c...BACKGROUND Intervention to improve outcomes in cirrhotic patients (CP) after hospital discharge often focus on 30 d readmission rate (RR). However, recent studies suggest dissociation between RR and survival. At our center, CP are now offered outpatient telephonic transitional care (OTTC) by a care coordinator for 30 d after hospital discharge. AIM To determine the effect of OTTC on survival in CP. METHODS In this cohort study from a tertiary center, CP who received OTTC formed the intervention group. They were compared with a control group discharged during the same period. Mortality and RR were compared between the groups. RESULTS After OTTC introduction, 194 CP were discharged. After applying exclusion criteria, 169 CP (51% male, mean age 58 years ± 12 years) were included. OTTC group comprised 76 patients and was compared with 93 controls. Baseline disease and index admission related characteristics were not significantly different between the groups. The intervention group showed significantly higher 6 mo survival compared to controls (84.2% vs 68.8%;P = 0.03), while RR at 1, 3, and 6 mo were comparable. On multivariable analysis, the intervention group showed lower odds for mortality compared to the controls (hazard ratio: 0.4;95% confidence interval: 0.2-0.82;P = 0.012), while higher model for endstage liver disease scores were associated with higher mortality (hazard ratio: 1.05;95% confidence interval: 1.01-1.1;P = 0.024).CONCLUSION CP provided OTTC had higher 6 mo survival compared to controls without a difference in RR. Use of RR to gauge quality of care provided during hospitalization or subsequent transitional care programs should be revisited.展开更多
BACKGROUND Transition is a critical period for adolescents as they begin to assume responsibility for their own health.Similarly,the shift from pediatric to adult healthcare represents a vulnerable phase,marked by uni...BACKGROUND Transition is a critical period for adolescents as they begin to assume responsibility for their own health.Similarly,the shift from pediatric to adult healthcare represents a vulnerable phase,marked by unique challenges in adolescent health care.Despite its importance,only a few studies have explored healthcare transition among adolescents in Uganda.AIM To identify factors associated with the transition to adult human immunodeficiency virus(HIV)-centered care among adolescents attending HIV/AIDS clinics in Uganda.METHODS A cross-sectional mixed-methods study was conducted among 265 adolescents,randomly selected from three antiretroviral therapy(ART)clinics,using a structured questionnaire.Focus group discussions and key informant interviews were conducted.Individuals aged 10-20 years who were actively enrolled in the ART program between January 4,2022 and January 30,2023 were recruited.The primary outcome of interest was the transition to adult care.Bivariate and multivariate analyses were performed for quantitative data,while content analysis was used to analyze qualitative data.RESULTS The prevalence of transition to adult care was 40.6%.Most participants were male(53.6%)and fell within the 13-15 age group(35.6%).Multivariate logistic regression analysis identified several factors significantly associated with transition to adult care:Age group 10-12 years[prevalence ratio(PR)=2.525,95%CI:2.121-2.944,P=0.002],Age group 13-15 years(PR=1.900,95%CI:1.196-3.416,P=0.001),successful viral load suppression(PR=1.534,95%CI:1.173-1.648,P=0.016),disclosure of HIV status to relatives(PR=5.001,95%CI:3.411-3.611,P=0.000),being prepared for transitioning(PR=5.417,95%CI:3.468-7.135,P=0.041)and having skilled pediatric caregivers(PR=3.724,95%CI:2.084-4.105,P=0.005).CONCLUSION Transition to adult care among adolescents was low.Improving transition outcomes may require strengthening individual support within the family context and integrating transition-focused care into existing specialized clinical settings to enhance the delivery of adolescent-friendly services.展开更多
Objective: To systematically review the effect of Transitional Care model (TCM) on the growth and development of premature infants. Methods: Randomized controlled trials (RCTs) or quasi-RTCs regarding the effect of TC...Objective: To systematically review the effect of Transitional Care model (TCM) on the growth and development of premature infants. Methods: Randomized controlled trials (RCTs) or quasi-RTCs regarding the effect of TCM in low birth weight premature infants were retrieved in electronic databases such as the Cochrane Library, PubMed, EMbase, Web of Science, CBM (Chinese Biomedicine Database), CNKI (China National Knowledge Infrastructure), VIP (Chinese Scientific Journals Database) and Wanfang Database. Then, we adopted RevMan 5.3 software to perform a meta-analysis. Results: A total of 11 articles were included, including 1282 preterm infants. The result showed that compared with the routine care model, TCM can effectively increase the weight when premature infants discharged one week [MD=225.57, 95%CI (171.78, 279.37), P<0.001], increase the weight after discharged one month [MD=0.89, 95%CI (0.72, 1.06), P<0.001], increase the weight after discharged three months [MD=670.44, 95%CI (527.65, 813.23), P<0.001], promote the height of newborns [MD=4.54, 95%CI (2.42, 6.65), P<0.001], reduce readmission rate [RR=0.38, 95%CI (0.25, 0.58), P<0.001], alleviate adverse skin reactions [RR=0.33, 95%CI (0.22, 0.50), P<0.001], increase nursing satisfaction of the families [RR=1.21, 95%CI (1.13, 1.31), P<0.001]. Conclusion: TCM can effectively promote the growth and development of the low birth weight premature infants, reduce the hospital readmission rate, alleviate adverse skin reactions of premature infants and improve the nursing satisfaction of the families. However, due to the limitation of the region and quality of the included studies, which the accuracy of the result still be treated with more caution. Further high-quality studies are needed to verify the conclusion.展开更多
The purpose of this paper is utilizing quasi-experimental study to evaluate the educational value of a documentary film for transitional care about children dental health management The method used in this study is a ...The purpose of this paper is utilizing quasi-experimental study to evaluate the educational value of a documentary film for transitional care about children dental health management The method used in this study is a pre-post survey among nurse viewers. The study was completed over a 12-month period. In the experimental group, when the nurses watched the documentary film, they evaluated the documentary film highly and reported an intention to change their transitional care practice and mind as a result of watching the documentary film. Following viewing, children and their parents felt more strongly that ＂children with dental problems should meet with a nurse early＂ and that ＂transitional care greatly impacts children oral health＂. As a result, a documentary film about oral transitional care is an effective educational tool to improve nurses＇ transitional care awareness among children about the importance and needs of children. The results suggest that if significant modifications are obtained, this approach can be an efficient way applicable to other contexts of patient care.展开更多
Cardiovascular disease remains the leading cause of morbidity and mortality,posing a significant challenge to healthcare systems worldwide.Transitional care interventions,which ensure coordination and continuity of ca...Cardiovascular disease remains the leading cause of morbidity and mortality,posing a significant challenge to healthcare systems worldwide.Transitional care interventions,which ensure coordination and continuity of care as patients move between different levels of healthcare,have been shown to reduce unnecessary healthcare utilization and improve patient outcomes.While much attention has been given to transitional care in heart failure,this review aims to map the interventions implemented for patients following an acute myocardial infarction(AMI).A scoping review was conducted following the Joanna Briggs Institute(JBI)methodology,with literature searches performed in the Cochrane,CINAHL,MEDLINE,JBI,and SciELO databases,focusing on publications from 2013 onwards in both Portuguese and English.Seventy-five studies were included,with most combining multiple interventions that contributed to improved cardiovascular health outcomes,including increased adherence to healthy lifestyle behaviors,enhanced medication compliance,and better healthcare self-management.These interventions were effective in reducing cardiovascular-related Emergency Department visits,unplanned 30-day readmissions,and mortality following a first-time myocardial infarction.Key strategies identified included discharge planning,digital health solutions,outpatient care,and healthcare coordination.The findings of this review underscore the need for developing methodologies that enhance the transition of care from hospital to primary care following an AMI.There is an urgent need to design and implement new healthcare programs that integrate discharge interventions,digital health,outpatient care,and healthcare coordination to ensure continuity of care and optimize patient outcomes post-discharge.展开更多
AIM: To describe the disease and psychosocial outcomes of an inflammatory bowel disease (IBD) transition cohort and their perspectives.METHODS: Patients with IBD, aged > 18 years, who had moved from paedia...AIM: To describe the disease and psychosocial outcomes of an inflammatory bowel disease (IBD) transition cohort and their perspectives.METHODS: Patients with IBD, aged > 18 years, who had moved from paediatric to adult care within 10 years were identified through IBD databases at three tertiary hospitals. Participants were surveyed regarding demographic and disease specific data and their perspectives on the transition process. Survey response data were compared to contemporaneously recorded information in paediatric service case notes. Data were compared to a similar age cohort who had never received paediatric IBD care and therefore who had not undergone a transition process.RESULTS: There were 81 returned surveys from 46 transition and 35 non-transition patients. No statistically significant differences were found in disease burden, disease outcomes or adult roles and responsibilities between cohorts. Despite a high prevalence of mood disturbance (35%), there was a very low usage (5%) of psychological services in both cohorts. In the transition cohort, knowledge of their transition plan was reported by only 25/46 patients and the majority (54%) felt they were not strongly prepared. A high rate (78%) of discussion about work/study plans was recorded prior to transition, but a near complete absence of discussion regarding sex (8%), and other adult issues was recorded. Both cohorts agreed that their preferred method of future transition practices (of the options offered) was a shared clinic appointment with all key stakeholders.CONCLUSION: Transition did not appear to adversely affect disease or psychosocial outcomes. Current transition care processes could be optimised, with better psychosocial preparation and agreed transition plans.展开更多
BACKGROUND Inflammatory bowel disease(IBD) is a chronic, inflammatory disorder characterised by both intestinal and extra-intestinal pathology. Patients may receive both emergency and elective care from several provid...BACKGROUND Inflammatory bowel disease(IBD) is a chronic, inflammatory disorder characterised by both intestinal and extra-intestinal pathology. Patients may receive both emergency and elective care from several providers, often in different hospital settings. Poorly managed transitions of care between providers can lead to inefficiencies in care and patient safety issues. To ensure that the sharing of patient information between providers is appropriate, timely, accurate and secure, effective data-sharing infrastructure needs to be developed. To optimise inter-hospital data-sharing for IBD patients, we need to better understand patterns of hospital encounters in this group.AIM To determine the type and location of hospital services accessed by IBD patients in England.METHODSThis was a retrospective observational study using Hospital Episode Statistics, a large administrative patient data set from the National Health Service in England.Adult patients with a diagnosis of IBD following admission to hospital were followed over a 2-year period to determine the proportion of care accessed at the same hospital providing their outpatient IBD care, defined as their ‘home provider'. Secondary outcome measures included the geographic distribution of patient-sharing, regional and age-related differences in accessing services, and type and frequency of outpatient encounters.RESULTS95055 patients accessed hospital services on 1760156 occasions over a 2-year follow-up period. The proportion of these encounters with their identified IBD‘home provider' was 73.3%, 87.8% and 83.1% for accident and emergency,inpatient and outpatient encounters respectively. Patients living in metropolitan centres and younger patients were less likely to attend their ‘home provider' for hospital services. The most commonly attended specialty services were gastroenterology, general surgery and ophthalmology.CONCLUSION Transitions of care between secondary care settings are common for patients with IBD. Effective systems of data-sharing and care integration are essential to providing safe and effective care for patients. Geographic and age-related patterns of care transitions identified in this study may be used to guide interventions aimed at improving continuity of care.展开更多
Inflammatory bowel disease(IBD)is a heterogeneous group of chronic diseases with a rising prevalence in the pediatric population,and up to 25%of IBD patients are diagnosed before 18 years of age.Adolescents with IBD t...Inflammatory bowel disease(IBD)is a heterogeneous group of chronic diseases with a rising prevalence in the pediatric population,and up to 25%of IBD patients are diagnosed before 18 years of age.Adolescents with IBD tend to have more severe and extensive disease and eventually require graduation from pediatric care toadult services.The transition of patients from pediatric to adult gastroenterologists requires careful preparation and coordination,with involvement of all key players to ensure proper collaboration of care and avoid interruption in care.This can be challenging and associated with gaps in delivery of care.The pediatric and adult health paradigms have inherent differences between health care models,as well as health care priorities in IBD.The readiness of the young adult also influences this transition of care,with often times other overlaps in life events,such as school,financial independence and moving away from home.These patients are therefore at higher risk for poorer clinical disease outcomes.The aim of this paper is to review concepts pertinent to transition of care of young adults with IBD to adult care,and provides resources appropriate for an IBD pediatric to adult transition of care model.展开更多
The aim of this study was to gain increased knowledge about nurses’ experiences of care transition of older patients from hospital to municipal health care, based on two research questions: How is nurses’ experience...The aim of this study was to gain increased knowledge about nurses’ experiences of care transition of older patients from hospital to municipal health care, based on two research questions: How is nurses’ experience continuity during care transition of older patients from hospital to municipal health care? How would nurses describe an optimal care transition? Nurses have a pivotal role during care transitions of older patients. More knowledge about their experiences is necessary to develop favorable improvements for this important period in the older patient’s treatment and care. The study has a qualitative explorative design with follow-up focus group interviews. Nurses (N = 30) working in hospital (n = 16) and municipal (n = 14) health care were organized in five mixed focus groups during the period October-January 2014/2015. The focus groups met twice, answering the research questions following a previously circulated semi-structured interview guide. The interview analysis was inspired by content analysis. The analysis resulted in the themes “Administrative demands challenge terms for collaboration” and “Essentials for nursing determine optimal care transitions for older patients”. Administrative demands may prevent nurses’ professional dialogue and collaboration across health care levels. Older patients’ best interests should be ensured through a collaborative relationship between hospital and municipal nurses, to form continuous care across health care levels. Clinical practice should be aware of essentials for nursing, which could influence and facilitate a more individualized and continuous transition for older patients.展开更多
基金Supported by Lanzhou Philosophy and Social Science Planning Project,No.24-B13the Youth Project of Philosophy and Social Science Foundation of Gansu Province,No.2024QN015the General Project of Philosophy and Social Science Foundation of Gansu Province,No.2024YB049.
文摘Autism spectrum disorder(ASD)poses significant challenges for families,with limited access to specialized care being a critical concern.The coronavirus disease 2019 pandemic has accelerated the adoption of remote support,highlighting its potential to enhance family-centered care for children with ASD.In this editorial,we comment on the article by Lu et al,emphasizing the effectiveness of integrating remote support courses with traditional caregiver-mediated interventions.We further explore the benefits of remote support in delivering family-centered care,summarize the essential components of effective family-centered remote support,outline key considerations for implementation,and discuss potential future research directions.We conclude that family-centered remote support has the potential to significantly improve outcomes and quality of life for individuals with ASD and their families.
文摘Objective:This article employs a scoping review methodology,integrates knowledge and information about current pediatric nurses'practices and perceptions regarding family-centered care in pediatric settings.Methods:Published articles were retrieved from databases including EBSCO host,PubMed,Springer,Science Direct,Ovid,and CINAHL between 2013 and 2023.Results:The finding shows a better understanding of pediatric nurses'perceptions of family-centered care in association with their clinical settings.However,the evidence indicates that integrating family-centered care components into health care services is difficult and confusing to nurses and is often not implemented in a clinical setting.As evidenced by this review,studies have consistently reported similar results;family-centered care was a good perception and understood by pediatric nurses as a concept but inconsistently used in a daily practice setting.Conclusions:This scoping review is the first phase in promoting a strategic plan to provide educational interventions for pediatric nurses to implement family-centered care in their daily practice settings.It's necessary to recognize pediatric nurses'perceptions and practices concerning family-centered care to provide optimal healthcare services in pediatric settings.
文摘Objective:To explore the application effect of continuous nursing in elderly patients with chronic diseases.Methods:A total of 100 elderly patients with chronic diseases were selected and randomly divided into experimental group and control group,50 cases in each group.Patients in the experimental group received continuous nursing,while patients in the control group received routine nursing.Comparison of two groups of patients’quality of life,health and nursing satisfaction.Results:the patient’s quality of life,health and nursing satisfaction were significantly higher than control group(p<0.05).Conclusion:Continuous nursing has a significant application effect in elderly patients with chronic diseases,which is worthy of further promotion and application.
文摘Background:The Transitional Care Model(TCM)for nursing care has yet to be implemented in China despite its success in Western countries.However,rapid social changes have demanded an upgrade in the quality of nursing care;in 2010,the Chinese government has acknowledged the need to implement the TCM in China.Objective:This study has the following objectives:(1)perform a thorough review of the literature regarding the development and implementation of the TCM in China's Mainland within the past 5 years;(2)provide a comprehensive discussion of the current status,problems,and strategies related to the implementation of the TCM in China's Mainland;and(3)suggest strategies pertaining to the future of the TCM in China.Design:The current pertinent literature is systematically reviewed.Data sources:Systematic and manual searches in computerized databases for relevant studies regarding the TCM led to the inclusion of 26 papers in this review.Review methods:Abstracts that satisfied the inclusion criteria were reviewed independently by the two authors of this manuscript,and discrepancies were resolved through discussion.The same reviewers independently assessed the paper in its entirety for selected abstracts.Results:The present English literature reviewrevealed a paucity of updated information about the development and implementation of the TCM in China's Mainland.Nevertheless,the dramatic growth of the TCM in the past 5 years has had a vital impact within the society and in nursing development.This review also revealed numerous issues regarding the focus of the TCM.Overall implications for practiceandrecommendations for future researchare discussed.Conclusion:Despite the potential of this nursing model to have a successful and beneficial impact in China's Mainland,it remains an under-researched topic.Further research on education and training as well as premium policies for nurses under the TCM are needed.
基金This research project was supported by the China Medical Board of New York,Inc.Faculty of Nursing,Mahidol University.
文摘Objectives:This study was conducted to examine the differences between perceptions and practices of family-centered care among Thai pediatric nurses.Methods:This mixed-methods study consisted of two phases,in the first phase,a descriptive comparative design using the Family-Centered Care Questionnaire-Revised(FCCQ-R)was administered to 142 pediatric nurses from a university hospital in Bangkok,Thailand.in the second phase,qualitative interviews were conducted with 16 pediatric nurses to gather complementary information regarding the major findings from the first phase.Results:The results revealed that family strengths and individuality were rated the highest as the most important elements and the most frequent practices.Parent/professional collaboration was perceived as the least important element,while the design of the heath care delivery system was rated as the least frequent practice.The qualitative data revealed that the major reasons for suboptimal implementation included a common perception that family-centered care is a Western concept,nurses'weak attitudes towards their roles,and a shortage of nurses.Conclusions:Nurses agreed that the identified elements of family-centered care were necessary but that they did not incorporate the concepts into their daily nursing practice to maintain their endorsement of the family-centered care model.Further study is needed to explore how family-centered care is understood and operationalized by Thai nurses and how hospital administration and environments can be modified to support this care model.
文摘Background： The world is facing increasing pressure with the continuous growth of the older population. Older patients are usually discharged with complex medical problems, high stress and vulnerability, and these factors place the elderly at risk for poor outcomes. Purpose： The present review summarizes a method for providing appropriate and affordable health services by nursing professionals to meet older patient＇s health care needs during their transitional period which is defined as a period from discharge after hospitalization for a major disorder to recovery in a home setting. Summary： Older patients with chronic diseases need seamless health care during a transitional period-a highly stressful and vulnerable period for them. Nurse professionals can conduct decent discharge planning to assist older patients with transitional problems through continuous healthcare. This review summarized the need of continuing care for older patients during the transitional period, the definition of discharge planning, the conceptual framework of discharge planning, and the professionals involved in discharge planning. It also highlighted the problems of discharge planning and follow-up intervention implementation in the mainland of China. Clinical implications： Inadequate discharge planning and follow-up were leading factors associ- ated with the readmission of discharged older patients. Further nursing-led discharge planning should be reinforced in China.
基金This study was supported by Natural Science Foundation of Guangdong Province,China(Project No.07001681).
文摘Objectives:To observe the effects of transitional care on the quality of life of chronic obstructive pulmonary disease(COPD)patients.Methods:A total of 114 COPD patients were recruited from the First Affiliated Hospital,Sun Yat-sen University,Guangzhou,China and divided equally into an intervention group and control group.Following discharge,patients from the intervention group recieved threemonths intervention in addition to regular nursing care,while control group patients received regular nursing care only.Patients’quality of life was measured using the St.George’s respiratory questionnaire(SGRQ),the 12-item General Health Questionnaire(GHQ-12)and body mass index(BMI).Results:The symptoms section score,the activity section score,the impacts section score,the total score and the rate of mental disorders were significantly changed after the intervention while there was no statistical difference in BMI between groups.Conclusions:Transitional care can improve health-related quality of life in COPD patients who have recently suffered an exacerbation.
基金supported by Jiangsu Provincial Commission of Health and Family Planning(No.H2015032)Yancheng Commission of Health and Family Planning(No.YK2017010)
文摘Objective: To explore the effects of “hospital–community integrated transitional care” model on quality of life in patients with chronic obstructive pulmonary disease (COPD). Methods: A total of 117 inpatients with COPD from the Department of Respiratory Medicine in a tertiary general hospital in Nanjing were enrolled by convenience sampling from January to December in 2016 and then were divided into intervention group (n = 60) and control group (n = 57) by random number table. Patients in the intervention group accepted both routine care and hospital– community integrated transitional care for 3 months after discharge. Assessment of quality of life by telephone follow-up or interview within a week before discharge and 1, 3, and 6 months after discharge was evaluated using the Short Form-36 (SF-36) health survey questionnaire. Results: For a total score of quality of life, there was a significant difference between the two groups (P < 0.05): 1, 3, and 6 months after discharge. In addition, for each dimension score of quality of life, there were no significant differences (P > 0.05) except vitality dimension, 1 month after discharge, and there were significant differences in all dimensions, 3 and 6 months after discharge (P < 0.05) Conclusions: Hospital–community integrated transitional care model can improve the quality of life of patients with COPD.
基金Funding from Jiangsu Provincial Commission of Health and Family Planning Foundation(H2015032)
文摘Objective：To objectively assess the effect of transitional care on readmission for patients with chronic obstructive pulmonary disease.Methods：The PubMed,Science Direct,Web of Science,Cochrane Library,CNKI,and Wanfang databases were searched for relevant randomized controlled trials（RCTs） published from January 1990 through April 2016.The quality of eligible studies was assessed by two investigators.The primary outcome assessed was readmission for COPD and all-cause readmission.The pooled effect sizes were expressed as the relative risk and standard mean difference with 95%confidence intervals.Heterogeneity among studies was assessed using the Cochrane Handbook for Systematic Reviews of Interventions（Version5.1.0） and determined with an I^2 statistic.Results：A total of seven RCTs that included 1879 participants who met the inclusion criteria were analyzed.The results of subgroup analysis showed significant differences in readmission for COPD at the6 month and 18 month time points and all-cause readmission at the 18 month follow-up.Transitional care could reduce readmission for COPD at the 6 month[RR = 0.51,95%CI（0.38,0.68）,P 〈 0.00001]and18 month time points[RR = 0.56,95%CI（0.45,0.69）,P 〈 0.00001,and also reduce all-cause readmission after 18 months[RR = 0.72,95%CI（0.62,0.84）,P 〈 0.0001].The reduction of all-cause readmission between the intervention and control groups in the 2nd year,however,was less than that in the 1st year.Conclusions：Transitional care is beneficial to reducing readmission for patients with COPD.Duration of≥ 6 and ≤ 18 months are more effective,and the effect weakens over intervention time,especially after the end of intervention.Both durations point to the importance of ongoing intervention and reinforcement after the end of intervention.
文摘Adolescence and the journey to adulthood involves exciting opportunities as well as psychosocial stress for young people growing up.These normal experiences are potentially magnified for teenagers living with chronic illness or disability and their families.Advances in care have improved survival for children with a variety of serious chronic medical conditions such that many who may once have died in childhood now survive well into adulthood with ongoing morbidity.For those with highly complex needs,care is often provided at major paediatric hospitals with expertise,specially trained personnel,and resources to support young people and their families for the first decades of life.At the end of adolescence,however,it is generally appropriate and necessary for young adults and their caregivers to transition to the care of clinicians trained in the care of adults at general hospitals.While there are some well-managed models to support this journey of transition,these are often specific to certain conditions and usually do not involve intensive care.Many patients may encounter considerable challenges during this period.Difficulties may include the loss of established therapeutic relationships,a perception of austerity and reduced amenity in facilities oriented to caring for adult patients,and care by clinicians with less experience with more common paediatric conditions.In addition,there is a risk of potential conflict between clinicians and families regarding goals of care in the event of a critical illness when it occurs in a young adult with major disability and long-term health issues.These challenges present genuine opportunities to better understand the transition from paediatric to adult-based care and to improve processes that assist clinicians who support patients and families as they shift between healthcare settings.
文摘Objective： We sought to determine any benefits of applying a transitional care model in the continuum of cancer pain management, especially after patients＇ discharge from the hospital. Methods： A total of 156 eligible participants were recruited and randomly assigned into intervention or control groups. The control group received standard care, while the intervention group received extra, specialized transitional care of pain management. Outcomes were measured at weeks 0 and 2-4 and included demographic data, the Brief Pain Inventory, Global Quality of Life Scale, and Satisfaction Degree of Nursing Service. Adequacy of analgesia and severity of pain were assessed with the Pain Management Index and interview findings. Results： After 2-4 weeks of intervention, there was a significant difference in the change in average pain score between intervention and control groups （P 〈 0.05）. Reductions in pain scores were significantly greater in the intervention group than in the control group （difference： 0.98, P 〈 0.05）. Regarding pain management outcomes, there was a significantly better condition in the intervention group compared with the control group; in the intervention group, 79% of patients had adequate opioids, whereas in the control group, only 63% of patients reported having adequate opioids. Furthermore, there was a signif- icant difference between the two groups in quality of life （QOL） scores （P 〈 0.05）; the intervention group had significantly higher quality of life than the control group （difference： 1.06）. Finally, there was a significant difference in the degree of satisfaction with the home nursing service; the intervention group had a significantly higher degree of satisfaction with the home nursing service in three aspects： quality, content, and attitude of service. Conclusions： The application of a transitional care model in cancer pain management after discharge could help patients to improve their cancer pain management knowledge and analgesics compliance. In addition, the continuum of care service will contribute to effective communication between health care providers and patients, which could further improve their relationship.
文摘BACKGROUND Intervention to improve outcomes in cirrhotic patients (CP) after hospital discharge often focus on 30 d readmission rate (RR). However, recent studies suggest dissociation between RR and survival. At our center, CP are now offered outpatient telephonic transitional care (OTTC) by a care coordinator for 30 d after hospital discharge. AIM To determine the effect of OTTC on survival in CP. METHODS In this cohort study from a tertiary center, CP who received OTTC formed the intervention group. They were compared with a control group discharged during the same period. Mortality and RR were compared between the groups. RESULTS After OTTC introduction, 194 CP were discharged. After applying exclusion criteria, 169 CP (51% male, mean age 58 years ± 12 years) were included. OTTC group comprised 76 patients and was compared with 93 controls. Baseline disease and index admission related characteristics were not significantly different between the groups. The intervention group showed significantly higher 6 mo survival compared to controls (84.2% vs 68.8%;P = 0.03), while RR at 1, 3, and 6 mo were comparable. On multivariable analysis, the intervention group showed lower odds for mortality compared to the controls (hazard ratio: 0.4;95% confidence interval: 0.2-0.82;P = 0.012), while higher model for endstage liver disease scores were associated with higher mortality (hazard ratio: 1.05;95% confidence interval: 1.01-1.1;P = 0.024).CONCLUSION CP provided OTTC had higher 6 mo survival compared to controls without a difference in RR. Use of RR to gauge quality of care provided during hospitalization or subsequent transitional care programs should be revisited.
文摘BACKGROUND Transition is a critical period for adolescents as they begin to assume responsibility for their own health.Similarly,the shift from pediatric to adult healthcare represents a vulnerable phase,marked by unique challenges in adolescent health care.Despite its importance,only a few studies have explored healthcare transition among adolescents in Uganda.AIM To identify factors associated with the transition to adult human immunodeficiency virus(HIV)-centered care among adolescents attending HIV/AIDS clinics in Uganda.METHODS A cross-sectional mixed-methods study was conducted among 265 adolescents,randomly selected from three antiretroviral therapy(ART)clinics,using a structured questionnaire.Focus group discussions and key informant interviews were conducted.Individuals aged 10-20 years who were actively enrolled in the ART program between January 4,2022 and January 30,2023 were recruited.The primary outcome of interest was the transition to adult care.Bivariate and multivariate analyses were performed for quantitative data,while content analysis was used to analyze qualitative data.RESULTS The prevalence of transition to adult care was 40.6%.Most participants were male(53.6%)and fell within the 13-15 age group(35.6%).Multivariate logistic regression analysis identified several factors significantly associated with transition to adult care:Age group 10-12 years[prevalence ratio(PR)=2.525,95%CI:2.121-2.944,P=0.002],Age group 13-15 years(PR=1.900,95%CI:1.196-3.416,P=0.001),successful viral load suppression(PR=1.534,95%CI:1.173-1.648,P=0.016),disclosure of HIV status to relatives(PR=5.001,95%CI:3.411-3.611,P=0.000),being prepared for transitioning(PR=5.417,95%CI:3.468-7.135,P=0.041)and having skilled pediatric caregivers(PR=3.724,95%CI:2.084-4.105,P=0.005).CONCLUSION Transition to adult care among adolescents was low.Improving transition outcomes may require strengthening individual support within the family context and integrating transition-focused care into existing specialized clinical settings to enhance the delivery of adolescent-friendly services.
文摘Objective: To systematically review the effect of Transitional Care model (TCM) on the growth and development of premature infants. Methods: Randomized controlled trials (RCTs) or quasi-RTCs regarding the effect of TCM in low birth weight premature infants were retrieved in electronic databases such as the Cochrane Library, PubMed, EMbase, Web of Science, CBM (Chinese Biomedicine Database), CNKI (China National Knowledge Infrastructure), VIP (Chinese Scientific Journals Database) and Wanfang Database. Then, we adopted RevMan 5.3 software to perform a meta-analysis. Results: A total of 11 articles were included, including 1282 preterm infants. The result showed that compared with the routine care model, TCM can effectively increase the weight when premature infants discharged one week [MD=225.57, 95%CI (171.78, 279.37), P<0.001], increase the weight after discharged one month [MD=0.89, 95%CI (0.72, 1.06), P<0.001], increase the weight after discharged three months [MD=670.44, 95%CI (527.65, 813.23), P<0.001], promote the height of newborns [MD=4.54, 95%CI (2.42, 6.65), P<0.001], reduce readmission rate [RR=0.38, 95%CI (0.25, 0.58), P<0.001], alleviate adverse skin reactions [RR=0.33, 95%CI (0.22, 0.50), P<0.001], increase nursing satisfaction of the families [RR=1.21, 95%CI (1.13, 1.31), P<0.001]. Conclusion: TCM can effectively promote the growth and development of the low birth weight premature infants, reduce the hospital readmission rate, alleviate adverse skin reactions of premature infants and improve the nursing satisfaction of the families. However, due to the limitation of the region and quality of the included studies, which the accuracy of the result still be treated with more caution. Further high-quality studies are needed to verify the conclusion.
文摘The purpose of this paper is utilizing quasi-experimental study to evaluate the educational value of a documentary film for transitional care about children dental health management The method used in this study is a pre-post survey among nurse viewers. The study was completed over a 12-month period. In the experimental group, when the nurses watched the documentary film, they evaluated the documentary film highly and reported an intention to change their transitional care practice and mind as a result of watching the documentary film. Following viewing, children and their parents felt more strongly that ＂children with dental problems should meet with a nurse early＂ and that ＂transitional care greatly impacts children oral health＂. As a result, a documentary film about oral transitional care is an effective educational tool to improve nurses＇ transitional care awareness among children about the importance and needs of children. The results suggest that if significant modifications are obtained, this approach can be an efficient way applicable to other contexts of patient care.
文摘Cardiovascular disease remains the leading cause of morbidity and mortality,posing a significant challenge to healthcare systems worldwide.Transitional care interventions,which ensure coordination and continuity of care as patients move between different levels of healthcare,have been shown to reduce unnecessary healthcare utilization and improve patient outcomes.While much attention has been given to transitional care in heart failure,this review aims to map the interventions implemented for patients following an acute myocardial infarction(AMI).A scoping review was conducted following the Joanna Briggs Institute(JBI)methodology,with literature searches performed in the Cochrane,CINAHL,MEDLINE,JBI,and SciELO databases,focusing on publications from 2013 onwards in both Portuguese and English.Seventy-five studies were included,with most combining multiple interventions that contributed to improved cardiovascular health outcomes,including increased adherence to healthy lifestyle behaviors,enhanced medication compliance,and better healthcare self-management.These interventions were effective in reducing cardiovascular-related Emergency Department visits,unplanned 30-day readmissions,and mortality following a first-time myocardial infarction.Key strategies identified included discharge planning,digital health solutions,outpatient care,and healthcare coordination.The findings of this review underscore the need for developing methodologies that enhance the transition of care from hospital to primary care following an AMI.There is an urgent need to design and implement new healthcare programs that integrate discharge interventions,digital health,outpatient care,and healthcare coordination to ensure continuity of care and optimize patient outcomes post-discharge.
基金Supported by Alice Bennett received financial support during her research year from Abb Vie
文摘AIM: To describe the disease and psychosocial outcomes of an inflammatory bowel disease (IBD) transition cohort and their perspectives.METHODS: Patients with IBD, aged > 18 years, who had moved from paediatric to adult care within 10 years were identified through IBD databases at three tertiary hospitals. Participants were surveyed regarding demographic and disease specific data and their perspectives on the transition process. Survey response data were compared to contemporaneously recorded information in paediatric service case notes. Data were compared to a similar age cohort who had never received paediatric IBD care and therefore who had not undergone a transition process.RESULTS: There were 81 returned surveys from 46 transition and 35 non-transition patients. No statistically significant differences were found in disease burden, disease outcomes or adult roles and responsibilities between cohorts. Despite a high prevalence of mood disturbance (35%), there was a very low usage (5%) of psychological services in both cohorts. In the transition cohort, knowledge of their transition plan was reported by only 25/46 patients and the majority (54%) felt they were not strongly prepared. A high rate (78%) of discussion about work/study plans was recorded prior to transition, but a near complete absence of discussion regarding sex (8%), and other adult issues was recorded. Both cohorts agreed that their preferred method of future transition practices (of the options offered) was a shared clinic appointment with all key stakeholders.CONCLUSION: Transition did not appear to adversely affect disease or psychosocial outcomes. Current transition care processes could be optimised, with better psychosocial preparation and agreed transition plans.
基金Supported by grants from the National Institute for Health Research(NIHR)Imperial Patient Safety and Translational Research Centre(PSTRC)and the Peter Sowerby FoundationInfrastructure support for this research was provided by the NHIR Imperial Biomedical Research Centre(BRC)MB acknowledges support from EPSRC [grant number EP/N014529/1] supporting the EPSRC Centre for Mathematics of Precision Healthcare
文摘BACKGROUND Inflammatory bowel disease(IBD) is a chronic, inflammatory disorder characterised by both intestinal and extra-intestinal pathology. Patients may receive both emergency and elective care from several providers, often in different hospital settings. Poorly managed transitions of care between providers can lead to inefficiencies in care and patient safety issues. To ensure that the sharing of patient information between providers is appropriate, timely, accurate and secure, effective data-sharing infrastructure needs to be developed. To optimise inter-hospital data-sharing for IBD patients, we need to better understand patterns of hospital encounters in this group.AIM To determine the type and location of hospital services accessed by IBD patients in England.METHODSThis was a retrospective observational study using Hospital Episode Statistics, a large administrative patient data set from the National Health Service in England.Adult patients with a diagnosis of IBD following admission to hospital were followed over a 2-year period to determine the proportion of care accessed at the same hospital providing their outpatient IBD care, defined as their ‘home provider'. Secondary outcome measures included the geographic distribution of patient-sharing, regional and age-related differences in accessing services, and type and frequency of outpatient encounters.RESULTS95055 patients accessed hospital services on 1760156 occasions over a 2-year follow-up period. The proportion of these encounters with their identified IBD‘home provider' was 73.3%, 87.8% and 83.1% for accident and emergency,inpatient and outpatient encounters respectively. Patients living in metropolitan centres and younger patients were less likely to attend their ‘home provider' for hospital services. The most commonly attended specialty services were gastroenterology, general surgery and ophthalmology.CONCLUSION Transitions of care between secondary care settings are common for patients with IBD. Effective systems of data-sharing and care integration are essential to providing safe and effective care for patients. Geographic and age-related patterns of care transitions identified in this study may be used to guide interventions aimed at improving continuity of care.
文摘Inflammatory bowel disease(IBD)is a heterogeneous group of chronic diseases with a rising prevalence in the pediatric population,and up to 25%of IBD patients are diagnosed before 18 years of age.Adolescents with IBD tend to have more severe and extensive disease and eventually require graduation from pediatric care toadult services.The transition of patients from pediatric to adult gastroenterologists requires careful preparation and coordination,with involvement of all key players to ensure proper collaboration of care and avoid interruption in care.This can be challenging and associated with gaps in delivery of care.The pediatric and adult health paradigms have inherent differences between health care models,as well as health care priorities in IBD.The readiness of the young adult also influences this transition of care,with often times other overlaps in life events,such as school,financial independence and moving away from home.These patients are therefore at higher risk for poorer clinical disease outcomes.The aim of this paper is to review concepts pertinent to transition of care of young adults with IBD to adult care,and provides resources appropriate for an IBD pediatric to adult transition of care model.
文摘The aim of this study was to gain increased knowledge about nurses’ experiences of care transition of older patients from hospital to municipal health care, based on two research questions: How is nurses’ experience continuity during care transition of older patients from hospital to municipal health care? How would nurses describe an optimal care transition? Nurses have a pivotal role during care transitions of older patients. More knowledge about their experiences is necessary to develop favorable improvements for this important period in the older patient’s treatment and care. The study has a qualitative explorative design with follow-up focus group interviews. Nurses (N = 30) working in hospital (n = 16) and municipal (n = 14) health care were organized in five mixed focus groups during the period October-January 2014/2015. The focus groups met twice, answering the research questions following a previously circulated semi-structured interview guide. The interview analysis was inspired by content analysis. The analysis resulted in the themes “Administrative demands challenge terms for collaboration” and “Essentials for nursing determine optimal care transitions for older patients”. Administrative demands may prevent nurses’ professional dialogue and collaboration across health care levels. Older patients’ best interests should be ensured through a collaborative relationship between hospital and municipal nurses, to form continuous care across health care levels. Clinical practice should be aware of essentials for nursing, which could influence and facilitate a more individualized and continuous transition for older patients.
