ISSN 2097-6054（网络） ISSN 1672-9234（印刷） CN 11-5289/R
主管：中国科学技术协会　主办：中华护理学会
出版：中华护理杂志社
收录：中国科学引文数据库（CSCD）来源期刊
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中华护理教育

中华护理教育 >

2023 , Vol. 20 >Issue 11: 1403 - 1408

DOI: https://doi.org/10.3761/j.issn.1672-9234.2023.11.020

综述

脑卒中患者从医院到家庭过渡期护理研究进展

  • 杨红燕 ,
  • 杨婷 ,
  • 魏慧 ,
  • 张亚萍
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  • 310009 杭州市 浙江大学医学院附属第二医院护理部
杨红燕，女，本科，副主任护师，E-mail：2198025@zju.edu.cn

收稿日期: 2023-01-04

  网络出版日期: 2023-11-17

基金资助

浙江省教育厅一般研究项目（自然科学类）(Y202249689)

收起

A review of transitional care of stroke patients during hospital-to-home

  • Hongyan YANG ,
  • Ting YANG ,
  • Hui WEI ,
  • Yaping ZHANG
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Received date: 2023-01-04

  Online published: 2023-11-17

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摘要

从医院到家庭的过渡是脑卒中患者连续护理过程中的一个脆弱时期，在此期间，患者容易受到与过渡相关的风险影响，导致再入院率增加、患者满意度和安全性降低及生活质量下降等。良好的过渡期护理可以降低患者的再入院率及全因死亡率。该文对脑卒中患者过渡期护理的概念起源与发展、过渡期护理模型、过渡期护理干预、影响因素进行综述，以期为我国脑卒中患者从医院到家庭过渡期护理的进一步发展提供参考。

关键词： 脑卒中; 综述; 医院到家庭; 过渡期护理

本文引用格式

杨红燕 , 杨婷 , 魏慧 , 张亚萍 . 脑卒中患者从医院到家庭过渡期护理研究进展[J]. 中华护理教育, 2023 , 20(11) : 1403 -1408 . DOI: 10.3761/j.issn.1672-9234.2023.11.020

Abstract

The transition from hospital to family is a fragile period in the continuous nursing process of stroke patients. During this period，patients are vulnerable to transition related risks，resulting in increased readmission rate，decreased patient satisfaction and safety，and poorer quality of life. Good transitional care can reduce the readmission rate and all-cause mortality of patients. This paper reviews the concept origin and development，model，scheme and influencing factors of transitional care，with a view to provide reference for the transitional care further development of stroke survivors from hospital to home in China.

Key words： Stroke; Review; Hospital-to-home; Transitional care

参考文献

[1] World Stroke Organisation(2019). Facts and figures about stroke[EB/OL].[2023-01-04]. https://www.world-stroke.org/component/content/article/16-forpatients/84-facts-and-figures-about-stroke.
[2] Liu LP, Liu JY, Wang YL, et al. Substantial improvement of stroke care in China[J]. Stroke, 2018, 49(12):3085-3091.
[3] Wang WZ, Jiang B, Sun HX, et al. Prevalence,incidence,and mortality of stroke in China:results from a nationwide popula-tion-based survey of 480 687 adults[J]. Circulation, 2017, 135(8):759-771.
[4] Markle-Reid M, Valaitis R, Bartholomew A, et al. An integrated hospital-to-home transitional care intervention for older adults with stroke and multimorbidity:a feasibility study[J]. J Comorb, 2020, 10:2235042X19900451.
[5] Pindus DM, Mullis R, Lim L, et al. Stroke survivors’ and infor-mal caregivers’ experiences of primary care and community healthcare services:a systematic review and meta-ethnography[J]. PLoS One, 2018, 13(2):e0192533.
[6] Cameron JI, Naglie G, Silver FL, et al. Stroke family caregivers’ support needs change across the care continuum:a qualitative study using the timing it right framework[J]. Disabil Rehabil, 2013, 35(4):315-324.
[7] Ridwan ES, Hadi H, Wu YL, et al. Effects of transitional care on hospital readmission and mortality rate in subjects with COPD:a systematic review and meta-analysis[J]. Respir Care, 2019, 64(9):1146-1156.
[8] Blum RW, Garell D, Hodgman CH, et al. Transition from child-centered to adult health-care systems for adolescents with chronic conditions[J]. J Adolesc Health, 1993, 14(7):570-576.
[9] Brooten D, Brown LP, Munro BH, et al. Early discharge and specialist transitional care[J]. Image J Nurs Sch,1988, 20(2):64-68.
[10] Naylor MD, Brooten D, Campbell R, et al. Comprehensive dis-charge planning and home follow-up of hospitalized elders:a randomized clinical trial[J]. JAMA, 1999, 281(7):613-620.
[11] Coleman EA, Boult C, American Geriatrics Society Health Care Systems Committee. Improving the quality of transitional care for persons with complex care needs[J]. J Am Geriatr Soc, 2003, 51(4):556-557.
[12] Lutz BJ, Reimold AE, Coleman SW, et al. Implementation of a transitional care model for stroke:perspectives from frontline clinicians,administrators,and COMPASS-TC implementation staff[J]. Gerontologist, 2020, 60(6):1071-1084.
[13] Kalanithi L, Tai WM, Conley J, et al. Better health,less spen-ding:delivery innovation for ischemic cerebrovascular disease[J]. Stroke, 2014, 45(10):3105-3111.
[14] Naylor MD, Bowles KH, McCauley KM, et al. High-value tran-sitional care:translation of research into practice[J]. J Eval Clin Pract, 2013, 19(5):727-733.
[15] Laws L, Ritter L, Loescher L, et al. Stroke-specific refinements to naylor’s transitional care model to address the storm of uncertainty and unmet survivor and caregiver needs[J]. J Neurosci Nurs, 2022, 54(1):23-29.
[16] Condon C, Lycan S, Duncan P, et al. Reducing readmissions after stroke with a structured nurse practitioner/registered nurse transitional stroke program[J]. Stroke, 2016, 47(6):1599-1604.
[17] McClain JV, Chance EA. The advanced practice nurse will see you now:impact of a transitional care clinic on hospital readmissions in stroke survivors[J]. J Nurs Care Qual, 2020, 35(2):147-152.
[18] Duncan PW, Bushnell CD, Jones SB, et al. Randomized prag-matic trial of stroke transitional care:the COMPASS study[J]. Circ Cardiovasc Qual Outcomes, 2020, 13(6):e006285.
[19] Bushnell CD, Duncan PW, Lycan SL, et al. A person-centered approach to poststroke care:the COMprehensive post-acute stroke services model[J]. J Am Geriatr Soc, 2018, 66(5):1025-1030.
[20] Naylor MD, Shaid EC, Carpenter D, et al. Components of com-prehensive and effective transitional care[J]. J Am Geriatr Soc, 2017, 65(6):1119-1125.
[21] Reeves MJ, Fritz MC, Woodward AT, et al. Michigan stroke transitions trial[J]. Circ Cardiovasc Qual Outcomes, 2019, 12(7):e005493.
[22] 肖燕, 武筱旋, 姚韦伟,等. 湖北省医务社会工作试点及成效分析[J]. 中国医院管理, 2023, 43(1):25-29.
[22] Xiao Y, Wu XX, Yao WW, et al. Medical social work pilot and effect analysis in Hubei Province[J]. Chin Hosp Manag, 2023, 43(1):25-29.
[23] Kam YWF, Wang SL, Ng SSM, et al. Effects of a transitio-nal home-based care program for stroke survivors in Harbin,China:a randomized controlled trial[J]. Age Ageing, 2022, 51(2):afac027.
[24] Finch E, Foster M, Fleming J. Disrupted biographies:making sense of minor stroke after hospital discharge[J]. Disabil Rehabil, 2021, 43(18):2632-2639.
[25] Pringle J, Drummond JS, McLafferty E. Revisioning,reconnec-ting and revisiting:the psychosocial transition of returning home from hospital following a stroke[J]. Disabil Rehabil, 2013, 35(23):1991-1999.
[26] Rittman M, Boylstein C, Hinojosa R, et al. Transition experien-ces of stroke survivors following discharge home[J]. Top Stroke Rehabil, 2007, 14(2):21-31.
[27] Kennedy C, Kidd L. Interventions for post-stroke fatigue:a Cochrane review summary[J]. Int J Nurs Stud, 2018, 85:136-137.
[28] Connolly T, Mahoney E. Stroke survivors’ experiences transi-tioning from hospital to home[J]. J Clin Nurs, 2018, 27(21/22):3979-3987.
[29] Lin SL, Wang CL, Wang QM, et al. The experience of stroke survivors and caregivers during hospital-to-home transitional care:a qualitative longitudinal study[J]. Int J Nurs Stud, 2022, 130:104213.
[30] Chung ML, Bakas T, Plue LD, et al. Effects of self-esteem,optimism,and perceived control on depressive symptoms in stroke survivor-spouse dyads[J]. J Cardiovasc Nurs, 2016, 31(2):E8-E16.
[31] Lutz BJ, Young ME, Cox KJ, et al. The crisis of stroke:ex-periences of patients and their family caregivers[J]. Top Stroke Rehabil, 2011, 18(6):786-797.
[32] Cameron JI, Naglie G, Silver FL, et al. Stroke family caregivers’ support needs change across the care continuum:a qualita-tive study using the timing it right framework[J]. Disabil Rehabil, 2013, 35(4):315-324.
[33] Young ME, Lutz BJ, Creasy KR, et al. A comprehensive asse-ssment of family caregivers of stroke survivors during inpatient rehabilitation[J]. Disabil Rehabil, 2014, 36(22):1892-1902.
[34] Finch E, Foster M, Fleming J. Disrupted biographies:making sense of minor stroke after hospital discharge[J]. Disabil Rehabil, 2021, 43(18):2632-2639.
[35] Hartford W, Lear S, Nimmon L. Stroke survivors’ experiences of team support along their recovery continuum[J]. BMC Health Serv Res, 2019, 19(1):723.
[36] Pereira CM, Greenwood N, Jones F. From recovery to regaining control of life-the perspectives of people with stroke,their carers and health professionals[J]. Disabil Rehabil, 2021, 43(20):2897-2908.
[37] White CL, Brady TL, Saucedo LL, et al. Towards a better un-derstanding of readmissions after stroke:partnering with stroke survivors and caregivers[J]. J Clin Nurs, 2015, 24(7/8):1091-1100.
[38] Lutz BJ, Young ME, Creasy KR, et al. Improving stroke care-giver readiness for transition from inpatient rehabilitation to home[J]. Gerontologist, 2017, 57(5):880-889.
[39] Cobley CS, Fisher RJ, Chouliara N, et al. A qualitative study exploring patients’ and carers’ experiences of early supported discharge services after stroke[J]. Clin Rehabil, 2013, 27(8):750-757.
[40] Bryant-Lukosius D, Carter N, Reid K, et al. The clinical effec-tiveness and cost-effectiveness of clinical nurse specialist-led hospital to home transitional care:a systematic review[J]. J Eval Clin Pract, 2015, 21(5):763-781.
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