Qualitative Insights Into Patients' and Family Members’ Experiences of In-Hospital Medication Management After a Critical Care Episode

Richard S. Bourne PhD , Mark Jeffries PhD , Eleanor Meakin MSc , Ross Norville , Darren M. Ashcroft PhD
{"title":"Qualitative Insights Into Patients' and Family Members’ Experiences of In-Hospital Medication Management After a Critical Care Episode","authors":"Richard S. Bourne PhD ,&nbsp;Mark Jeffries PhD ,&nbsp;Eleanor Meakin MSc ,&nbsp;Ross Norville ,&nbsp;Darren M. Ashcroft PhD","doi":"10.1016/j.chstcc.2024.100072","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Patient recovery after a critical illness can be protracted, requiring a care continuum that extends along a patient pathway from the critical care unit, hospital ward, and into the community care setting. High-quality care on patient transfer from critical care, including medication safety, is facilitated by education for patients and families, family engagement, support systems, and health care professional (HCP)-patient communication. Currently, uncertainty exists regarding how HCPs can and should engage with critical care patients and family members about their medication.</p></div><div><h3>Research Question</h3><p>What are the views and experiences of critical care patients and family members about their involvement in, communication about, understanding of, and decision-making related to their medication after transfer from critical care to the hospital ward?</p></div><div><h3>Study Design and Methods</h3><p>This qualitative study used semistructured interviews, conducted with critical care patients and family members after transfer from critical care to a hospital ward in a large National Health Service hospital trust. Anonymized transcripts of interviews were analyzed thematically using a coding framework developed from understandings of patient and family engagement in medication administration.</p></div><div><h3>Results</h3><p>Twenty-seven participants (15 patients and 12 family members of patients) completed the interviews. We identified five themes and 15 subthemes, providing an overview of patients’ and family members’ views on medication management during acute illness and ongoing recovery. Themes identified were: impact of acute illness and treatment burden on preexisting illness, preexisting knowledge and capability, beliefs about persons roles and expectations, care continuity and individualized information exchange, and engagement in practice.</p></div><div><h3>Interpretation</h3><p>This study demonstrated that critical care patients and family members want to engage with HCPs about medication administration. HCPs must take an individualized approach to communication and timing, acknowledging the dynamic interplay between patients and family members, using multimodal forms of communication.</p></div>","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"2 2","pages":"Article 100072"},"PeriodicalIF":0.0000,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949788424000261/pdfft?md5=4408a026036715241b54733ad088c86c&pid=1-s2.0-S2949788424000261-main.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"CHEST critical care","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2949788424000261","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

Abstract

Background

Patient recovery after a critical illness can be protracted, requiring a care continuum that extends along a patient pathway from the critical care unit, hospital ward, and into the community care setting. High-quality care on patient transfer from critical care, including medication safety, is facilitated by education for patients and families, family engagement, support systems, and health care professional (HCP)-patient communication. Currently, uncertainty exists regarding how HCPs can and should engage with critical care patients and family members about their medication.

Research Question

What are the views and experiences of critical care patients and family members about their involvement in, communication about, understanding of, and decision-making related to their medication after transfer from critical care to the hospital ward?

Study Design and Methods

This qualitative study used semistructured interviews, conducted with critical care patients and family members after transfer from critical care to a hospital ward in a large National Health Service hospital trust. Anonymized transcripts of interviews were analyzed thematically using a coding framework developed from understandings of patient and family engagement in medication administration.

Results

Twenty-seven participants (15 patients and 12 family members of patients) completed the interviews. We identified five themes and 15 subthemes, providing an overview of patients’ and family members’ views on medication management during acute illness and ongoing recovery. Themes identified were: impact of acute illness and treatment burden on preexisting illness, preexisting knowledge and capability, beliefs about persons roles and expectations, care continuity and individualized information exchange, and engagement in practice.

Interpretation

This study demonstrated that critical care patients and family members want to engage with HCPs about medication administration. HCPs must take an individualized approach to communication and timing, acknowledging the dynamic interplay between patients and family members, using multimodal forms of communication.

病人和家属对重症监护后院内药物管理的定性分析
背景危重病后患者的康复可能会旷日持久,需要从危重病监护室、医院病房到社区护理环境的连续护理。对患者和家属的教育、家庭参与、支持系统以及医护人员(HCP)与患者之间的沟通都有助于在患者从重症监护室转出时提供高质量的护理,包括用药安全。研究设计和方法这项定性研究采用半结构化访谈的方式,在一家大型国民健康服务托管医院对从危重症监护转入病房后的危重症患者和家属进行访谈。采用根据患者和家属参与药物管理的理解而制定的编码框架,对匿名访谈记录进行了主题分析。结果27 名参与者(15 名患者和 12 名患者家属)完成了访谈。我们确定了 5 个主题和 15 个次主题,概述了患者和家属对急性病和持续康复期间药物管理的看法。确定的主题包括:急性病和治疗负担对原有疾病的影响、原有知识和能力、对个人角色和期望的信念、护理的连续性和个性化信息交流以及参与实践。医护人员必须采取个性化的沟通方式和时间安排,承认患者和家属之间的动态互动,并使用多模式的沟通方式。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CHEST critical care
CHEST critical care Critical Care and Intensive Care Medicine, Pulmonary and Respiratory Medicine
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信