Psychosocial Factors Associated with Hospital-to-Home Transitions of Older People: A Review

Background: Hospital-to-home transitions are periods of vulnerability for older people and their caregivers. Furthermore, few studies have looked thoroughly into the psychosocial factors influencing these transitions. Nurses must understand those factors well in order to provide effective care during transitions. Objectives: To explore the psychosocial factors associated with the hospital-to-home transitions of older people, and to describe how they influence those transitions. Methods: We made a literature search of seven electronic databases for qualitative articles published from 2000-2017 and focusing on the psychosocial factors related to the hospital-to-home transitions of older people discharged from acute care hospitals. Data were synthesized using a thematic synthesis. Results: Eight articles met the review’s inclusion/exclusion criteria. Six significant psychosocial factors emerged from the thematic synthesis: Self-management of activities of daily living, informal support, and formal support, participation in discharge planning, living alone, and social participation. The factors emerged mainly after discharge and could either facilitate transitions via positive influences (e.g., patients’ feelings of safety, and independence in activities of daily living) or hinder them via negative influences (e.g., patient anxiety, poor adherence to medication, emotional burden on the caregiver, discontinuity in the activities of daily living and care, and risk of rehospitalization). Conclusion: The influences of psychosocial factors can be associated with patient health and continuity in the activities of daily living and care. Integrating the evaluations of both patients and caregivers to identify needs or problems related to medical and psychosocial factors in transitional care seems essential for facilitating those