Loretta Piccenna1,2,3, Natasha A Lannin4,5,6, Russell Gruen7,8, Loyal Pattuwage1, Peter Bragge1,9. 1. a National Trauma Research Institute, The Alfred Hospital and Department of Surgery , Monash University , Melbourne , Australia. 2. b Department of Community and Clinical Allied Health, La Trobe University, Melbourne, Australia. 3. c Summer Foundation , Box Hill, Melbourne , Australia. 4. d Department of Occupational Therapy , La Trobe University , Melbourne , Australia. 5. e Occupational Therapy Department , Alfred Health , Melbourne , Australia. 6. f John Walsh Centre for Rehabilitation Research , Kolling Institute of Medical Research, University of Sydney , Sydney , Australia. 7. g Department of Surgery and Public Health , Monash University , Melbourne , Australia. 8. h Lee Kong Chian School of Medicine , Nanyang Technological University , Singapore. 9. i BehaviourWorks Australia , Monash University , Melbourne , Australia.
Abstract
BACKGROUND: Discharge planning for patients with an acquired brain injury (ABI) is considered best practice for assisting the patient and caregiver to successfully transition from hospital to home and is complex because of the long-term care and support needs of the patient. This review aimed to describe and synthesize the perspectives of patients with ABI and their family/caregivers on the transition from hospital to home to better understand opportunities to optimize the process. METHODS: Electronic medical databases (n = 5) and grey literature published between January-May 2015 were searched to identify qualitative studies on the experience of transition from the hospital to home setting following ABI. Relevant studies were appraised and narratively synthesized. RESULTS: Nine eligible studies that met the inclusion criteria were identified. Two major themes were identified-Engagement and Support. Three underlying sub-themes-poor communication, limited participation and disorganized arrangements for support services-were identified as key contributors to an unsatisfactory experience for patients and their family/caregivers. CONCLUSION: The transition for patients with an ABI and their family/caregivers was characterized as fragmented and unsatisfactory for supporting a successful return home. This review highlights the importance of tailored education and involvement of the patient and their family/caregiver to increase readiness for returning home and reduce unplanned re-admissions.
BACKGROUND: Discharge planning for patients with an acquired brain injury (ABI) is considered best practice for assisting the patient and caregiver to successfully transition from hospital to home and is complex because of the long-term care and support needs of the patient. This review aimed to describe and synthesize the perspectives of patients with ABI and their family/caregivers on the transition from hospital to home to better understand opportunities to optimize the process. METHODS: Electronic medical databases (n = 5) and grey literature published between January-May 2015 were searched to identify qualitative studies on the experience of transition from the hospital to home setting following ABI. Relevant studies were appraised and narratively synthesized. RESULTS: Nine eligible studies that met the inclusion criteria were identified. Two major themes were identified-Engagement and Support. Three underlying sub-themes-poor communication, limited participation and disorganized arrangements for support services-were identified as key contributors to an unsatisfactory experience for patients and their family/caregivers. CONCLUSION: The transition for patients with an ABI and their family/caregivers was characterized as fragmented and unsatisfactory for supporting a successful return home. This review highlights the importance of tailored education and involvement of the patient and their family/caregiver to increase readiness for returning home and reduce unplanned re-admissions.