PDF(Pubmed)
Abstract：
BACKGROUND: Discharging older adult patients from the hospital poses risks due to their vulnerable conditions, complex instructions and limited health literacy. Insufficient information about medication side effects adds to patient concerns. To address this, a post-discharge information summary system was developed. While it has shown positive impacts, concerns exist regarding implementation fidelity.
OBJECTIVE: This study employed a theory-driven approach to understand health providers\' perspectives on effective implementation.
METHODS: Individual semi-structured interviews were conducted via telephone with nurses, doctors and pharmacists from local public hospitals. All interviews were audio-recorded and transcribed verbatim. Theoretical Domains Framework (TDF) was applied for direct content analysis. Belief statements were generated by thematic synthesis under each of the TDF domains.
RESULTS: A total of 98 participants were interviewed. Out of the 49 belief statements covering eight TDF domains, 19 were determined to be highly relevant to the implementation of the post-discharge information summary system. These TDF domains include knowledge, skills, social/professional role and identity, beliefs about consequences, intentions, memory, attention and decision processes, environmental context and resources and social influences.
CONCLUSIONS: Our study contributes to the understanding of determinants in implementing discharge interventions for older adult patients\' self-care. Our findings can inform tailored strategies for frontline staff, including aligning programme rationale with stakeholders, promoting staff engagement through co-creation, reinforcing positive programme outcomes and creating default settings. Future research should employ rigorous quantitative designs to examine the actual impact and relationships among these determinants.
OBJECTIVE: This study employed a theory-driven approach to understand health providers\' perspectives on effective implementation.
METHODS: Individual semi-structured interviews were conducted via telephone with nurses, doctors and pharmacists from local public hospitals. All interviews were audio-recorded and transcribed verbatim. Theoretical Domains Framework (TDF) was applied for direct content analysis. Belief statements were generated by thematic synthesis under each of the TDF domains.
RESULTS: A total of 98 participants were interviewed. Out of the 49 belief statements covering eight TDF domains, 19 were determined to be highly relevant to the implementation of the post-discharge information summary system. These TDF domains include knowledge, skills, social/professional role and identity, beliefs about consequences, intentions, memory, attention and decision processes, environmental context and resources and social influences.
CONCLUSIONS: Our study contributes to the understanding of determinants in implementing discharge interventions for older adult patients\' self-care. Our findings can inform tailored strategies for frontline staff, including aligning programme rationale with stakeholders, promoting staff engagement through co-creation, reinforcing positive programme outcomes and creating default settings. Future research should employ rigorous quantitative designs to examine the actual impact and relationships among these determinants.
摘要：
背景：由于老年患者的脆弱状况，将其从医院出院会带来风险，复杂的指导和有限的健康素养。关于药物副作用的信息不足增加了患者的担忧。为了解决这个问题，开发了出院后信息汇总系统。虽然它显示出积极的影响，存在对实施保真度的担忧。
目的：本研究采用了理论驱动的方法来了解卫生提供者对有效实施的看法。
方法：通过电话与护士进行个人半结构化访谈，来自当地公立医院的医生和药剂师。所有访谈都是录音和逐字转录的。理论域框架(TDF)应用于直接内容分析。信念陈述是通过在每个TDF域下的主题合成产生的。
结果：共有98名参与者接受了访谈。在涵盖八个TDF领域的49个信念声明中，19人被确定与出院后信息汇总系统的实施高度相关。这些TDF领域包括知识，技能,社会/职业角色和身份，关于后果的信念，意图,记忆,注意力和决策过程，环境背景、资源和社会影响。
结论：我们的研究有助于理解对老年患者实施出院干预措施的决定因素。我们的发现可以为前线员工提供量身定制的策略，包括使计划理由与利益相关者保持一致，通过共同创造促进员工参与，加强积极的计划成果并创建默认设置。未来的研究应采用严格的定量设计来检查这些决定因素之间的实际影响和关系。
目的：本研究采用了理论驱动的方法来了解卫生提供者对有效实施的看法。
方法：通过电话与护士进行个人半结构化访谈，来自当地公立医院的医生和药剂师。所有访谈都是录音和逐字转录的。理论域框架(TDF)应用于直接内容分析。信念陈述是通过在每个TDF域下的主题合成产生的。
结果：共有98名参与者接受了访谈。在涵盖八个TDF领域的49个信念声明中，19人被确定与出院后信息汇总系统的实施高度相关。这些TDF领域包括知识，技能,社会/职业角色和身份，关于后果的信念，意图,记忆,注意力和决策过程，环境背景、资源和社会影响。
结论：我们的研究有助于理解对老年患者实施出院干预措施的决定因素。我们的发现可以为前线员工提供量身定制的策略，包括使计划理由与利益相关者保持一致，通过共同创造促进员工参与，加强积极的计划成果并创建默认设置。未来的研究应采用严格的定量设计来检查这些决定因素之间的实际影响和关系。
