RESUMEN
The purpose of this qualitative study was to explore the everyday issues, challenges, struggles, and needs of elderly, community-dwelling women in the first weeks posthospital discharge. Fourteen elderly women were interviewed in their homes 6 to 8 weeksfollowing hospitalization. In addition, using a process based on photo novella or photovoice, 4 of the women took photographs of their everyday lives. The photos were used as triggers during the interviews. The interviews were analyzed to identify the themes of the women's experiences. The overarching theme was that hospital discharge plans "fall short of the mark" because theyfailed to reflect the complexity of the posthospitalization experience by focusing primarily on very basic physical and medically related needs rather than on the reality of the women's recovery. These findings are alarming given the aging population. The implications for hospital discharge planners, home care service providers, and policy decision makers are discussed.
Asunto(s)
Adaptación Psicológica , Anciano/psicología , Actitud Frente a la Salud , Alta del Paciente , Mujeres/psicología , Actividades Cotidianas , Cuidados Posteriores/normas , Anciano de 80 o más Años , Familia/psicología , Femenino , Amigos , Servicios de Atención de Salud a Domicilio/normas , Humanos , Estilo de Vida , Evaluación de Necesidades , Investigación Metodológica en Enfermería/métodos , Ontario , Fotograbar , Investigación Cualitativa , Apoyo Social , Encuestas y CuestionariosRESUMEN
As care needs continue to increase in complexity in inpatient settings, and nurses' scope of practice evolves to keep pace with these changing demands, it is imperative that nurse leaders ensure nursing care delivery models are well aligned to current realities. Older, traditional models of nursing service may no longer foster safe, effective and efficient care or contribute to job satisfaction and high-quality work life for nurses. This paper describes the Autonomous-Collaborative Care Model and its application in a continuing care setting. This innovative and flexible model fosters autonomy and accountability in nursing practice, reduces duplication in the execution of nursing tasks, enhances effective communication and outlines mechanisms for collaboration among various members of the nursing and interprofessional teams. The model has positioned the authors' organization to meet impending shortages of nursing personnel by ensuring that the right category of nurse is assigned to the appropriate patient, by reducing non-nursing work and by supporting nurses' autonomy to practise to their full scope.