Table 4 Table of studies, methods and quality appraisal
Study | Methods | Participants | Aims | Main findings | Quality appraisal | |||||
|---|---|---|---|---|---|---|---|---|---|---|
1 | 2 | 3 | 4 | 5 | 6 | |||||
Bauer et al. 2011 [28] Fitzgerald et al. 2011 [29] | Semi-structured interviews | 25 carers | Understand family carers experience of discharge planning, support, and what improvements could be made. | Breakdown in communication: lack of coordination, Hospital staff having poor capability for caring for people with dementia. Inadequate preparation, undervaluing family carer as a resource. | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ |
Bloomer et al. 2016 [30] | Semi-structured interviews / conversation approach | 20 carers | Explore the experience of carers through hospitalisation and rehab with a view to transitioning to residential care. | Families found the process difficult. Decisions about moving into care was challenging, carers would like to be better informed, concerns about the care provided whilst in hospital. | ✓ | ✓ | ✓ | x | ✓ | x |
Digby et al. 2012 [31] | Semi –structured interviews | 8 people living with mild to moderate dementia, transferred in the preceding 5 days | Understand the experience of people living with dementia (plwd) who are settling in after transfer from acute hospital to sub-acute facility. | People felt disorientated. Participants felt patronised by staff and unsettled by the loss of control in the environment. Family support was a great consolation. | ✓ | ✓ | ✓ | x | x | x |
Emmett et al. 2014 [32] | Ethnographic approach using observation, interviews and focus groups. | 35 health and social care prof 29 patient interviews and cases 28 nominated relative | Explore the role of relatives during the discharge planning process and when decisions are made to discharge plwd from hospital either back home or to long-term care. | Roles relatives play; advocates, information gatherers, and care takers which included assisting. Lack of information inadequate preparation. Conflicts of interest between relatives and patients. | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ |
Gilmore-Bykovsky et al. 2017 [33] | Focus groups and semi structured interviews | 40 licensed nurses from SNF’s | To examine SNF nurses’ perspectives regarding experiences and needs of plwd during hospital-to-SNF transitions. | Inadequate preparation of person, being excluded form care decisions. Unprepared receiving environment. Role of timing of transition. Inadequate information about social and health needs and behaviour related symptoms. Staff feeling ill-equipped to provide safe care. Misalignment between hospital pressures and transitional care needs of patient. | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ |
Kable et al. 2015 [34] | Focus groups | 33 Health care professionals (HCPs) of which 21 hospital staff 12 community staff | Explore HCP perspectives on the discharge process and transitional care arrangements for plwd and their families. | Acute staff experienced difficulty caring for people with dementia. Patients were over sedated on return. System pressures to discharge. Inadequate preparation time for work capacity issues. Inadequate communication between health professionals working in different settings. | ✓ | ✓ | ✓ | x | ✓ | x |
Kuluski et al. 2017 [35] | Semi structured interviews | 15 family members across 12 interviews | Understand the hospital experience of carers of patients who require an Alternate Level of Care, (waiting for long-term placement). | Inconsistent quality of care, non-medical needs and characteristics ignored. Families addressing the gaps in the system. Confusing process. | ✓ | ✓ | ✓ | ✓ | ✓ | x |
Renehan et al. 2013 [36] | Interviews, focus groups, file audits, | 11 cases of which 8 had completed records, 7 family members took part in the qualitative evaluation 17 staff from the hospital, facility and destination facility | To evaluate the transitional care cognitive assessment management pilot. Identify barriers and enablers to implementation. | Significant reduction in agitated behaviours once moved to the transitional facility. Adequate communication provision and valued the clinical nurse consultant. Discharge destination facilities reported information timely and thorough. | Intervention | |||||
x | x | x | ✓ | x | ||||||