Transitional care to caregivers of dependent older people: an integrative literature review

Ferreira, Bruna Alexandra da Silva; Gomes, Thawanna Jeremias Barbosa; Baixinho, Cristina Rosa Soares Lavareda; Ferreira, Óscar Manuel Ramos

doi:10.1590/0034-7167-2020-0394

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Revista Brasileira de Enfermagem

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Sumário

REVIEW • Rev. Bras. Enferm. 73 (suppl 3) • 2020 • https://doi.org/10.1590/0034-7167-2020-0394 copy

Transitional care to caregivers of dependent older people: an integrative literature review

Atención transicional a cuidadores de ancianos dependientes: revisión integrativa de la literatura

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To identify the needs of caregivers of dependent older people related to self-care in the transition from hospital to home.

Methods:

Integrative literature review that followed a predefined protocol, carried out from March to May 2019 in the platforms EBSCO, B-On, Scopus, Web of Science, and Joanna Briggs Institute. Descriptors and eligibility criteria were defined for the bibliographic sample, which was ten articles. The search was limited to articles published between 2015 and 2019 to guarantee evidence topicality.

Results:

The needs of caregivers related to transitional care can be grouped into five categories: needs in the transition into the role of caregiver; needs related to self-care of caregivers themselves; health needs; economic needs; and social and collective needs.

Final considerations:

The work developed by nurses regarding transitional care of caregivers must have two focuses: managing care provided to dependent older people and managing the needs of caregivers and the care offered to them.

Descriptors:
Transitional Care; Hospitalization; Caregivers; Elderly; Patient Discharge

Inclusion criteria

Exclusion criteria

Caregivers of dependent older people (≥ 65 years);

Studies on the needs of caregivers;

Studies addressing hospitalization, hospital discharge, and hospital-home transition during the first 30 days after returning home;

Quantitative, qualitative, or quali-quantitative studies;

Articles in English or Portuguese;

Articles available in full text and free of charge;

Time limit from 2016 to 2019.

Children, adolescents, and adults;

Formal caregivers;

Caregivers of people with mental disorder or dementia;

Caregiver overload.

Reference	Year Country	Study type Sample	Objective	Outcomes
S1⁽²¹21 Allen J, Hutchinson A, Brown R, Livingston P. User experience and care integration in transitional care for older people from hospital to home: a meta-synthesis. Qual Health Res. 2017;27(1):24-36. doi: 10.1177/1049732316658267 https://doi.org/10.1177/1049732316658267... ⁾	2017 Australia	Metasynthesis 20 studies	To improve the understanding of the experience of older people and caregivers, as well as of care integration in the hospital-home transition.	Information and search for information-related needs, integration of transitional care, and improvement of the transition experience.
S2⁽²²22 Alves A, Santana M, Figueiredo N, Andrade N, Slompo N, Pessalacia J. Depression in caregivers of the elderly: Integrative review. Hos Pal Med Int Jnl. 2018;2(6):295-301. doi: 10.15406/hpmij.2018.02.00111 https://doi.org/10.15406/hpmij.2018.02.0... ⁾	2018 Brazil	ILR 9 articles	To analyze the Brazilian literature on depression in caregivers of older people.	There were social support needs. This can originate a network that can help create mechanisms to reduce the impact of depression and improve the mental well-being of caregivers.
S3⁽²³23 Fernandes C, Angelo M. Family caregivers: what do they need? an integrative review. Rev Esc Enferm USP. 2016;50(4):675-82. doi: 10.1590/s0080-623420160000500019 https://doi.org/10.1590/s0080-6234201600... ⁾	2016 Brazil	ILR 11 articles	To identify the main needs expressed by caregivers regarding care provided to dependent people.	Need for knowledge and learning; need for time to carry out a variety of activities; emotional and interpersonal needs; social needs, support network for caregivers, financial and structural support; and information and communication.
S4⁽²⁴24 Neves P, Sequeira C, Mar L, Sousa L, Ferre-Grau C. Information needs of family caregivers of dependent individuals. IJCNMH. 2017;4(5):1-6. doi: 10.21035/ijcnmh.2017.4.5 https://doi.org/10.21035/ijcnmh.2017.4.5... ⁾	2017 Portugal	ILR 11 articles	To identify information needs of caregivers of dependent people.	Information needs of caregivers could be grouped into three main themes: 1) knowledge and skills of caregivers; 2) potential resources for caregivers; and 3) well-being and coping strategies of caregivers.
S5⁽²⁵25 Pindus D, Mullis R, Lim L, Wellwood I, Rundell A, Aziz N, Mant J. Stroke survivors' and informal caregivers' experiences of primary care and community healthcare services: systematic review and meta-ethnography. PLoS ONE. 2018;13(2):e0192533. doi: 10.1371/journal.pone.0192533 https://doi.org/10.1371/journal.pone.019... ⁾	2018 United Kingdom	Systematic review with meta-ethnography 51 articles	To describe and explain the experiences of cerebrovascular accident survivors and their informal caregivers.	Needs related to care continuity, access to services, and information and education.
S6⁽²2 Alvarez I, Ong M, Abocejo F. Learning needs and quality care among family caregivers and elderly patients of Guadalupe, Cebu City, Central Philippines. Eur Sci J. 2017;13(24):356-76. doi: 10.19044/esj.2017.v13n24p356 https://doi.org/10.19044/esj.2017.v13n24... ⁾	2017 Philippines	Qualitative 65 caregivers	To identify and evaluate the learning and high-quality care needs of family caregivers of older people.	Caregivers had learning needs regarding: medical conditions of older people; medication administration; precautions that must be considered concerning techniques, diet, and nutrition; walking techniques and strategies; financial support; peer support; and family management.
S7⁽²⁶26 Allen J, Hutchinson A, Brown R, Livingston P. User experience and care for older people transitioning from hospital to home: patients' and carers' perspectives. Health Expect. 2018;21(2):518-27. doi: 10.1111/hex.12646 https://doi.org/10.1111/hex.12646... ⁾	2018 Australia	Qualitative 19 dependent people and 7 informal caregivers	To report the experience of caregivers and sick older people.	Support needs; needs related to care provided by health professionals; search for information; discussing and negotiating the transitional care plan; and learning needs related to self-care.
S8⁽¹²12 Ewing G, Austin L, Jones D, Grande G. Who cares for the carers at hospital discharge at the end of life? A qualitative study of current practice in discharge planning and the potential value of using The Carer Support Needs Assessment Tool (CSNAT) Approach. Palliat Med. 2018;32(5):939-49. doi: 10.1177/0269216318756259 https://doi.org/10.1177/0269216318756259... ⁾	2018 United Kingdom	Qualitative 40 health professionals and 22 caregivers	To explore whether and how caregivers are supported when hospital discharge occurs; and to evaluate perceived benefits and the acceptability and applicability of the Carer Support Needs Assessment Tool.	Communication, support, and psychoemotional needs, and needs related to the evaluation of their own requirements and not only of those of the sick people they cared for.
S9⁽⁹9 Aoun S, Stegmann R, Slatyer S, Hill K, Parsons R, Moorin R, Bronson M, Walsh D, Toye C. Hospital postdischarge intervention trialled with family caregivers of older people in Western Australia: potential translation into practice. BMJ Open. 2018;8(11):1-9. doi: 10.1136/bmjopen-2018-022747 https://doi.org/10.1136/bmjopen-2018-022... ⁾	2018 Australia	Randomized study 64 caregivers	To describe a new approach to identify and address the needs of caregivers of older people after hospital discharge.	The three main support needs identified by caregivers were: knowing what to expect in the future, knowing who to contact, and practical support at home.
S10⁽¹¹11 Bierhals C, Santos N, Fengler F, Raubustt K, Forbes D, Paskulin L. Needs of family caregivers in home care for older adults. Rev Latino-Am Enferm. 2017;25:e2870. doi: 10.1590/1518-8345.1511.2870 https://doi.org/10.1590/1518-8345.1511.2... ⁾	2017 Brazil	Quali-quantitative exploratory study 55 caregivers	To identify the perceived and standard needs of main caregivers related to the instrumental support to older people.	The perceived needs were related to information on instrumental support activities (bed bath and shower bath; dressing dependent people; diaper change; and precautions related to medications) and subjective aspects of care. Caregivers showed a higher number of standard needs related to precautions regarding medication administration.

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[1] Corresponding author: Cristina Lavareda Baixinho. E-mail: crbaixinho@esel.pt