Indu Shrestha, Sudaporn Payakkaraung, Wanida Sanasuttipun
Pain Management Competency and its Associated Factors among Nurses
Journal of Nepal Health Research Council
older cardiac patients high risk readmission mortality transitional care interventions tcis might contribute prevention adverse outcomes cardiac care bridge program randomized nursecoordinated tci combining case management disease management homebased rehabilitation hospitalized frail older cardiac patients qualitative study explored experiences patients participating study part larger process evaluation might support interpretation neutral study outcomes addition understanding experiences could contribute design application future transitional care interventions frail older cardiac patients generic qualitative approach used semistructured interviews performed 16 patients 70 years participated intervention group participants selected gender diagnosis living arrangement hospital inclusion data analysed using thematic analysis addition quantitative data intervention delivery analysed three themes emerged data 1 appreciation care continuity 2 varying experiences recovery 3 influence existing care network participants felt supported transitional care intervention experienced postdischarge support continuity care perceived contribution program participants recovery varied participants reported physical improvements others felt impeded comorbidities frailty home visits community nurse appreciated although participants recognize added value participants existing healthcare provider network preferred consult providers instead providers involved transitional care intervention results contribute explanation neutral study nursecoordinated transitional care intervention future purpose important identify patients might benefit tcis furthermore intensity content tcis could personalized tailoring interventions older cardiac patients needs considering frailty selfmanagement skills existing formal informal caregiver networks