Experiences of Older Adults and their Unpaid Caregivers Transitioning from Hospital to Home Through a Facility-Based Transitional Care Program: A Series of Interpretive Phenomenological Studies
Bibliographic record
Abstract
Delayed discharge of hospitalized older adults, who experience barriers to returning home after completion of acute treatment, is a prevailing health system challenge. Evidence suggests remaining in hospital longer than necessary can be detrimental to older adults’ physical and mental health. Given this, it is imperative to transition this population out of the hospital and into an environment designed to better support their needs. While there is a growing body of evidence to support the role of transitional care programs (TCPs) for older adults moving from hospital to home, most of this evidence focuses on interventions delivered in hospital or home settings. There is a paucity of literature exploring the facility-based model of care for older adults transitioning from hospital to home, particularly within the Canadian health system. The overarching aim of this dissertation was to contribute valuable evidence to the body of literature related to TCPs for Canadian older adults. This work encompasses four distinct, but interrelated, studies. The first study aimed to provide conceptual clarity around facility-based TCPs, applying Rodgers’ evolutionary approach to conceptual analysis. The second and third studies adopted Interpretive Phenomenological Analysis (IPA) to explore the meaning of transitioning from hospital to home from the perspective of older adults discharged from a facility-based TCP, as well as their unpaid caregivers. The fourth study used Multiperspectival IPA to identify and examine similarities and differences in the transitional experiences of older adults and unpaid caregivers. The integrated findings from these four studies highlight the need for a deeper understanding of the current operation of facility-based TCPs in Canada, including program characteristics and governance structures. This understanding is crucial for identifying which older adults are most likely to benefit from this model of transitional care and how these programs can be effectively integrated as a core healthcare service for older Canadians.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.014 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.013 | 0.012 |
| Scholarly communication | 0.006 | 0.006 |
| Open science | 0.002 | 0.008 |
| Research integrity | 0.002 | 0.005 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".