Evidence map›Paper›PMID 39670344›Full record

ArticleJournal of advanced nursing2025

Perceptions of Frail Older Adults on Contributing Factors Causing the Onset of Crises Leading to Hospital Admissions: A Qualitative Study.

Gercora Hoitinga, Janet Macneil-Vroomen, Daisy Kolk, Saskia Rijkenberg, Karianne Melkert, Bianca M Buurman

Abstract read
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Article in Journal of advanced nursing, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Gercora HoitingaAmsterdam UMC, University of Amsterdam, Department of Emergency Medicine, Amsterdam, the Netherlands.ORCID https://orcid.org/0000-0003-3972-9491
Janet Macneil-VroomenDepartment of Internal Medicine, Section of Geriatric Medicine, University of Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands.
Daisy KolkDepartment of Internal Medicine, Section of Geriatric Medicine, University of Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands.
Saskia RijkenbergZiekenhuis Amstelland, Section Geriatric Medicine, Amstelveen, the Netherlands.
Karianne MelkertDepartment of Internal Medicine, Section of Geriatric Medicine, University of Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands.
Bianca M BuurmanDepartment of Internal Medicine, Section of Geriatric Medicine, University of Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimTo explore frail older people's perceptions of factors contributing to a health crisis, describe similarities and depict these in a chronological, aggregated patient journey map.

designAn exploratory-descriptive qualitative study.

methodsFrail older patients visiting the emergency department of a metropolitan academic hospital in the Netherlands during the first 6 months of 2021 were recruited by purposive sampling. Semi-structured interviews were conducted and analysed thematically. Patient journey mapping was used to identify, combine and depict chronological similarities in perceptions.

resultsFifteen interviews contained five themes: continuity of healthcare, self-perception on frailty, self-management, impact of support system within an urban environment and acute event before the emergency department visit. The patient journey map identified uncoordinated care by healthcare providers, deterioration from at least 6 months before the emergency department visit and a time demarcation at 4 weeks before the emergency department visit with an unexpected event leading to an acute health problem.

conclusionWhile patients were aware of the health event leading to the acute hospitalisation, they were less aware of the impact of contributing cascading events in the months before. The journey map suggests that strategies can be applied to inform older adults, be more patient-oriented and provide an anticipated plan towards advance care, healthy ageing and admission avoidance. IMPACT: Findings showed contributing factors to a health crisis were not interpreted accordingly, creating a cascade of problems, difficult to counter when someone is already frail. By generating knowledge, standardising frequent assessments of daily life and intervening at an earlier stage by making use of the patient journey map, the risk of a potential crisis and hospitalisation could be reduced or even avoided. REPORTING

methodCOREQ (COnsolidated criteria for REporting Qualitative research). PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Indexed as

Frail ElderlyHospitalizationAgedAged, 80 and overEmergency Service, HospitalFemaleHumansMaleNetherlandsQualitative Researchemergency departmentfrailtygeriatric carehealth crisesnursingpatient journey mapperceptionsqualitative research

Identifiers

PMID39670344
PMCPMC12271647

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.