Trajectory, transition and vulnerability in adult medical-surgical patients: a framework for understanding in-hospital convalescence

Abstract

Relatively recent changes in health care have seen shorter hospital stays and a considerable increase in day-only admissions, anticipated to involve 60% of all patients admitted for surgery and / or investigations within the next couple of years. Surprisingly little is known about the experiences of the approximately 40% of patients who will begin to convalesce in hospital following illness, trauma or surgery. Findings from a qualitative study, briefly reported here, identified a sense of vulnerability in transition as a significant discomfort.

By examining assumptions underlying the care of patients recovering in hospital, the nexus between system-determined care trajectories, transition, and patient vulnerability can be identified and problems suitably addressed.

Key Words:

• trajectory
• transition
• vulnerability
• medical-surgical patients
• convalescence