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.ImpactFindings 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 ContributionNo patient or public contribution.

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对虚弱老年人对导致导致住院危机发作的促成因素的看法：一项定性研究


目的为了探索虚弱的老年人对导致健康危机的因素的看法，描述相似之处并在按时间顺序汇总的患者旅程图中描述这些相似之处。设计一项探索性-描述性定性研究。方法通过目的抽样招募了 2021 年前 6 个月在荷兰一家大都会学术医院急诊科就诊的虚弱老年患者。进行半结构化访谈并按主题进行分析。患者旅程地图用于识别、组合和描述感知中的时间相似性。结果15 次访谈包含五个主题：医疗保健的连续性、对虚弱的自我认知、自我管理、城市环境中支持系统的影响以及急诊科就诊前的急性事件。患者旅程图确定了医疗保健提供者的不协调护理、急诊科就诊前至少 6 个月的恶化以及急诊科就诊前 4 周的时间划分，以及导致急性健康问题的意外事件。结论虽然患者知道导致急性住院的健康事件，但他们不太意识到在前几个月导致级联事件的影响。旅程地图表明，可以应用策略来告知老年人，更加以患者为导向，并为提前护理、健康老龄化和避免入院提供预期计划。ImpactFindings 显示，导致健康危机的因素没有得到相应的解释，从而产生了一连串的问题，当一个人已经很虚弱时，很难应对。 通过生成知识、标准化日常生活的频繁评估以及利用患者旅程地图在早期阶段进行干预，可以降低甚至避免潜在危机和住院的风险。报告方法COREQ（重新报告定性研究的合并标准）。患者或公众捐款没有患者或公众捐款。