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Patient experience of heart failure care transition from hospital to home : an interpretive description

University of British Columbia

Background: Heart failure is the second most common reason for hospital admission in Canada. Research has shown that failure to plan a safe, smooth transition home results in emergency department visits and hospital readmissions. Despite the existence of national heart failure care transition best practice guidelines, the evidence is largely missing the patient perspective. The purpose of this study was to understand the patient and caregiver’s experience of the transition from hospital to home. Methods: Interpretive description methodology guided this qualitative study. Participants were recruited from two hospitals within the central interior of British Columbia between January and December, 2017. Semi-structured face-to-face interviews were conducted with patients (n=8) and their caregivers (n=3) at their homes, or by telephone, within two weeks of discharge. Findings: Inductive thematic analysis was used to identify four themes related to the hospital stay experience: focusing on the person, not the task; feeling included or excluded from decisions; some information is better than none; and variation in discharge readiness compared to the health care team’s discharge plan. Once at home, two themes emerged: still recovering at home and self-care. Implications: This study highlights the importance of assessing the patient and family’s ideal level of participation in decision-making and discharge readiness in relation to the health care team throughout the hospital stay. Patients prefer heart failure information to be tailored to their needs, and offered early in the hospital stay. Educators should apply a person-centered lens when practicing skills with students. Guidelines and care design should be completed with patients as partners to ensure their perspectives are incorporated. Lastly, researchers should partner with patients and decision-makers to conduct studies with larger samples of heart failure patient and caregiver groups, in multiple centers across Canada to further validate these findings, focusing on priorities set by patients and caregivers.

Text

2019-07-26

Attribution-NonCommercial-NoDerivatives 4.0 International

http://hdl.handle.net/2429/66616

Nursing

University of British Columbia

UBCO

http://creativecommons.org/licenses/by-nc-nd/4.0/