Patients’ experiences of being treated for acute illness at home as an alternative to hospital admission: a qualitative study in Denmark

Abstract

ObjectiveWe aimed to investigate the experiences of Danish patients treated at home for an acute illness instead of being hospitalised.DesignThis study had a qualitative design inspired by the methodology of interpretive description. Data were collected through semistructured interviews.SettingHome treatment was conducted by a team of nurses (n=10–15) supported by physiotherapists and physicians, all affiliated with an emergency department, located in the capital region of Denmark. Interviews were conducted between August 2020 and April 2021.ParticipantsTwenty-one patients, aged 34–94 years, narrated their experiences of being treated at home for an acute illness.ResultsThe overarching theme in our analyses was that ‘being the centre of the nurses’ attention provided safety, patient involvement and quality of life during home treatment’. The following six themes emerged from analyses: (1) exclusive attention facilitates involvement and activity; (2) hospitals are for the sick; (3) maintaining a meaningful everyday life; (4) the hospital exudes productivity and busyness; (5) family relations and roles are maintained; (6) and concerns of deterioration.ConclusionsFrom a patient’s perspective, home treatment made sense and was perceived as a quality improvement. Being the centre of nurses’ attention induced a sense of safety, involvement and enhanced quality of life among patients during the treatment course for an acute illness.

Patients' and caregivers' perceptions of the quality of hospital‐at‐home service: A scoping review

“…The quality of HaH service was studied from the perspective of patients and caregivers in 18 studies and shown to provide hospital‐level treatment at home and met patients' needs (Bove et al, 2022; Dismore et al, 2019; Facultad & Lee, 2019; Lai et al, 2021; Leff et al, 2008; Udesen et al, 2021; Utens et al, 2014; Vaartio‐Rajalin et al, 2021; Wang et al, 2012). Applying the objective outcomes, such as 30‐day all‐cause hospital readmissions (Federman et al, 2018), length of hospital stay (Samaranayake et al, 2020), patients and caregivers reported that they perceived better health outcomes (Dismore et al, 2019; Federman et al, 2018; Herranz et al, 2022; Ko et al, 2022; Levine, Pian, et al, 2021; Samaranayake et al, 2020; Wang et al, 2012).…”

“…Patients' and caregivers' experienced interactions with HaH services have been found to exert a significant influence on their preferences when selecting such services. Within the realm of HaH service utilisation, eight studies consistently highlight the paramount importance of feeling secure and receiving safe care at home as a fundamental consideration (Bove et al, 2022; Chua et al, 2022b; Facultad & Lee, 2019; Leff et al, 2006; Makela et al, 2020; Samaranayake et al, 2020; Udesen et al, 2021; Wang et al, 2012). Addressing the location of care, the convenience and comfort afforded by HaH services were frequently highlighted as advantages (Lemelin et al, 2007).…”

“…Table 3 presents the perceived concerns and barriers to HaH services reported by patients and caregivers in the included studies. These concerns were primarily drawn from studies that investigate the reasons behind patients' hesitation in selecting HaH services (Bove et al, 2022; Dismore et al, 2019; Rossinot et al, 2019; Saenger et al, 2020), as well as from contexts like rural areas and Singapore where the service was newly introduced and developed (Chua et al, 2022b; Ko et al, 2022; Lai et al, 2021; Levine, Desai, et al, 2021). Patients expressed apprehension about the adequacy of HaH services in meeting their care needs (Makela et al, 2020; Saenger et al, 2020; Utens et al, 2013) and the availability of skilled professionals (Levine, Desai, et al, 2021; Maniaci et al, 2022).…”

“…Applying the objective outcomes, such as 30‐day all‐cause hospital readmissions (Federman et al, 2018), length of hospital stay (Samaranayake et al, 2020), patients and caregivers reported that they perceived better health outcomes (Dismore et al, 2019; Federman et al, 2018; Herranz et al, 2022; Ko et al, 2022; Levine, Pian, et al, 2021; Samaranayake et al, 2020; Wang et al, 2012). In terms of their opinions, patients favoured the maintenance of normal lives and an improvement of quality of life with the HaH service (Bove et al, 2022; Chua et al, 2022b; Udesen et al, 2021). Based on overall care assessment and health value evaluation, patients and caregivers expressed high levels of satisfaction with the integrated care of HaH services (Facultad & Lee, 2019; Leff et al, 2006; Lemelin et al, 2007; Samaranayake et al, 2020; Schofield et al, 2006; Utens et al, 2013, 2014).…”

“…Patients expressed apprehension about the adequacy of HaH services in meeting their care needs (Makela et al, 2020; Saenger et al, 2020; Utens et al, 2013) and the availability of skilled professionals (Levine, Desai, et al, 2021; Maniaci et al, 2022). Specifically, patients were worried about the instantaneous connectivity, including the accessibility of direct clinical supervision and immediate care in case of a deterioration in their health, which made them feel less secure than in‐hospital care (Bove et al, 2022; Dismore et al, 2019; Ko et al, 2022; Levine, Desai, et al, 2021; Saenger et al, 2020; Utens et al, 2013).…”