Users’ views on hospital and home care for acute illness in childhood

Abstract

This mainly qualitative study compared 40 families' experience of hospital and home care. This is one aspect of a randomised, controlled trial, which aimed to evaluate the clinical and cost effectiveness of a paediatric hospital at home service (HAH) for acute illness in children. This paper builds upon previous work that has aimed to examine parents' and children's views as service users. Forty families from a larger sample population took part in structured interviews. Eleven children aged 5 to 12 years took part in semistructured interviews. A drawing technique was the chosen method of augmentation in the children's interviews. Research findings showed that HAH is an acceptable alternative to hospital care where there are essentially nursing needs. Thirty-six (90%) parents and seven children stated a clear preference for HAH. The parents' preference was based on a perception that their child's illness wasn't serious or life threatening and therefore could be managed at home with appropriate support from health professionals. The social and financial costs of hospital care compared with HAH were the other main drivers, rather than a comparison of the quality of nursing care of their child.

The first eighteen months of a paediatric ambulatory and community service

“…Studies of paediatric nurse home-visiting services have found a variable impact on inpatient service utilisation with some studies showing no change in general readmission rates 2 and others showing a reduction for specific diagnosis related groups such as asthma. 12 Importantly, one consistent finding in the literature has been parental preference for such services, 13,14 which is in keeping with our experience. One limitation to our survey is that it may be difficult for families who are from culturally and linguistically different backgrounds, or who are illiterate, to respond.…”

O processo de recuperação da criança após a alta hospitalar: revisão integrativa

“…At home, they continued with their usual tasks and were satisfied actively participating in their child's care, learning how to recognize signals and symptoms that required intervention, document children's progress, monitor temperature, administer medication and inhalation (25) .…”

“…Children themselves affirmed they would rather remain at home than in the hospital, saying that they felt safer, and could play with their own toys. Parents affirmed they had more freedom, and comfort, received individual attention from the nursing team, continued the family's normal life, decreased financial costs, observed that children were better recovering at home, and that the disease was not so serious (25) .…”

“…They affirmed that they would approve some follow up out of the hospital (2,5,19) , preferably by a healthcare professional who knew their child's case (19) . The nursing team commitment to visit and provide orientation concerning home care made parents feel more confident taking their children home and continuing with the recovery process (24)(25) . Individualized attention provided by the nursing team during the follow up after hospital discharge made parents feel constantly informed (25) .…”

Transforming community health services for children and young people who are ill: a quasi-experimental evaluation

“…Evidence shows CCN services provide health care at home for a wide range of needs, 9 including acute (for example, see [16][17][18][19][20] ) long-term and complex (for example, see [21][22][23][24] ) and end of life. 9 They undertake a range of clinical care activities (for example, home chemotherapy regimens) and, depending on skill mix, may be able to offer advanced nurse practice, such as assessing and prescribing.…”