“The light at the end of the tunnel”. Discharge experience of older patients with chronic diseases: A multi‐centre qualitative study

Abstract

Aim To explore the experiences of being discharged from hospital of older patients with chronic diseases at time of discharge. Design Multi‐centre descriptive qualitative study. Methods Semi‐structured interviews were conducted with older patients with chronic diseases discharged from two Italian university hospitals, between March 2017 and October 2019. The interviews were audio‐recorded, transcribed verbatim and analysed using inductive content analysis. Several strategies were used to ensure the credibility, dependability, confirmability, authenticity and transferability of the findings. The study was reported in accordance with Standards for Reporting Qualitative Research and Consolidated criteria for reporting qualitative research. Results Sixty‐five patients participated in the study. Six main categories emerged: feelings, need for information, time of fragility, need for support, need for trusting relationships, and home as a caring place. Conclusion Older patients with chronic diseases are patients who require quality discharge planning with a patient‐centred care vision. Healthcare professionals should intervene more extensively and deeply in the discharge process, balancing the patients' perception of their needs against organizational priorities and the wish to return home with that of not being abandoned. Impact Discharge from hospital remains an area of concern as older people have varying degrees of met and unmet needs during and following hospital discharge. Discharge is characterized by conflicting feelings of patients, who need information and support of healthcare professionals through trusting and continuous relationships. Understanding the experience of discharge is essential to support older patients with chronic diseases, considering that discharge from hospital is not an end point of care but a stage of the process involving care transition. The reframing of discharge as another transition point is crucial for healthcare professionals, who will be responsible for making their patients fit for discharge by preparing them to manage their chronic condition at home.

Nurses' experiences of person‐centred care planning using video‐conferencing

“…Our study also shows that older persons have limited opportunities to really influence care design: the scope for action is too small and they experience that they are not given any choices during the video conference itself. Facchinetti et al ( 2021 ) believe that this is because the care staff need to inform, involve and prepare the older persons for the discharge, so that they can handle their condition at home without feeling abandoned. Sinclair et al ( 2020 ) found that functioning coordinated planning of care interventions before discharge has become more important in connection with the outbreak of the Covid‐19 pandemic in 2020.…”

“…They experience insecurity and feel neglected in a situation unknown to them. Our study also shows that older persons have limited opportunities to really influence care design: the scope for action is too small and they experience that they are not given any choices during the video conference itself Facchinetti et al (2021). believe that this is because the care staff need to inform, involve and prepare the older persons for the discharge, so that they can handle their condition at home without feeling abandoned Sinclair et al (2020).…”