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Experiences of Patients and Their Caregivers Admitted to a Hospital-at-Home Program in Singapore: a Descriptive Qualitative Study

BACKGROUND: Hospital at Home (HaH) programs have been shown to improve clinical outcomes, quality of care, and patient satisfaction. However, how Asian patients experience HaH remained underexplored. OBJECTIVE: To explore the perceptions and experiences of patients and caregivers admitted to a hospi...

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Autores principales: Ko, Stephanie Qianwen, Chua, Crystal Min Siu, Koh, Shu Hua, Lim, Yee Wei, Shorey, Shefaly
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9409616/
https://www.ncbi.nlm.nih.gov/pubmed/36008593
http://dx.doi.org/10.1007/s11606-022-07765-1
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author Ko, Stephanie Qianwen
Chua, Crystal Min Siu
Koh, Shu Hua
Lim, Yee Wei
Shorey, Shefaly
author_facet Ko, Stephanie Qianwen
Chua, Crystal Min Siu
Koh, Shu Hua
Lim, Yee Wei
Shorey, Shefaly
author_sort Ko, Stephanie Qianwen
collection PubMed
description BACKGROUND: Hospital at Home (HaH) programs have been shown to improve clinical outcomes, quality of care, and patient satisfaction. However, how Asian patients experience HaH remained underexplored. OBJECTIVE: To explore the perceptions and experiences of patients and caregivers admitted to a hospital-at-home program in Singapore. DESIGN: Descriptive qualitative study design. PARTICIPANTS: Purposive sampling was used to conduct 36 interviews with 13 patients, nine Legally Acceptable Representatives (LARs), and 14 caregivers until data saturation was achieved. INTERVENTIONS: NUHS@Home is a HaH program providing care through a multi-disciplinary team, enabled by remote vital signs monitoring through a tablet and wireless blood pressure and oxygen meters. APPROACH: This study used in-depth semi-structured individual interviews. Interviews were transcribed and thematically analyzed using Braun and Clark’s six-step inductive approach. KEY RESULTS: The overarching theme identified was “Enablers, difficulties, and improvements to the HaH experiences” which was supported by three key themes: (1) Perceived better care at home, (2) Importance of social support, and (3) Organizational structures required to support HaH. Participants described overall HaH experiences around factors contributing to their impeding engagement, overall satisfaction, and quality of care. CONCLUSIONS: Although HaH is unfamiliar to the Singapore population, most of the participants in this study had an overall positive experience. The key challenges found in this paper were the stress and inconvenience caused to caregivers. The enablers for positive HaH experiences were (1) consideration of patient’s family members as key participants in the patients’ therapeutic alliance; (2) the HaH care team must be accessible, approachable, and reassuring, and communicate frequently and timely with patients and their families; and (3) financing strategies to ensure HaH out-of-pockets costs remain affordable which are critical to keeping HaH as an option for patients and families.
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spelling pubmed-94096162022-08-26 Experiences of Patients and Their Caregivers Admitted to a Hospital-at-Home Program in Singapore: a Descriptive Qualitative Study Ko, Stephanie Qianwen Chua, Crystal Min Siu Koh, Shu Hua Lim, Yee Wei Shorey, Shefaly J Gen Intern Med Original Research: Qualitative Research BACKGROUND: Hospital at Home (HaH) programs have been shown to improve clinical outcomes, quality of care, and patient satisfaction. However, how Asian patients experience HaH remained underexplored. OBJECTIVE: To explore the perceptions and experiences of patients and caregivers admitted to a hospital-at-home program in Singapore. DESIGN: Descriptive qualitative study design. PARTICIPANTS: Purposive sampling was used to conduct 36 interviews with 13 patients, nine Legally Acceptable Representatives (LARs), and 14 caregivers until data saturation was achieved. INTERVENTIONS: NUHS@Home is a HaH program providing care through a multi-disciplinary team, enabled by remote vital signs monitoring through a tablet and wireless blood pressure and oxygen meters. APPROACH: This study used in-depth semi-structured individual interviews. Interviews were transcribed and thematically analyzed using Braun and Clark’s six-step inductive approach. KEY RESULTS: The overarching theme identified was “Enablers, difficulties, and improvements to the HaH experiences” which was supported by three key themes: (1) Perceived better care at home, (2) Importance of social support, and (3) Organizational structures required to support HaH. Participants described overall HaH experiences around factors contributing to their impeding engagement, overall satisfaction, and quality of care. CONCLUSIONS: Although HaH is unfamiliar to the Singapore population, most of the participants in this study had an overall positive experience. The key challenges found in this paper were the stress and inconvenience caused to caregivers. The enablers for positive HaH experiences were (1) consideration of patient’s family members as key participants in the patients’ therapeutic alliance; (2) the HaH care team must be accessible, approachable, and reassuring, and communicate frequently and timely with patients and their families; and (3) financing strategies to ensure HaH out-of-pockets costs remain affordable which are critical to keeping HaH as an option for patients and families. Springer International Publishing 2022-08-25 2023-02 /pmc/articles/PMC9409616/ /pubmed/36008593 http://dx.doi.org/10.1007/s11606-022-07765-1 Text en © The Author(s), under exclusive licence to Society of General Internal Medicine 2022, Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
spellingShingle Original Research: Qualitative Research
Ko, Stephanie Qianwen
Chua, Crystal Min Siu
Koh, Shu Hua
Lim, Yee Wei
Shorey, Shefaly
Experiences of Patients and Their Caregivers Admitted to a Hospital-at-Home Program in Singapore: a Descriptive Qualitative Study
title Experiences of Patients and Their Caregivers Admitted to a Hospital-at-Home Program in Singapore: a Descriptive Qualitative Study
title_full Experiences of Patients and Their Caregivers Admitted to a Hospital-at-Home Program in Singapore: a Descriptive Qualitative Study
title_fullStr Experiences of Patients and Their Caregivers Admitted to a Hospital-at-Home Program in Singapore: a Descriptive Qualitative Study
title_full_unstemmed Experiences of Patients and Their Caregivers Admitted to a Hospital-at-Home Program in Singapore: a Descriptive Qualitative Study
title_short Experiences of Patients and Their Caregivers Admitted to a Hospital-at-Home Program in Singapore: a Descriptive Qualitative Study
title_sort experiences of patients and their caregivers admitted to a hospital-at-home program in singapore: a descriptive qualitative study
topic Original Research: Qualitative Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9409616/
https://www.ncbi.nlm.nih.gov/pubmed/36008593
http://dx.doi.org/10.1007/s11606-022-07765-1
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