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The experience of patients and family caregivers during hospital-at-home in France.
BMC Health Serv Res 2019; 19(1):470BH

Abstract

BACKGROUND

Public health policies tend to generalize the use of Hospital-At-Home (HAH) to answer the growing will of patients to be treated or to die at home. HAH is a model of care that provides acute-level services in the patient's home with the interventions of variety of health care professionals. Relatives participate also in the interventions by helping for sick patients at home, but we lack data on the care of patients and caregivers in HAH. The aim of this study was to make an inventory of the experiences of patients and family caregivers in HAH.

METHODS

The research was qualitative using nineteen semi-directed interviews from nine patients and ten caregivers of one care unit of Greater Paris University Hospitals' HAH, and the grounded theory was used to analyze the transcripts. Caregivers were also asked, after the interview, to fill in the Zarit Burden Inventory.

RESULTS

HAH remained mostly unknown for patients and caregivers before the admission proposition and the outlook of being admitted in HAH was perceived as positive, for both of them. Caregivers had a versatile role throughout HAH, leading to situations of suffering, but also had sources of support. The return home was considered satisfactory by both caregivers and patients, related to the quality of care and increased morale despite HAH's organizational constraints. We noted an impact of HAH on the relationship between the patient and the caregiver(s), but caused by multiple factors: the fact that the care takes places at home, its consequences but also the disease itself.

CONCLUSION

HAH strongly involved the patient's caregiver(s) all along the process. HAH's development necessitates to associate both patients and caregivers and to take into account their needs at every step. This study highlights the need to better assess the ability of the caregiver to cope with his or her relative in HAH with acute and subacute care at home.

Authors+Show Affiliations

Publique Hôpitaux de Paris (AP-HP), Hospitalisation à Domicile (HAD), 14 rue Vésale, 75005, Paris, France.Publique Hôpitaux de Paris (AP-HP), Hospitalisation à Domicile (HAD), 14 rue Vésale, 75005, Paris, France.Publique Hôpitaux de Paris (AP-HP), Hospitalisation à Domicile (HAD), 14 rue Vésale, 75005, Paris, France. matthieu.de-stampa@aphp.fr. Unité Mixte de Recherche (UMR) 1168 INSERM, UVSQ, Vieillissement et Maladies Chroniques (VIMA), Villejuif, France. matthieu.de-stampa@aphp.fr.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31288804

Citation

Rossinot, Hélène, et al. "The Experience of Patients and Family Caregivers During Hospital-at-home in France." BMC Health Services Research, vol. 19, no. 1, 2019, p. 470.
Rossinot H, Marquestaut O, de Stampa M. The experience of patients and family caregivers during hospital-at-home in France. BMC Health Serv Res. 2019;19(1):470.
Rossinot, H., Marquestaut, O., & de Stampa, M. (2019). The experience of patients and family caregivers during hospital-at-home in France. BMC Health Services Research, 19(1), p. 470. doi:10.1186/s12913-019-4295-7.
Rossinot H, Marquestaut O, de Stampa M. The Experience of Patients and Family Caregivers During Hospital-at-home in France. BMC Health Serv Res. 2019 Jul 9;19(1):470. PubMed PMID: 31288804.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The experience of patients and family caregivers during hospital-at-home in France. AU - Rossinot,Hélène, AU - Marquestaut,Odile, AU - de Stampa,Matthieu, Y1 - 2019/07/09/ PY - 2017/12/02/received PY - 2019/06/24/accepted PY - 2019/7/11/entrez PY - 2019/7/11/pubmed PY - 2019/7/11/medline KW - Caregivers and patients at home KW - Healthcare organization KW - Hospital at home KW - Quality of life SP - 470 EP - 470 JF - BMC health services research JO - BMC Health Serv Res VL - 19 IS - 1 N2 - BACKGROUND: Public health policies tend to generalize the use of Hospital-At-Home (HAH) to answer the growing will of patients to be treated or to die at home. HAH is a model of care that provides acute-level services in the patient's home with the interventions of variety of health care professionals. Relatives participate also in the interventions by helping for sick patients at home, but we lack data on the care of patients and caregivers in HAH. The aim of this study was to make an inventory of the experiences of patients and family caregivers in HAH. METHODS: The research was qualitative using nineteen semi-directed interviews from nine patients and ten caregivers of one care unit of Greater Paris University Hospitals' HAH, and the grounded theory was used to analyze the transcripts. Caregivers were also asked, after the interview, to fill in the Zarit Burden Inventory. RESULTS: HAH remained mostly unknown for patients and caregivers before the admission proposition and the outlook of being admitted in HAH was perceived as positive, for both of them. Caregivers had a versatile role throughout HAH, leading to situations of suffering, but also had sources of support. The return home was considered satisfactory by both caregivers and patients, related to the quality of care and increased morale despite HAH's organizational constraints. We noted an impact of HAH on the relationship between the patient and the caregiver(s), but caused by multiple factors: the fact that the care takes places at home, its consequences but also the disease itself. CONCLUSION: HAH strongly involved the patient's caregiver(s) all along the process. HAH's development necessitates to associate both patients and caregivers and to take into account their needs at every step. This study highlights the need to better assess the ability of the caregiver to cope with his or her relative in HAH with acute and subacute care at home. SN - 1472-6963 UR - https://www.unboundmedicine.com/medline/citation/31288804/The_experience_of_patients_and_family_caregivers_during_hospital-at-home_in_France L2 - https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-019-4295-7 DB - PRIME DP - Unbound Medicine ER -