Lived experiences of older adults within an integrated hospital-at-home service: an interpretive phenomenological analysis.

Abstract

Background: The Hospital at Home (HaH) service has developed and evolved over the past few years with the Covid-19 pandemic and improved the integration of care in the community from acute hospital settings. Despite these advancements, there remains a limited understanding of patients' lived experiences with the HaH service. This study aims to explore the experiences and perceptions of older adults who have received HaH services to inform future quality improvement initiatives.

Methods: A qualitative approach utilizing semi-structured interviews was employed to comprehensively understand how patients and family caregivers individually interpreted and made sense of their interactions with the HaH service in the context of an urban setting in the United Kingdom. Purposive sampling was used to select key informants (n = 7) who had previously utilized the HaH service in early 2023. Using an interpretive phenomenological analysis, approaches of interpretive interviews, initial data review, segmentation of data into coherent units, and condensation into cohesive themes were involved. Reporting of findings adhered to the Standards for Reporting Qualitative Research (SRQR) Guidelines.

Results: Four distinct themes, each accompanied by its own set of interpretive practices and subordinate themes, emerged: [1] positive experiences of using HaH service [2], supporting family-centred care within HaH service [3], perceived challenges faced by individuals and caregivers in HaH [4], messages for quality improvement of HaH service.

Conclusions: The study's findings provide insight into the experiences and interpretations of users within an integrated HaH service. The positive aspects of the service, its encouragement of family-centred care, identified challenges, and suggested improvements collectively contribute to advancing the quality enhancement of future HaH endeavours.