Clarke, Aileen, 1955-, Sohanpal, R., Wilson, G. and Taylor, Stephanie J. C.. (2010) Patients' perceptions of early supported discharge for chronic obstructive pulmonary disease : a qualitative study. Quality and Safety in Health Care, Vol.19 (No.2). pp. 95-98. ISSN 1475-3898

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Abstract

Objective: To explore patients' views of an early supported discharge service for chronic obstructive pulmonary disease (COPD).

Intervention: Early supported discharge service (EDS) with discharge at 3.5 days (average length of stay for COPD at the time was 9.5 days). After discharge, patients were visited at home daily for 3 days by a nurse from the early discharge service and then, as required, up to 2 weeks.

Participants: Purposive, maximum variation sample of 23 mainly older, retired patients admitted to hospital with an acute exacerbation of COPD in 2005. 14 patients listed as receiving EDS, and 9 listed as refusing EDS.

Design: Qualitative analysis of audiotaped, semistructured, face-to-face interviews.

Setting: Economically deprived inner-city borough in England.

Results: 1) Negotiation and consent. Patients had little recall of being approached to join the scheme. They often felt they had been discharged from hospital before they were ready. They were often unable or unwilling to negotiate timing of discharge with hospital staff. (2) Process of discharge from hospital. Patients experienced difficulties with transport home and supplies of medication. (3) Life at home after a hospital admission. Resuming life at home after an admission for an acute exacerbation for COPD was difficult. Not all patients found the home nursing component of the service helpful.

Conclusions: Early supported discharge with domiciliary care is a model that ought to promote a more equal partnership between patient and healthcare, but this did not appear to be the case in practice.

Item Type:	Journal Article
Subjects:	R Medicine > RA Public aspects of medicine R Medicine > RC Internal medicine
Divisions:	Faculty of Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) > Warwick Evidence Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Hospitals -- Admission and discharge -- Evaluation, Lungs -- Diseases, Obstructive, Home care services -- Evaluation, Qualitative research
Journal or Publication Title:	Quality and Safety in Health Care
Publisher:	BMJ Group
ISSN:	1475-3898
Official Date:	April 2010
Volume:	Vol.19
Number:	No.2
Number of Pages:	4
Page Range:	pp. 95-98
Identification Number:	10.1136/qshc.2007.025668
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
Funder:	DH NHS R&D NCCRCD Programme (SJCT), local NHS through Strategic Health Authority
URI:	http://wrap.warwick.ac.uk/id/eprint/6182

Data sourced from Thomson Reuters' Web of Knowledge

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