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Hospital care following emergency admission : a critical incident case study of the experiences of patients with advanced lung cancer and Chronic Obstructive Pulmonary Disease
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Bailey, Cara, Hewison, Alistair, Karasouli, Eleni, Staniszewska, Sophie and Munday, Daniel (2016) Hospital care following emergency admission : a critical incident case study of the experiences of patients with advanced lung cancer and Chronic Obstructive Pulmonary Disease. Journal of Clinical Nursing, 25 (15-16). pp. 2168-2179. doi:10.1111/jocn.13170 ISSN 0962-1067.
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Official URL: http://dx.doi.org/10.1111/jocn.13170
Abstract
Aims and objectives
To explore the experiences of patients with advanced Chronic Obstructive Pulmonary Disease (COPD) and lung cancer, their carers and healthcare professionals following emergency admission to acute care hospital.
Background
Emergency admissions of people with lung cancer and COPD have increased and there is global concern about the number of patients who die in hospital. The experience of patients with advanced lung cancer and COPD admitted to hospital as an emergency when nearing the end of life has not previously been investigated.
Design
Qualitative critical incident case study.
Methods
Semistructured interviews were conducted with 39 patients (15 with COPD and 24 with lung cancer), 20 informal carers and 50 healthcare professionals, exploring patients’ experiences of emergency hospital admission. Interviews took place after admission and following discharge. Participants nominated relatives and healthcare professionals for interview. Data were analysed thematically.
Results
Patients were satisfied with their ‘emergency’ care but not the care they received once their initial symptoms had been stabilised. The poorer quality care they experienced was characterised by a lack of attention to their fundamental needs, lack of involvement of the family, poor communication about care plans and a lack of continuity between primary and secondary care. A conceptual model of ‘spectacular’ and ‘subtacular’ trajectories of care was used to relate the findings to the wider context of health care provision.
Conclusion
The complex nature of illness for patients with advanced respiratory disease makes emergency hospital admissions likely. Whilst patients (with COPD and lung cancer) were satisfied with care in the acute ‘spectacular’ phase of their admission, more attention needs to be given to the continuing care needs of patients in the ‘subtacular’ phase.
Relevance to Clinical Practice
This is the first study to explore the patient experience of acute care following an emergency admission and identifies where there is potential for care to be improved.
| Item Type: | Journal Article | ||||||||
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| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Journal or Publication Title: | Journal of Clinical Nursing | ||||||||
| Publisher: | Wiley-Blackwell Publishing Ltd. | ||||||||
| ISSN: | 0962-1067 | ||||||||
| Official Date: | August 2016 | ||||||||
| Dates: |
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| Volume: | 25 | ||||||||
| Number: | 15-16 | ||||||||
| Page Range: | pp. 2168-2179 | ||||||||
| DOI: | 10.1111/jocn.13170 | ||||||||
| Status: | Peer Reviewed | ||||||||
| Publication Status: | Published | ||||||||
| Access rights to Published version: | Restricted or Subscription Access |
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