Rosanne van Seben1, Lucienne A Reichardt1, Dirk R Essink2, Barbara C van Munster3,4, Jos A Bosch5, Bianca M Buurman1,6. 1. Department of Internal Medicine, Section of Geriatric Medicine, Academic Medical Center, Amsterdam, the Netherlands. 2. Athena Institute, Faculty of Earth and Life Sciences, VU University, Amsterdam, the Netherlands. 3. Department of Geriatrics, Gelre Hospitals, Apeldoorn, the Netherlands. 4. Department of Geriatric Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands. 5. Department of Clinical Psychology, University of Amsterdam, the Netherlands. 6. ACHIEVE Centre of Expertise, Faculty of Health, Amsterdam University of Applied Sciences, the Netherlands.
Abstract
BACKGROUND: The transition between hospital and home is a vulnerable period for acutely hospitalized older patients during which they are at increased risk for adverse health outcomes. Yet, studies describing experiences of a geriatric patient population postdischarge from a patient perspective are missing. OBJECTIVE: To characterize patient experiences with recovering at home after acute hospitalization. DESIGN AND METHODS: Qualitative semi-structured interviews, involving 20 recently discharged patients (age ≥ 70), were conducted. A thematic analysis of the content was performed. RESULTS: Ten categories were identified as recurring topics, which were grouped into 3 major themes. The first theme describes the effect of hospitalization on daily life. Participants described that the problems they encountered were mostly caused by symptoms they experienced since discharge, which were grouped into 2 themes: (a) physical consequences of hospitalization and (b) motivational and psychological problems after hospitalization. Among most frequently presented symptoms were fatigue, apathy, unsteadiness while standing, and fear of falling. IMPLICATIONS: Impairment in mobility and instrumental activities of daily living was the dominant experience for interviewed patients. This disability was mainly attributed to four main symptoms: fatigue, apathy, unsteadiness while standing, and fear of falling. We propose a tentative model that summarizes the role of posthospital symptoms in the recovery process and the potential syndromes (frailty, posthospital syndrome, palliative symptoms, and sickness behavior) that could underlie these shared symptoms which may act as a conceptual framework for future research. Our study points at the relevance of symptom experiences in functional recovery postdischarge.
BACKGROUND: The transition between hospital and home is a vulnerable period for acutely hospitalized older patients during which they are at increased risk for adverse health outcomes. Yet, studies describing experiences of a geriatric patient population postdischarge from a patient perspective are missing. OBJECTIVE: To characterize patient experiences with recovering at home after acute hospitalization. DESIGN AND METHODS: Qualitative semi-structured interviews, involving 20 recently discharged patients (age ≥ 70), were conducted. A thematic analysis of the content was performed. RESULTS: Ten categories were identified as recurring topics, which were grouped into 3 major themes. The first theme describes the effect of hospitalization on daily life. Participants described that the problems they encountered were mostly caused by symptoms they experienced since discharge, which were grouped into 2 themes: (a) physical consequences of hospitalization and (b) motivational and psychological problems after hospitalization. Among most frequently presented symptoms were fatigue, apathy, unsteadiness while standing, and fear of falling. IMPLICATIONS: Impairment in mobility and instrumental activities of daily living was the dominant experience for interviewed patients. This disability was mainly attributed to four main symptoms: fatigue, apathy, unsteadiness while standing, and fear of falling. We propose a tentative model that summarizes the role of posthospital symptoms in the recovery process and the potential syndromes (frailty, posthospital syndrome, palliative symptoms, and sickness behavior) that could underlie these shared symptoms which may act as a conceptual framework for future research. Our study points at the relevance of symptom experiences in functional recovery postdischarge.
Authors: Kathryn Anzuoni; Terry S Field; Kathleen M Mazor; Yanhua Zhou; Lawrence D Garber; Alok Kapoor; Jerry H Gurwitz Journal: J Am Geriatr Soc Date: 2020-07-25 Impact factor: 5.562
Authors: Hardeep Singh; Terence Tang; Carolyn Steele Gray; Kristina Kokorelias; Rachel Thombs; Donna Plett; Matthew Heffernan; Carlotta M Jarach; Alana Armas; Susan Law; Heather V Cunningham; Jason Xin Nie; Moriah E Ellen; Kednapa Thavorn; Michelle LA Nelson Journal: JMIR Aging Date: 2022-05-19
Authors: Rosanne van Seben; Kenneth E Covinsky; Lucienne A Reichardt; Jesse J Aarden; Marike van der Schaaf; Martin van der Esch; Raoul H H Engelbert; Jos W R Twisk; Jos A Bosch; Bianca M Buurman Journal: J Gerontol A Biol Sci Med Sci Date: 2020-06-18 Impact factor: 6.053
Authors: Hardeep Singh; Alana Armas; Susan Law; Terence Tang; Carolyn Steele Gray; Heather V Cunningham; Rachel Thombs; Moriah Ellen; Jasvinei Sritharan; Jason X Nie; Donna Plett; Carlotta Micaela Jarach; Kednapa Thavorn; Michelle L A Nelson Journal: BMJ Open Date: 2021-02-25 Impact factor: 2.692
Authors: Ruth E Pel-Littel; Diny E Stekelenburg; Hanna C Willems; Steffy W M Jansen; Jan Festen; Carolien M J van der Linden Journal: Gerontol Geriatr Med Date: 2022-03-27
Authors: Michelle LA Nelson; Alana Armas; Rachel Thombs; Hardeep Singh; Joseph Fulton; Heather V Cunningham; Sarah Munce; Sander Hitzig; Janet Prvu Bettger Journal: BMJ Open Date: 2021-07-05 Impact factor: 2.692