Source:

Solan
LG
,
Beck
AF
,
Brunswick
SA
, et al
.
The family perspective on hospital to home transitions: a qualitative study
.
Pediatrics
.
2015
;
136
(
6
):
e1539
e1549
; doi:
https://doi.org/10.1542/peds.2015-2098

Researchers from multiple institutions conducted a qualitative study to assess the experience of parents whose children had gone through a transition from hospital to home. Parents or caregivers of children hospitalized at Cincinnati Children’s Hospital Medical Center (CCHMC) with common, acute conditions were recruited if they had been cared for on the hospitalist, neurology, or neurosurgical service and could attend a focus group at CCHMC within 30 days of discharge. Focus groups of enrolled participants were held to characterize the experience of parents around the transition from hospital to home for their children and to identify barriers to successful transitions. During focus group sessions, the research team used an open-ended, semi-structured question guide that they had developed. Each session lasted about 90 minutes and was audiotaped and transcribed verbatim. The audiotapes and transcripts were reviewed by the research team using a standardized process to develop a set of themes and concepts describing parental experience. Results were continuously analyzed and recruitment was suspended once thematic saturation was achieved.

A total of 15 sessions were held with 61 participants. Four of these sessions yielded only 1 participant and were then conducted as personal interviews. Participants were 87% female, 46% nonwhite, and 38% were the sole adult in the household. Initial review of focus group sessions yielded 12 major themes with associated subthemes. As these were further analyzed, the team found that themes fit into 4 primary concepts: (1) “In a fog”/barriers to integrating information, (2) “What I wish I had”/suggested information or improvements, (3) “Am I ready to go home?”/discharge readiness, and (4) “I’m home, now what?”/confidence in postdischarge care. These concepts often overlapped and influenced one another.

The “In a fog” concept was focused on factors influencing a family’s ability to process and use information. Factors included mental exhaustion, handling uncertainty, information overload, and usability of information. “What I wish I had” identified themes for improvement including information desired and suggested improvements in the discharge process. “Am I ready to go home?” included concerns about both emotional and clinical discharge readiness. Finally, “I’m home, now what?” included 4 main themes: (1) knowing whom to call, (2) bridging the gap (desiring a call or nurse home visit), (3) caring for a sick child, and (4) confidence in caring for a sick child.

The authors conclude that examination of the perspectives of caregivers of children who have experienced the transition from hospital to home can be used to inform interventions to support families and facilitate an easier reentry to home.

Dr Moore has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.

Multiple factors influence the transition home after discharge from the hospital. This topic has received more...

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