Continuity of care from hospital to municipal health care. Experiences of older patients, next of kin and nurses

Abstract

Background: A successful care transition from hospital to municipal health care involves coordination and management of multiple factors tied to the patient’s treatment and care. Due to a fragmented health care system in the western world, several health care levels, with different areas of competence and financial systems, together provide treatment and care to older patients. At the same time, recent research finds that patients aged 80 years or older have different needs during care transition than younger older patients. Next of kin report that they want to help their older relative but receive little support from health care. Norwegian health authorities have a consistent focus on increased continuity across health care levels. Nurses are considered central during care transitions, due to their competence and their position on both hospital and municipal health care levels. Aims: The overall aim of this thesis is to explore and describe how patients aged 80 years or older, their next of kin, and nurses from hospital and municipal health care, experience care transition from hospital to municipal health care. The aims of the three sub-studies were: I. to explore how patients, ≥ 80 years of age, experience the care transition from hospital to municipal health care services; II. to understand how next of kin experience the care transition of an older relative from hospital to municipal health care; III. to gain increased knowledge about nurses´ experiences of care transitions of older patients from hospital to municipal health care. Methods: Inductive exploratory and descriptive design, using semistructured individual interviews, was used to capture the experiences of older patients and their next of kin in study I and II. A total of 14 patients aged 80 years or older, and 13 next of kin, named by the patient, participated in the study. Study III, exploring the experiences of hospital and municipal nurses, used step-wise focus group interviews.