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Exploring the Support Provided by the Formal and Informal Network Members during “Hospital at Home” Treatment from a Nursing Perspective: An Interview Study

Jack Gillham Orcid Logo, Ivaylo Vassilev Orcid Logo, Becky Band Orcid Logo

Health & Social Care in the Community, Volume: 2024, Issue: 1

Swansea University Author: Becky Band Orcid Logo

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DOI (Published version): 10.1155/2024/6942462

Abstract

Pressure on healthcare systems to address growing population needs is forcing services to adapt, which includes supporting acute patients in the community. One emerging service in the United Kingdom that offers this level of treatment is “Hospital at Home” (HaH). Self-management support is an area o...

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Published in: Health & Social Care in the Community
ISSN: 0966-0410 1365-2524
Published: Wiley 2024
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URI: https://cronfa.swan.ac.uk/Record/cronfa67919
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last_indexed 2024-11-25T14:21:05Z
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Self-management support is an area of particular importance in this context considering that acute treatment is provided in a community setting with limited input and monitoring by healthcare professionals. There is currently limited understanding about the range of formal and informal support and resources needed and accessed by patients in such circumstances, and whether and how HaH professionals engage with the everyday contexts and the network members of patients. Semistructured interviews were conducted with nurses (n&#x2009;=&#x2009;9) from a single Hospital at Home site to further understand their experiences of providing acute treatments in the context of patients&#x2019; homes; and how self-management and social network support roles are perceived. Thematic analysis was used and four themes were identified: The value of prioritising illness work at home within a discourse of person-centered care; the work involved in the &#x201C;naturally&#x201D; therapeutic environment of the home; partners as key members of the informal care team; limited awareness and engagement with (in)formal networks. Findings demonstrate tensions between discourses where nurses idealise the value of the home and a holistic service provision, while in practice prioritising illness (over relational, emotional, and practical) work and delivering a service that is routinised, and time- and cost-efficient. Nurses recognise the positive role of network members for illness management in the context of people&#x2019;s everyday life, but awareness and engagement are limited to partners and the formal services that HaH staffs are familiar with. 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spelling 2024-11-05T13:21:05.6604979 v2 67919 2024-10-07 Exploring the Support Provided by the Formal and Informal Network Members during “Hospital at Home” Treatment from a Nursing Perspective: An Interview Study 06b53a31f254b004de8649a376ce2fbd 0000-0001-5403-1708 Becky Band Becky Band true false 2024-10-07 HSOC Pressure on healthcare systems to address growing population needs is forcing services to adapt, which includes supporting acute patients in the community. One emerging service in the United Kingdom that offers this level of treatment is “Hospital at Home” (HaH). Self-management support is an area of particular importance in this context considering that acute treatment is provided in a community setting with limited input and monitoring by healthcare professionals. There is currently limited understanding about the range of formal and informal support and resources needed and accessed by patients in such circumstances, and whether and how HaH professionals engage with the everyday contexts and the network members of patients. Semistructured interviews were conducted with nurses (n = 9) from a single Hospital at Home site to further understand their experiences of providing acute treatments in the context of patients’ homes; and how self-management and social network support roles are perceived. Thematic analysis was used and four themes were identified: The value of prioritising illness work at home within a discourse of person-centered care; the work involved in the “naturally” therapeutic environment of the home; partners as key members of the informal care team; limited awareness and engagement with (in)formal networks. Findings demonstrate tensions between discourses where nurses idealise the value of the home and a holistic service provision, while in practice prioritising illness (over relational, emotional, and practical) work and delivering a service that is routinised, and time- and cost-efficient. Nurses recognise the positive role of network members for illness management in the context of people’s everyday life, but awareness and engagement are limited to partners and the formal services that HaH staffs are familiar with. Developing a better understanding of the role of social networks (SNs) in supporting people with acute needs at home can help improve patient experiences and care and HaH services, especially for people who are vulnerable, with complex needs, living alone, and with limited access to resources. Journal Article Health &amp; Social Care in the Community 2024 1 Wiley 0966-0410 1365-2524 4 10 2024 2024-10-04 10.1155/2024/6942462 COLLEGE NANME Health and Social Care School COLLEGE CODE HSOC Swansea University Another institution paid the OA fee University of Southampton; Dorset County Hospital 2024-11-05T13:21:05.6604979 2024-10-07T10:18:37.0272208 Faculty of Medicine, Health and Life Sciences The Centre for Innovative Ageing Jack Gillham 0000-0001-8938-7720 1 Ivaylo Vassilev 0000-0002-2206-8247 2 Becky Band 0000-0001-5403-1708 3 67919__32851__83aa2c07a7e94a15bed25e6c1033d0c2.pdf 67919.VoR.pdf 2024-11-05T13:18:11.5538445 Output 416463 application/pdf Version of Record true Copyright © 2024 Jack Gillham et al. This is an open access article distributed under the Creative Commons Attribution License. true eng http://creativecommons.org/licenses/by/4.0/
title Exploring the Support Provided by the Formal and Informal Network Members during “Hospital at Home” Treatment from a Nursing Perspective: An Interview Study
spellingShingle Exploring the Support Provided by the Formal and Informal Network Members during “Hospital at Home” Treatment from a Nursing Perspective: An Interview Study
Becky Band
title_short Exploring the Support Provided by the Formal and Informal Network Members during “Hospital at Home” Treatment from a Nursing Perspective: An Interview Study
title_full Exploring the Support Provided by the Formal and Informal Network Members during “Hospital at Home” Treatment from a Nursing Perspective: An Interview Study
title_fullStr Exploring the Support Provided by the Formal and Informal Network Members during “Hospital at Home” Treatment from a Nursing Perspective: An Interview Study
title_full_unstemmed Exploring the Support Provided by the Formal and Informal Network Members during “Hospital at Home” Treatment from a Nursing Perspective: An Interview Study
title_sort Exploring the Support Provided by the Formal and Informal Network Members during “Hospital at Home” Treatment from a Nursing Perspective: An Interview Study
author_id_str_mv 06b53a31f254b004de8649a376ce2fbd
author_id_fullname_str_mv 06b53a31f254b004de8649a376ce2fbd_***_Becky Band
author Becky Band
author2 Jack Gillham
Ivaylo Vassilev
Becky Band
format Journal article
container_title Health &amp; Social Care in the Community
container_volume 2024
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publishDate 2024
institution Swansea University
issn 0966-0410
1365-2524
doi_str_mv 10.1155/2024/6942462
publisher Wiley
college_str Faculty of Medicine, Health and Life Sciences
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hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
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department_str The Centre for Innovative Ageing{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}The Centre for Innovative Ageing
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description Pressure on healthcare systems to address growing population needs is forcing services to adapt, which includes supporting acute patients in the community. One emerging service in the United Kingdom that offers this level of treatment is “Hospital at Home” (HaH). Self-management support is an area of particular importance in this context considering that acute treatment is provided in a community setting with limited input and monitoring by healthcare professionals. There is currently limited understanding about the range of formal and informal support and resources needed and accessed by patients in such circumstances, and whether and how HaH professionals engage with the everyday contexts and the network members of patients. Semistructured interviews were conducted with nurses (n = 9) from a single Hospital at Home site to further understand their experiences of providing acute treatments in the context of patients’ homes; and how self-management and social network support roles are perceived. Thematic analysis was used and four themes were identified: The value of prioritising illness work at home within a discourse of person-centered care; the work involved in the “naturally” therapeutic environment of the home; partners as key members of the informal care team; limited awareness and engagement with (in)formal networks. Findings demonstrate tensions between discourses where nurses idealise the value of the home and a holistic service provision, while in practice prioritising illness (over relational, emotional, and practical) work and delivering a service that is routinised, and time- and cost-efficient. Nurses recognise the positive role of network members for illness management in the context of people’s everyday life, but awareness and engagement are limited to partners and the formal services that HaH staffs are familiar with. Developing a better understanding of the role of social networks (SNs) in supporting people with acute needs at home can help improve patient experiences and care and HaH services, especially for people who are vulnerable, with complex needs, living alone, and with limited access to resources.
published_date 2024-10-04T14:37:24Z
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