Replacing hospital nurse consultations with home-based nurse consultations for severe spasticity patients on intrathecal baclofen: a qualitative study.

AbstractAimMethodResultsConclusion\nIMPLICATIONS FOR REHABILITATIONThis qualitative study explored the experiences of patients, caregivers and healthcare professionals after replacing hospital consultations with a home service solution for patients treated for severe spasticity with intrathecal baclofen.Semi-structured interviews were conducted with six patients, six caregivers and six healthcare professionals. The data were analysed using interpretative phenomenological analysis.Four themes were identified: 1) Caregivers’ new role and contribution to treatment, 2) Hospital consultations in home settings changed the balance of power, 3) A compassionate relationship, and 4) Contextual care for patients.The home-based consultations improved caregivers’ understanding of the treatment and helped them to become active spokespersons for the patient by contributing important information about the patient’s perspectives and the effects of the treatment. The balance of power shifted towards a more equitable dynamic between patients and nurses during home consultations, facilitated by greater involvement of the patient perspective. The nurses’ working conditions changed, but patients and caregivers appreciated the shift in treatment setting.Collaboration between nurses and caregivers is important to maintain optimal treatment as caregivers are often spokespersons for the patient and can explain patients’ preferences for treatmentHome-based treatment clarifies more of the patient’s everyday life, which can then be better incorporated into the nurses’ decisions and perspectivesHome-based treatment changes the balance of power between patients, caregivers, and nursesWhen hospital nurse consultations is replaced with consultations at home, there are both practical and organisational implications for nurses’ working conditionsCollaboration between nurses and caregivers is important to maintain optimal treatment as caregivers are often spokespersons for the patient and can explain patients’ preferences for treatmentHome-based treatment clarifies more of the patient’s everyday life, which can then be better incorporated into the nurses’ decisions and perspectivesHome-based treatment changes the balance of power between patients, caregivers, and nursesWhen hospital nurse consultations is replaced with consultations at home, there are both practical and organisational implications for nurses’ working conditions [ABSTRACT FROM AUTHOR]