Patients’ experience of Hospitalisation

1. Patients’ experience of Hospitalisation Dr Claire Connolly Dept of Health Promotion National University of Ireland, Galway Prof. Cecily Kelleher Dept. of Public Health & Epidemiology National University of Ireland, Dublin.

2. Methodology • Third Year Medical students in NUI Galway carry out interviews with hospital patients as part of their Behavioural Science Course.[ See Patient Contact Form below]. • 200 interviews[1999,2000,2001] were analysed using standard qualitative techniques.

3. Hospital details Interviews were carried out in University College Hospital, Galway. Ireland. This is a Health Board Hospital in the West ofIreland which serves patients from urban and rural areas.[See Map] Patients were of both sexes and mixed age groups.

4. Themes identified were: • Problems related to “actual experience of being in hospital” e.g Loneliness,lack of privacy,boredom • Concerns & worry about their condition or illness. • Problems related to what patient has left behind in the outside world • Family implications of hospitalisation.

5. Loneliness “away from my wife,we are married 50 years” “Miss my children” “Misses parents at home and friends at school” “There are other patients in her ward but they are no more than strangers.” Distance from hospital has a significant impact on the experience of loneliness Lack of privacy “ Everyone knows your business here” Private room “ complete privacy”,”100% privacy”, “never disturbed” Room with 4-8 patients “ doctors can be seendiscussing patients “ awareness of other patients” “ Nurses in and out, taking B.P” “noise level high” “ visitors at next bed” “ hectic activity”. Actual Experience of Hospitalisation

6. Boredom “ there’s nothing really to do at the hospital” Lack of control, Loss of independence “ everything she does is dictated by someone else” Disruption of daily routine Strange surroundings, or environment. Trouble sleeping “ didn’t sleep,- lonely & afraid. Food “ bland tasting food” Discomfort due to tests or treatment “urinary catheter” “ hate needles” “ Presence of a commode” “IV drip” “ testing can be painful” Relationships with staff Positive: “ “special praise for the doctors and nurses who have been very considerate towards her and have answered her questions fully”. Negative “examined by many, told bynone” Actual Experience of Hospitalisation.

7. Concerns about condition or illness. • Cause/ Diagnosis “doctors not sure what’s wrong, spend days waiting,worrying” • Apprehension re. Surgery. • Future implications of diagnosis. “would she ever be able to live on her own again, she dreads the thought of a nursing home” “she has multiple sclerosis,will she marry,have children,be in a wheelchair?” Knowledge is very important to patients in this category.

8. What the patient has left behind Occupation : Farm “ His main concern was his farm, which is being looked after by neighbours & wife” Teacher “ Worried about students” Self-employed “ had to close business and get a bank loan” Carer “his father is 93,his mother is 96, and he takes care of them” Financial worries “bills to pay, not working” Worrying about families at home “ her main concern is her children” Their house or home “ afraid house may be broken into” Less stress is experienced if Employer is understanding Strong support of family neighbours & friends. The Outside world.

9. Worry & concern for the patient “wife at home alone worrying” Extra responsibilities “husband has hands full with six children and elderly relative” “wife-extra farm work,also works as a nurse, collects children from school and brings them to their activities”. Visiting: Distance “ The main problem is for his wife who has to travel 60miles alone to come and visit him” “Husband lives in Mayo, far away and worried about icy roads” “live locally,they call three times a day” Time. “ She has to take time to visit which is affecting her work schedule” Family members

10. Relief of symptoms. Problems being adressed Receiving care”huge relief being in hospital, he needs the extra care, he doesn’t want to leave.” Safety “if anything goes wrong , doctors there. Place to rest, heal and think. “it has really caused her to look into her own life and realise what is really important” Long waiting time over. In the right Place “ in the right place, with the right people at the right time Many patients expressed relief at being in hospital.

11. Major influences on the experience of hospitalisation • Distance from home • Family, neighbour and community support. • Communication with health professionals • Effective coping strategies. “no point worrying about things he can’t control” “Take each day as it comes”