Being well? A meta-ethnography of older patients and their relatives’ descriptions of suffering and well-being in the transition from hospital to home

Abstract

Background As the average length of hospital stay decreases, more and more older patients will need support during and after the hospital transition, which will mainly be provided by their relatives. Studies highlight the enormous efect such a transition has on the lives of older patients and their relatives. However, research is lacking regarding in-depth understanding of the complexities and the notions of sufering and well-being the older patients and their relatives describe in the transition from hospital to home. Therefore, this study aims to examine the description of suffering and well-being on a deeper, existential level by drawing on existing phenomenological research. Methods In order to synthesize and reinterpret primary fndings, we used the seven-step method for meta-ethnography. Following specifc inclusion criteria and focusing on empirical phenomenological studies about older patients and their relatives experiences of hospital to home transitions, a systematic literature search was conducted. Data from ten studies have been analyzed. Results Our analysis identifed three intertwined themes: i) ‘Being excluded vs. being included in the transition process’, ii) ‘Being a team: a call for support and a call to support’ and iii) ‘Riding an emotional rollercoaster’. The last theme was unfolded by the two subthemes ‘Taking on the new role as a caregiver: oscillating between struggling and accepting’ and ‘Getting back to normal: oscillating between uncertainty and hope’. Within those themes, older patients and their relatives described rather similar than contradictory aspects. Conclusions This study ofers insights into the tension between existential sufering and well-being described by the older patients and their relatives during the transition from hospital to home. Especially, the description of wellbeing in all its nuances which, if achieved, enables older patients and their relatives to identify with the situation and to move forward, this process can then be supported by the health care professionals. However, there is still lack of knowledge with regards to a deeper understanding of existential well-being in this process. Given the increasing tendency towards early hospital discharges, the fndings underpin the need to further investigate the experiences of well-being in this process.