"I Feel Worn Out, as if I Neglected Myself": Older Patients' Perspectives on Post-hospital Symptoms After Acute Hospitalization

Rosanne van Seben; Lucienne A Reichardt; Dirk R Essink; Barbara C van Munster; Jos A Bosch; Bianca M Buurman

doi:10.1093/geront/gnx192

"I Feel Worn Out, as if I Neglected Myself": Older Patients' Perspectives on Post-hospital Symptoms After Acute Hospitalization

Gerontologist. 2019 Mar 14;59(2):315-326. doi: 10.1093/geront/gnx192.

Authors

Rosanne van Seben¹, Lucienne A Reichardt¹, Dirk R Essink², Barbara C van Munster^{3

4}, Jos A Bosch⁵, Bianca M Buurman^{1

6}

Affiliations

¹ Department of Internal Medicine, Section of Geriatric Medicine, Academic Medical Center, Amsterdam, the Netherlands.
² Athena Institute, Faculty of Earth and Life Sciences, VU University, Amsterdam, the Netherlands.
³ Department of Geriatrics, Gelre Hospitals, Apeldoorn, the Netherlands.
⁴ Department of Geriatric Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
⁵ Department of Clinical Psychology, University of Amsterdam, the Netherlands.
⁶ ACHIEVE Centre of Expertise, Faculty of Health, Amsterdam University of Applied Sciences, the Netherlands.

PMID: 29304202
DOI: 10.1093/geront/gnx192

Abstract

Background: The transition between hospital and home is a vulnerable period for acutely hospitalized older patients during which they are at increased risk for adverse health outcomes. Yet, studies describing experiences of a geriatric patient population postdischarge from a patient perspective are missing.

Objective: To characterize patient experiences with recovering at home after acute hospitalization.

Design and methods: Qualitative semi-structured interviews, involving 20 recently discharged patients (age ≥ 70), were conducted. A thematic analysis of the content was performed.

Results: Ten categories were identified as recurring topics, which were grouped into 3 major themes. The first theme describes the effect of hospitalization on daily life. Participants described that the problems they encountered were mostly caused by symptoms they experienced since discharge, which were grouped into 2 themes: (a) physical consequences of hospitalization and (b) motivational and psychological problems after hospitalization. Among most frequently presented symptoms were fatigue, apathy, unsteadiness while standing, and fear of falling.

Implications: Impairment in mobility and instrumental activities of daily living was the dominant experience for interviewed patients. This disability was mainly attributed to four main symptoms: fatigue, apathy, unsteadiness while standing, and fear of falling. We propose a tentative model that summarizes the role of posthospital symptoms in the recovery process and the potential syndromes (frailty, posthospital syndrome, palliative symptoms, and sickness behavior) that could underlie these shared symptoms which may act as a conceptual framework for future research. Our study points at the relevance of symptom experiences in functional recovery postdischarge.

Keywords: Activities of daily living; Acute hospitalization; Older patients; Posthospitalization; Symptoms.

MeSH terms

Accidental Falls
Activities of Daily Living*
Aged
Aged, 80 and over
Fatigue*
Fear
Female
Hospitalization
Humans
Male
Mobility Limitation*
Patient Discharge*
Qualitative Research
Recovery of Function*