Comparison of Stress Experienced by Family Members of Patients Treated in Hospital at Home with That of Those Receiving Traditional Acute Hospital Care

• Published in: Journal of the American Geriatrics Society (JAGS) 2008-01, Vol.56 (1), p.117-123
• Main Authors: Leff, Bruce, Burton, Lynda, Mader, Scott L., Naughton, Bruce, Burl, Jeffrey, Koehn, Debbie, Clark, Rebecca, Greenough III, William B., Guido, Susan, Steinwachs, Donald, Burton, John R.
• Format: Article
• Language: English
• Subjects: "Hospital at Home"; acute care for the elderly; Aged; Biological and medical sciences; caregiver; Cellulitis - therapy; Community-Acquired Infections - therapy; Comparative studies; Families & family life; Family - psychology; Family Relations; Female; Follow-Up Studies; General aspects; Health Services for the Aged; Heart Failure - therapy; Home Care Services, Hospital-Based; Home health care; hospital care; Hospitalization; Humans; Intensive Care Units; Male; Medical sciences; Miscellaneous; Older people; Pneumonia, Bacterial - therapy; Prognosis; Prospective Studies; Public health. Hygiene; Public health. Hygiene-occupational medicine; Pulmonary Disease, Chronic Obstructive - therapy; Stress; Stress, Psychological - etiology; Stress, Psychological - psychology; Surveys and Questionnaires; United States
• ISSN: 0002-8614; 1532-5415
• DOI: 10.1111/j.1532-5415.2007.01459.x

OBJECTIVES: To compare differences in the stress experienced by family members of patients cared for in a physician‐led substitutive Hospital at Home (HaH) and those receiving traditional acute hospital care. DESIGN: Survey questionnaire completed as a component of a prospective, nonrandomized clinical trial of a substitutive HaH care model. SETTING: Three Medicare managed care health systems and a Veterans Affairs Medical Center. PARTICIPANTS: Two hundred fourteen community‐dwelling elderly patients who required acute hospital admission for community‐acquired pneumonia, exacerbation of chronic heart failure, exacerbation of chronic obstructive pulmonary disease, or cellulitis. INTERVENTION: Treatment in a substitutive HaH model. MEASUREMENTS: Fifteen‐question survey questionnaire asking family members whether they experienced a potentially stressful situation and, if so, whether stress was associated with the situation while the patient received care. RESULTS: The mean and median number of experiences, of a possible 15, that caused stress for family members of HaH patients was significantly lower than for family members of acute care hospital patients (mean ± standard deviation 1.7 ± 1.8 vs 4.3 ± 3.1, P