Conectar
The aim of the study is to explore the experiences of adult relatives who cohabit with patients receiving hospital-at-home (HaH) care. The healthcare system is increasingly adopting HaH as a response to hospital overcrowding and the growing need for personalised, home-based care. While HaH has been shown to benefit patients, there is limited understanding of the impact on cohabiting relatives, who often assume a caregiving role without adequate preparation or support.
A qualitative inductive approach.
Semi-structured interviews were carried out with 10 cohabiting relatives of HaH patients from North Zealand and Denmark. Data collection took place over two periods between March 2023 and February– April 2024. Data were analysed using inductive qualitative content analysis to identify key themes in the relatives' experiences.
Relatives reported mixed feelings about HaH. While they appreciated the ability to be close to their loved ones and maintain a more normal daily routine, some felt overwhelmed by the caregiving responsibilities imposed upon them. The lack of involvement in treatment decisions, sometimes inadequate communication from healthcare professionals, and the pressure to manage both practical and emotional aspects of care were among the concerns. However, despite these challenges, relatives strongly preferred HaH over conventional hospital admissions due to the reduced disruption to their daily lives and the perceived improvement in their loved ones' well-being.
Although HaH presents additional burdens and concerns for relatives, they prefer this model of care over traditional hospitalisations. However, it is crucial that relatives are actively involved in the decision-making process and provided with adequate support to manage the caregiving responsibilities effectively. This involvement can help ensure a more positive experience for both relatives and patients, contributing to the overall success of HaH.
This study emphasises the vital role of relatives in HaH care, highlighting their preference for HaH despite the additional burden. Healthcare professionals must involve relatives in decision-making and provide adequate support to manage caregiving responsibilities. A more individualised approach can enhance the caregiving experience, reduce stress and improve patient outcomes.
This study fills a gap in understanding relatives' experiences in HaH care, stressing the need for better communication and support. By involving relatives more effectively, healthcare professionals can improve the success of HaH and reduce strain on healthcare systems.
This study adhered to the COREQ criteria.
No patient or public contribution.
Delivering nursing care to patients' fundamental needs in neurological settings is challenging due to complex needs such as long-term care, physical disability and cognitive or communicative impairment.
To examine how registered nurses and nurse assistants perceive their capability, opportunity and motivation to deliver fundamental nursing care and use this insight to inform implementation strategies based on the Fundamentals of Care framework.
Cross-sectional survey.
The questionnaire, grounded in the Capability–Opportunity–Motivation (COM-B) model and the Fundamentals of Care framework, was distributed to all nursing staff (n = 404) in four neurological departments at a university hospital in Denmark. Level of agreement was calculated as the proportion of responses in the top two Likert categories (‘to some extent agree’ and ‘completely agree’) and categorised as low (< 60%), medium (60%–85%) or high (> 85%). Quantitative results were analysed descriptively and inferentially; open-text answers were examined using deductive content analysis.
The response rate was 63%. Agreement was high for capability (90.6%), motivation (89.2%) and addressing physical needs (85.2%), while opportunity (75.3%) and relational care (69.1%) were lower. The relational domain scored notably high for taking time to listen (95.8%) and low for evaluating the nurse–patient relationship (43.5%). Nurse assistants showed significantly higher agreement in the physical care domain than registered nurses. Variation across departments highlighted higher agreement in spinal cord injury and neurology compared to anaesthesia, pain, respiratory and traumatic brain injury units.
Nursing staff show strong internal drive and perceived competence—particularly in physical care—but face structural barriers in relational nursing and continuity. Implementation strategies should leverage high motivation, strengthen leadership engagement, ensure resource allocation and systematically integrate relational care into practice.
No patient or public contribution.
Danish Data Protection Agency (P20231246)
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