Abstract
BackgroundHome mechanical ventilation probably represents the most advanced and complicated type of medical treatment provisioned outside a hospital setting. The aim of this study was both to explore the challenges experienced by health care professionals in community health care services when caring for patients dependent on home mechanical ventilation, continual care and highly advanced technology, and their proposed solutions to these challenges.MethodsUsing qualitative research methods, a grounded theory influenced approach was used to explore the respondents' experiences and proposed solutions. A total of 34 multidisciplinary respondents from five different communities in Norway were recruited for five focus groups.ResultsThe core category in our findings was what health care professionals in community health care services experience as "between a rock and a hard place," when working with hospitals, family members, and patients. We further identified four subcategories, "to be a guest in the patient's home," "to be accepted or not," "who decides," and "how much can we take." The main background for these challenges seems to stem from patients living and receiving care in their private homes, which often leads to conflicts with family members. These challenges can have a negative effect on both the community health caregivers' work environment and the community health service's provision of professional care.ConclusionsThis study has identified that care of individuals with complex needs and dependent on home mechanical ventilation presents a wide range of immense challenges for community health care services. The results of this study point towards a need to define the roles of family caregivers and health care professionals and also to find solutions to improve their collaboration. The need to improve the work environment for caregivers directly involved in home-care also exists. The study also shows the need for more dialogue concerning eligibility requirements, rights, and limitations of patients in the provision and use of ventilatory support in private homes.
Highlights
Home mechanical ventilation (HMV) probably represents the most advanced and complicated type of medical treatment provisioned outside a hospital setting [1,2]
Previous research shows that nurses believe their position of power and authority may be threatened or challenged when family members participate in specialised nursing care for family members dependent on highly advanced technology [8]
We found no variation in the experience of Health care professionals (HCP’s) caring for HMV-dependent children compared with those caring for HMV-dependent adults
Summary
Home mechanical ventilation probably represents the most advanced and complicated type of medical treatment provisioned outside a hospital setting. Home mechanical ventilation (HMV) probably represents the most advanced and complicated type of medical treatment provisioned outside a hospital setting [1,2]. This is especially apparent in the group of patients, consisting of both children and adults, who have tracheostomies and depend on specialised and costly care, monitoring, and ventilation support around the clock or for the majority of the day. In the UK, it has been speculated that community health care development has not kept up with the medical and technical advancements that make it possible to discharge children with complex needs from hospital [12]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
